目的研究单吻合器法经肛门取出标本在超低位直肠癌保肛手术的临床疗效。方法回顾性分析2016年1月—2018年1月同济大学附属东方医院胃肠肛肠外科行腹腔镜直肠前切除术的112例超低位直肠癌患者临床资料。其中单吻合器法经肛门取标本手术83...目的研究单吻合器法经肛门取出标本在超低位直肠癌保肛手术的临床疗效。方法回顾性分析2016年1月—2018年1月同济大学附属东方医院胃肠肛肠外科行腹腔镜直肠前切除术的112例超低位直肠癌患者临床资料。其中单吻合器法经肛门取标本手术83例,双吻合器法小切口手术29例,对比两组患者在手术时间、出血量、住院时间、初次造口排便时间、淋巴结检出数、下切缘长度、术后吻合口瘘发生率、肛门Wexner失禁评分以及1年无病生存率(disease-free survival, DFS)等方面的差异。结果全部112例手术顺利完成,两组患者在手术时间、出血量、淋巴结检出数、肛门Wexner失禁评分及1年DFS等方面差异无统计学意义( P >0.05);单吻合器组住院天数少于双吻合器组,分别为(7.9±3.5) d和(10.2±2.5) d,差异有统计学意义( P <0.01);两组初次造口排气时间分别为(13.7±6.0) h和(44.6±5.2) h,差异有统计学意义( P <0.01);两组肿瘤下切缘长度分别为(1.8±0.3) cm和(1.6±0.2) cm,差异有统计学意义( P <0.01);吻合口瘘发生率分别为2/83和4/29,差异有统计学意义( P <0.01)。结论与传统双吻合器法相比,单吻合器法经肛门取出标本进行超低位直肠癌保肛安全可行,可缩短住院时间、促进术后恢复。展开更多
Numerical calculations of creep damage development and life behavior of circular notched specimens of nickel-base single crystal had been performed. The creep stress distributions depend on the specimen geometry. For ...Numerical calculations of creep damage development and life behavior of circular notched specimens of nickel-base single crystal had been performed. The creep stress distributions depend on the specimen geometry. For a small notch radius, von Mises stress has an especial distribution. The damage distribution is greatly influenced by the notch depth, notch radius as well as notch type. The creep crack initiation place is different for each notched specimen. The characteristics of notch strengthening and notch weakening depend on the notch radius and notch type. For the same notch type, the creep rupture lives decrease with the decreasing of notch radius. A creep life model has been presented for the multiaxial stress states based on the crystallographic slip system theory.展开更多
文摘目的研究单吻合器法经肛门取出标本在超低位直肠癌保肛手术的临床疗效。方法回顾性分析2016年1月—2018年1月同济大学附属东方医院胃肠肛肠外科行腹腔镜直肠前切除术的112例超低位直肠癌患者临床资料。其中单吻合器法经肛门取标本手术83例,双吻合器法小切口手术29例,对比两组患者在手术时间、出血量、住院时间、初次造口排便时间、淋巴结检出数、下切缘长度、术后吻合口瘘发生率、肛门Wexner失禁评分以及1年无病生存率(disease-free survival, DFS)等方面的差异。结果全部112例手术顺利完成,两组患者在手术时间、出血量、淋巴结检出数、肛门Wexner失禁评分及1年DFS等方面差异无统计学意义( P >0.05);单吻合器组住院天数少于双吻合器组,分别为(7.9±3.5) d和(10.2±2.5) d,差异有统计学意义( P <0.01);两组初次造口排气时间分别为(13.7±6.0) h和(44.6±5.2) h,差异有统计学意义( P <0.01);两组肿瘤下切缘长度分别为(1.8±0.3) cm和(1.6±0.2) cm,差异有统计学意义( P <0.01);吻合口瘘发生率分别为2/83和4/29,差异有统计学意义( P <0.01)。结论与传统双吻合器法相比,单吻合器法经肛门取出标本进行超低位直肠癌保肛安全可行,可缩短住院时间、促进术后恢复。
基金supported by the National Natural Science Foundation of China(50005016,50375124)Natural Science Foundation of Shaanxi Province and China Aviation Foundation(02C53011,03B53003)as well as the Yangtze River Foundation
文摘Numerical calculations of creep damage development and life behavior of circular notched specimens of nickel-base single crystal had been performed. The creep stress distributions depend on the specimen geometry. For a small notch radius, von Mises stress has an especial distribution. The damage distribution is greatly influenced by the notch depth, notch radius as well as notch type. The creep crack initiation place is different for each notched specimen. The characteristics of notch strengthening and notch weakening depend on the notch radius and notch type. For the same notch type, the creep rupture lives decrease with the decreasing of notch radius. A creep life model has been presented for the multiaxial stress states based on the crystallographic slip system theory.
