Background. Postoperative lymphocyte to monocyte ratio (post-LMR) change (LMRc) reflects the dynamic change of balance between inflammatory reaction and immune reaction after curative operation. An elevated preoperative LMR (pre-LMR) has been shown to be a prognostic factor in patients with esophageal squamous cell carcinoma (ESCC), but the clinical value of the LMRc remains unknown. Methods. 674 patients in ESCC undergoing curative operation were enrolled in this study. LMRc (LMRc=pre‐LMR–post‐LMR) was counted on the basis of data within one week before and after operation. The median of LMRc was chosen to be the optimal cut-off value to evaluate the prognostic value of LMRc. Results. Kaplan-Meier curves revealed that LMRc≤1.59 was significantly associated with worse overall survival (OS) (P=0.003) and disease-free survival (DFS) (P=0.008). Multivariate analysis suggested that LMRc could serve as an independent prognostic predictor for both OS (P=0.006, HR=0.687, 95% CI 0.526-0.898) and DFS (P=0.003, HR=0.640, 95% CI 0.476-0.859). Conclusions. LMRc is a promising prognostic predictor for predicting the worse clinical outcome in patients with ESCC undergoing curative operation.

Postoperative sore throat (POST) is a complication that occurs with high prevalence following thyroid surgery. Compared with polyvinyl chloride (PVC) trach

Existing prognostic models for small-cell lung cancer (SCLC) are based on previous versions of tumor-node-metastasis (TNM) staging. Therefore, this study w

Esophageal cancer patients often face various challenges in the perioperative period, and unplanned tracheal intubation is a serious complication that can significantly impact patient outcomes. Therefore, this study aimed to identify the risk factors for reintubation in esophageal cancer patients after surgery. A retrospective study was carried out on esophageal cancer patients who underwent surgery at Zhejiang Cancer Hospital in 2019. Data on patient demographics, surgical details, and anesthesia techniques were collected. We employed logistic regression analysis to explore the factors associated with the occurrence of unplanned tracheal intubation. The study encompassed a total of 463 patients. 7.8% (36/463) of the enrolled patients encountered unplanned reintubation during the postoperative phase. Notably, respiratory failure (9/49, 18.4%) and pulmonary infection (8/49, 16.3%) emerged as the primary drivers prompting patients to undergo reintubation in the postoperative period. The results of multivariable logistic analysis indicated that analgesic technique was the independent risk factor for reintubation and compared with general anesthesia (GA) combined with epidural anesthesia, GA combined with nerve block was significantly associated with reintubation. This study analyzed the incidence of unplanned tracheal intubation in esophageal cancer patients after surgery and determined the key independent risk factors.

Patients undergoing ultrasound-guided percutaneous thermal ablation for hepatocellular carcinoma (HCC) generally experience varying degrees of pain, with s

Purpose: Postoperative anxiety is common in surgical patients and may impair recovery, especially in the patients with preoperative anxiety. However, effective strategies for treating postoperative anxiety remain limited. We hypothesized that esketamine could reduce postoperative anxiety in patients with preoperative anxiety undergoing major abdominal tumor surgery. Patients and Methods: 180 patients with preoperative anxiety scheduled for major abdominal surgery were randomly assigned to either esketamine or placebo. The primary outcome was the response rate on postoperative day 3 (POD3), defined as a ≥ 50% reduction from baseline Hamilton Anxiety Rating Scale (HAMA) score. Secondary outcomes included HAMA score on POD3 and POD30, depression and quality of recovery on POD3 and POD30, sleep quality on POD1-3 and POD30. Results: 86 patients in the esketamine group and 87 patients in the placebo group were analyzed. On POD3, the positive response rate was 39.5% in the esketamine group and 42.5% in the placebo group (risk ratio, 0.93; 95% CI, 0.65 to 1.33; P = 0.81). The secondary outcomes showed that HAMA scores were similar between groups at POD3 (median [IQR], 6 [3– 10] vs 7 [4– 11]; adjusted mean difference, 0; 95% CI, − 2 to 1; P = 0.59) and at POD30 (5 [3– 8] vs 7 [4– 11]; adjusted mean difference, − 1; 95% CI, − 3 to 1; P = 0.28). Patients in the esketamine group also demonstrated lower scores for depressive symptoms on POD30 (median [IQR], 5 [2– 8] vs 6 [3– 10]; adjusted mean difference, − 2; 95% CI, − 3 to − 1; P = 0.001). Conclusion: Esketamine did not reduce anxiety in patients with preoperative anxiety undergoing major abdominal tumor surgery on POD3 and POD30.