Application of low anterior mediastinal tracheostomy for locally advanced cervicothoracic esophageal cancer undergoing total laryngopharyngoesophagectomy: a case report
Bibliographic record
Abstract
A sixty-six year-old woman came to hospital, complaining of dysphagia and weight loss.Esophagoscope showed a neoplasm between 15 and 20 cm from the incisors, biopsy revealed esophageal squamous cell carcinoma.Chest computed tomography (CT) showed that the cervical esophageal wall became thicker, the narrowing of the lumen extended downwards to the upper thoracic esophagus.Tumor invaded the membranous parts of the 5th to 12th rings of the trachea, and no swollen lymph nodes were observed in the mediastinum.The clinical stage was cT4N0M0 with borderline resectable possibility.The patient was assessed with stable disease after receiving two courses of neoadjuvant chemotherapy using DTX/CDDP/5-FU strategy.After a standard multidisciplinary treatment evaluation, total laryngopharyngoesophagectomy plus low anterior mediastinal tracheostomy (AMT) was performed.To ensure radical resection, we innovatively adopted the application of Double S-shaped myocutaneous flaps, which helps to extend the trachea and facilitate the stoma.Meanwhile, we removed the upper sternum, sternum stem, clavicle head and first and second costal cartilage to facilitate the tracheostomy and reduce the space around the stoma to avoid fluid accumulation.The pathological result showed pT 4b N 0 M 0 stage with partial response after neoadjuvant chemotherapy.This patient developed a minor anastomotic leakage which was effectively managed.Finally, she was discharged successfully 21 days after surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".