Defining cure for esophageal cancer: Analysis of actual 5-year survivors following esophagectomy

Esophagectomy is the mainstay of curative treatment for localized esophageal cancer. However, what constitutes cure is not well defined. This study was undertaken to characterize actual 5-year survivors following esophagectomy and to determine prognostic factors for disease-specific survival (DSS) from 60 months

Quantifying movement of the tropical Australian cubozoan\ud Chironex fleckeri using acoustic telemetry

Cubomedusae are considered to have superior swimming abilities compared to other pelagic cnidarians, yet many of the theories describing such behaviours are based on anecdotal evidence, sting records or opportunistic sightings, rather than quantitative data. Acoustic telemetry was used to document the movements of adult Chironex fleckeri medusae within both coastal and estuarine habitats. The rate at which tagged medusae moved was influenced by an interaction between time period (day or night) and habitat (coastal or estuarine), with rates of travel being relatively similar during the day and night within the coastal habitat, but significantly greater at night than during the day within the estuarine habitat. Medusae in coastal habitats travelled at similar rates throughout all tidal states while estuarine medusae travelled at significantly faster rates towards the middle of the tide than at the low and high ebbs. Such movements occurred with, and independent of, tidally generated currents, but at increased current speeds, medusae tended to travel with the current. Data are also presented that show that large medusae may move from coastal to estuarine habitats

Laparoscopic Versus Open Loop Ileostomy Reversal: Is there an Advantage to a Minimally Invasive Approach?

Background: Ileostomy reversals are commonly performed procedures after colon and rectal operations. Laparoscopic ileostomy reversal (LIR) with lysis of adhesions has potential benefits over conventional open surgery. The aim of this study was to compare outcomes of laparoscopic and open ileostomy reversal. Methods: 133 consecutive patients undergoing ileostomy reversal at our institution between June 2009 and August 2013 were analyzed using a retrospective database. The group comprised 53 laparoscopic cases and 80 open cases, performed by four surgeons at a single center. The data were analyzed for patient demographics, operative characteristics, postoperative outcomes, and 30-day morbidity and mortality. Results: The two groups had comparable mean age, gender distribution, ASA scores, and BMI. The laparoscopic group had a significantly longer duration of surgery compared to the open reversal group (109 versus 93 min, p < 0.05). However, this group underwent more lysis of adhesions (60.4 % versus 26.3 %, p < 0.01) as well as concurrent stoma site mesh reinforcement (32.1 % versus 6.3 %, p < 0.01). In the laparoscopy group, 20.7 % of patients underwent intra-corporeal ileo-ileal anastomosis. There were no significant differences between the laparoscopic and open groups with regard to estimated blood loss (31 versus 40 ml, respectively) or mean length of stay (5.3 vs. 5.7 days, respectively). The rates of overall 30-day morbidity (16.9 % for laparoscopic vs. 21.3 % for open) as well as rates of specific complications were equivalent between groups. 30-day mortalities were not noted in either group. Conclusion: LIR is safe and effective with low perioperative morbidity and mortality. The use of laparoscopy as an option in terms of concomitant hernia repair and lysis of adhesions may be considered in selected patients