Objective: To identify the minimum length of esophageal resection to ensure a pathologically negative proximal margin (PM) in total gastrectomy for gastric cancer. Background: In total gastrectomy, a certain esophageal length is resected to obtain a pathologically negative PM because of the possibility of unexpected pathological esophageal invasion. However, a recommendation regarding the esophageal transection site in total gastrectomy has not been established. Methods: The data of patients who underwent total gastrectomy for gastric cancer from 2005 to 2018 were collected. We evaluated the length of unexpected pathological esophageal invasion (esophageal ΔPM) in each type of disease and each location of the gross proximal tumor boundary (PB) using the length between the PB and the esophagogastric junction (PB-EGJ length). Results: Of the 1005 patients eligible for this study, 277, 196, and 532 had cT1, cT2–4 expansive (Exp), and cT2–4 infiltrative (Inf) growth patterns, respectively. In cT1 and Exp, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >1 cm, whereas pathological esophageal invasion occurred in 20.0% of cT1 and 32.7% of Exp when the PB-EGJ length was ≤1 cm. The esophageal ΔPM was <1 cm. In Inf, no unexpected pathological esophageal invasion occurred when the PB-EGJ length was >3 cm, whereas pathological esophageal invasion occurred in 17.4% of patients when the PB-EGJ length was ≤3 cm. The esophageal ΔPM was <2 cm. Conclusions: New recommendations regarding the esophageal resection length required to ensure a pathologically negative PM in total gastrectomy are herein proposed.
Recently, climate change has resulted in an increasing number of heavy rainfall events. Heavy rainfalls tend to cause large-scale landslides and create large landslide dams. Large landslide dams retain a large amount of water and often burst causing floods and catastrophic damage in the downstream area. Therefore, the study of landslide dam deformation is essential for predicting potential floods to implement effective flood risk management. To understand the landslide dam deformation process and dam outflow discharge characteristics, we carried out field experiments of landslide dam erosion by overtopping flow. In the field experiments, we observed the landslide dam deformation process directly. In a third experimental case, small slope failure occurred and we found that small slope failure affects the outflow discharge. In addition, we developed a numerical model to simulate landslide dam erosion by overtopping flow. To improve the prediction of the outflow discharge, we incorporated the inertial debris flow model, the side bank erosion model, and the slope collapse model into our numerical model. The resulting proposed model is tested by comparing the results of simulation with observation. The numerical model is capable of predicting outflow discharge by landslide dam burst.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.