Background: The purpose of this study was to evaluate the impact of statins (HMG-CoA reductase inhibitors) on the prognosis of patients undergoing esophagectomy in a high incidence area. Methods: This study retrospectively analyzed the database of patients underwent esophagectomy in the First Affiliated Hospital of Zhengzhou University. Preoperative application of statins for more than one year as the grouping factor. A propensity score matching (PSM) analyses was conducted to reduce heterogeneity and increase the comparability of the two groups, then compared the survival time of the matched groups through the Kaplan-Meier method. All P values were 2-sided and P<0.05 was statistically significant. Results: 738 of 1,378 esophageal cancer patients with complete medical records (including 27 statins users) were selected in the study. Variables of the two matched groups in the male (sex), age, type II diabetes, cardiovascular comorbidity, differentiation of tumor and staging of tumor were no statistical difference after PSM. After 40 months of follow-up, there is no difference between the two groups regarding overall survival with P values of Breslow test (P=0.816). Conclusions: Statins use do not improve the survival time of patients after esophagectomy in a high incidence area of China.

OBJECTIVES: This study aimed to compare the outcomes of patients with ocular myasthenia gravis (OMG) who underwent thymectomy before generalization with the outcomes of those who underwent thymectomy after generalization. METHODS: We retrospectively reviewed patients who underwent robotic thymectomy for myasthenia gravis between January 2003 and February 2018. Patients who presented with purely ocular symptoms at myasthenia gravis onset were eligible for inclusion. Exclusion criteria were patients who were lost to follow-up and patients who underwent re-thymectomy. Patients with OMG who developed generalization before thymectomy were categorized into gOMG group and those who did not were categorized into OMG group. The primary outcome was complete stable remission according to the Myasthenia Gravis Foundation of America Post-Intervention Status (MGFA-PIS). RESULTS: One hundred and sixty-five (66 males and 99 females) out of 596 patients with myasthenia gravis were eligible for inclusion. Of these, there were 73 and 92 patients undergoing thymectomy before and after the generalization of OMG, respectively. After propensity score matching, a data set of 130 patients (65 per group) was formed and evaluating results showed no statistical differences between the 2 groups. The estimated cumulative probabilities of complete stable remission at 5 years were 49.5% [95% confidence interval (CI) 0.345-0.611] in the OMG group and 33.4% (95% CI 0.176-0.462) in the gOMG group (P=0.0053). Similar results were also found in patients with non-thymomatous subgroup [55 patients per group, OMG vs gOMG, 53.5% (95% CI 0.370-0.656) vs 28.9% (95% CI 0.131-0.419), P=0.0041]. CONCLUSIONS: Thymectomy in OMG before generalization might result in a higher rate of complete stable remission than thymectomy after generalization.

Background: To explore the risk factors and prevention methods of cervical mechanical anastomotic fistula and stenosis after the radical resection of esophageal cancer.Methods: From March 2018 to November 2018, 128 patients undergoing mechanical anastomosis of esophageal cancer were selected from the Department of Thoracic Surgery of The First Affiliated Hospital of Zhengzhou University. All the enrolled patients were operated on using the Mckeown method, and a retrospective study was conducted. Data for preoperative and postoperative test indices, intraoperative embedding materials, postoperative complications, and preoperative and postoperative treatment were collected, and the relationship between various factors and the incidence of cervical anastomotic fistula and stenosis was analysed. Univariate analysis was conducted using t tests or Fisher's exact probability method, and multivariate analysis was conducted using logistic regression models.Results: All 128 patients successfully underwent surgery without dying. The enrolled patients were evaluated using the Stooler classification, with 28 patients having grade 0, 41 patients having grade 1, 34 patients having grade 2, 21 patients having grade 3, and 4 patients having grade 4 stenosis. Patients with stenosis of grade 3 or above had obvious choking sensation, which could only be relieved by balloon dilation. Symptoms in all patients with stenosis were relieved by balloon dilation. There were no significant differences between the two groups regarding embedding materials, preoperative choking history, history of alcohol consumption, history of hypertension, history of coronary heart disease, history of diabetes, postoperative calcium concentration, average albumin concentration, average platelet concentration, body mass index, anastomotic fistula, preoperative chemotherapy, postoperative chemotherapy, or postoperative cough (P>0.05). There were significant differences in postoperative reflux (chi(2)= 11.338, P<0.05) and scar constitution (chi(2)= 12.497, P< .05). The effects of embedding materials in patients with anastomotic fistula were significantly different (chi(2)= 4.372, P<0.05).Conclusions: Postoperative reflux and scar constitution may be risk factors for postoperative anastomotic stenosis after resection of esophageal cancer. There was almost no difference in the effects on esophageal anastomotic stenosis between embedding materials and the omentum majus, but Neoveil (R) may have certain advantages in preventing cervical anastomotic fistula, and thus may have certain clinical application value.