BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessa...BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessary to retract or obstruct the hepatic left lateral lobe to ensure a clear field of vision.AIM To investigate the safety and clinical efficacy of the modified hepatic left lateral lobe inversion technique for LPG.METHODS A retrospective analysis was conducted on the clinical data of 13 consecutive patients with early-stage upper gastric adenocarcinoma or adenocarcinoma of the esophagogastric junction treated with LPG from January to December 2023 at the Department of Gastrointestinal Surgery,Second Affiliated Hospital of Fujian Medical University.The modified hepatic left lateral lobe inversion technique was used to expose the surgical field in all patients,and short-term outcomes were observed.RESULTS In all 13 patients,the modified hepatic left lateral lobe inversion technique was successful during surgery without the need for re-retraction or alteration of the liver traction method.There were no instances of esophageal hiatus occlusion,eliminating the need for forceps to assist in exposure.There was no occurrence of intraoperative hepatic hemorrhage,hepatic vein injury,or hepatic congestion.No postoperative digestive complications of Clavien-Dindo grade≥II occurred wi-thin 30 days after surgery,except for a single case of pulmonary infection.Some patients experienced increases in alanine aminotransferase and aspartate aminotransferase levels on the first day after surgery,which significantly decreased by the third day and returned to normal by the seventh day after surgery.CONCLUSION The modified hepatic left lateral lobe inversion technique has demonstrated satisfactory results,offering ad-vantages in terms of facilitating surgical procedures,reducing surgical trauma,and protecting the liver.展开更多
Experiments using electrical resistivity tomography(ERT) have shown promising results in reducing the uncertainty of solute plume characteristics related to estimates based on the analysis of local point measurements ...Experiments using electrical resistivity tomography(ERT) have shown promising results in reducing the uncertainty of solute plume characteristics related to estimates based on the analysis of local point measurements only.To explore the similarities and differences between two cross-borehole ERT inversion approaches for characterizing salt tracer plumes,namely the classical smoothness-constrained inversion and a geostatistically based approach,we performed two-dimensional synthetic experiments.Simplifying assumptions about the solute transport model and the electrical forward and inverse model allowed us to study the sensitivity of the ERT inversion approaches towards a variety of basic conditions,including the number of boreholes,measurement schemes,contrast between the plume and background electrical conductivity,use of a priori knowledge,and point conditioning.The results show that geostatistically based and smoothness-constrained inversions of electrical resistance data yield plume characteristics of similar quality,which can be further improved when point measurements are incorporated and advantageous measurement schemes are chosen.As expected,an increased number of boreholes included in the ERT measurement layout can highly improve the quality of inferred plume characteristics,while in this case the benefits of point conditioning and advantageous measurement schemes diminish.Both ERT inversion approaches are similarly sensitive to the noise level of the data and the contrast between the solute plume and background electrical conductivity,and robust with regard to biased input parameters,such as mean concentration,variance,and correlation length of the plume.Although sophisticated inversion schemes have recently become available,in which flow and transport as well as electrical forward models are coupled,these schemes effectively rely on a relatively simple geometrical parameterization of the hydrogeological model.Therefore,we believe that standard uncoupled ERT inverse approaches,like the ones discussed and展开更多
基金Key Clinical Specialty Discipline Construction Program of Fujian,Fujian Health Medicine and Politics,No.[2022]884.
文摘BACKGROUND In laparoscopic proximal gastrectomy(LPG),the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation.Therefore,it is necessary to retract or obstruct the hepatic left lateral lobe to ensure a clear field of vision.AIM To investigate the safety and clinical efficacy of the modified hepatic left lateral lobe inversion technique for LPG.METHODS A retrospective analysis was conducted on the clinical data of 13 consecutive patients with early-stage upper gastric adenocarcinoma or adenocarcinoma of the esophagogastric junction treated with LPG from January to December 2023 at the Department of Gastrointestinal Surgery,Second Affiliated Hospital of Fujian Medical University.The modified hepatic left lateral lobe inversion technique was used to expose the surgical field in all patients,and short-term outcomes were observed.RESULTS In all 13 patients,the modified hepatic left lateral lobe inversion technique was successful during surgery without the need for re-retraction or alteration of the liver traction method.There were no instances of esophageal hiatus occlusion,eliminating the need for forceps to assist in exposure.There was no occurrence of intraoperative hepatic hemorrhage,hepatic vein injury,or hepatic congestion.No postoperative digestive complications of Clavien-Dindo grade≥II occurred wi-thin 30 days after surgery,except for a single case of pulmonary infection.Some patients experienced increases in alanine aminotransferase and aspartate aminotransferase levels on the first day after surgery,which significantly decreased by the third day and returned to normal by the seventh day after surgery.CONCLUSION The modified hepatic left lateral lobe inversion technique has demonstrated satisfactory results,offering ad-vantages in terms of facilitating surgical procedures,reducing surgical trauma,and protecting the liver.
文摘Experiments using electrical resistivity tomography(ERT) have shown promising results in reducing the uncertainty of solute plume characteristics related to estimates based on the analysis of local point measurements only.To explore the similarities and differences between two cross-borehole ERT inversion approaches for characterizing salt tracer plumes,namely the classical smoothness-constrained inversion and a geostatistically based approach,we performed two-dimensional synthetic experiments.Simplifying assumptions about the solute transport model and the electrical forward and inverse model allowed us to study the sensitivity of the ERT inversion approaches towards a variety of basic conditions,including the number of boreholes,measurement schemes,contrast between the plume and background electrical conductivity,use of a priori knowledge,and point conditioning.The results show that geostatistically based and smoothness-constrained inversions of electrical resistance data yield plume characteristics of similar quality,which can be further improved when point measurements are incorporated and advantageous measurement schemes are chosen.As expected,an increased number of boreholes included in the ERT measurement layout can highly improve the quality of inferred plume characteristics,while in this case the benefits of point conditioning and advantageous measurement schemes diminish.Both ERT inversion approaches are similarly sensitive to the noise level of the data and the contrast between the solute plume and background electrical conductivity,and robust with regard to biased input parameters,such as mean concentration,variance,and correlation length of the plume.Although sophisticated inversion schemes have recently become available,in which flow and transport as well as electrical forward models are coupled,these schemes effectively rely on a relatively simple geometrical parameterization of the hydrogeological model.Therefore,we believe that standard uncoupled ERT inverse approaches,like the ones discussed and
