ABSTRACT
Purpose@#In minimally invasive esophagectomy (MIE), it is important to reduce the rate of anastomotic leakage to ensure its safety. At our institute, the double-ligation method (DLM) has been introduced to insert and fix the anvil of the circular stapler for intracorporeal circular esophagojejunostomy in gastric surgery. We adopted this method for intrathoracic anastomosis (IA) in MIE. The aim of this study was to investigate the safety of IA with DLM in MIE. @*Methods@#In this study, 48 patients diagnosed with primary middle or lower third segment thoracic esophageal carcinoma with clinical stage I, II, III or IV disease were retrospectively evaluated. Postoperative outcomes were assessed. @*Results@#Among the 48 patients, 42 patients underwent laparo-thoracoscopic esophagectomy and IA using a circular stapler with the DLM. The average total operation time and thoracoscopic operation time were 433 and 229 minutes, respectively. The average pursestring suturing time was 4.7 minutes. The rates of anastomotic leakage and stenosis were 2.4% and 14.3%, respectively. The overall incidence of postoperative complications (ClavienDindo grade of ≥III) was 16.7%. The average postoperative stay was 16 days. @*Conclusion@#The procedure of IA using a circular stapler with the DLM in MIE was safe and provided a low rate of anastomotic leakage.
ABSTRACT
Gait analysis was conducted on 7 healthy pregnant women (pregnant group) and 6 non-pregnant women (pseudo-pregnant group) using a 3-D motion analysis system (VICON 460) and two forceplates (Kistlar 9286A). The data was collected at 8-9 months of gestation (pregnant condition) and 4-8 months postpartum (non-pregnant condition) in the pregnant group. In the pseudo-pregnant group, the participants walked with a 5kg-load on their belly (pregnant condition) and without any load (non-pregnant condition). Comparisons using two-way ANOVAs with repeated measures were conducted. Interaction of group × condition was not observed in the measured gait parameters except the angle of the maximum hip adduction. Main effect in the condition and the group was found in some parameters. In the pregnant condition, gait velocity was slower (pregnant group 68.7±8.6 m/min pseudo-pregnant group 63.8±4.8 m/min) than in the non-pregnant condition (pregnant group 75.5±3.2 m/min pseudo-pregnant group 69.8±8.7 m/min). The second vertical peak ground reaction force was smaller in the pregnant condition (pregnant group 105.4±4.8 % pseudo-pregnant group 108.4±6.3 % of body-weight) than in the non-pregnant condition (pregnant group 114.3±7.4 % pseudo-pregnant group 113.5±4.2 % of body-weight). These results demonstrated that pregnant condition changed kinetic and kinematic characteristics of the gait.