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| 1 | Post-operative computed tomography scan – reliable tool for quality assessment of complete mesocolic excision显示文摘BACKGROUND Quality control in colon cancer surgery is an ongoing debate ever since standardization proved to be highly efficient in improving survival in rectal cancer. Complete mesocolic excision(CME) is widely acclaimed as the new goldstandard in colon cancer resections, thus it is imperative to establish quality criteria of CME in order to make it easily understood and verified by surgeons worldwide. One simple and reproducible tool could be the measurement of arterial stumps postoperatively and a straightforward way to test its reliability is to test it in a comparative study between CME and non-CME surgery.AIM To validate arterial stump measurement as a surgical quality tool by comparing CME with conventional radical colectomies.METHODS This was a retrospective study, carried out on a prospective database. We collected data from two groups of patients, divided according to standard CME with D2 central vascular ligation(group A) and non-standardized surgery(group B). The two groups were compared with regard to the arterial stump length after right-and left-sided colectomies for colon cancer. The actual stump lengths of the ileocolic artery(ICA) and inferior mesenteric artery(IMA) were compared with their theoretical best D2 position of predicted ligation levels(D2 PLLs) for calculating the potential for improvement. Measurements on follow-up computed tomography scans were carried out by three observers. Pathological data were recorded(specimen length, lymph node yield) and correlated with stump length.RESULTS We analysed 58 colectomies. The stump lengths(mean ± SD) in group A were16.97 ± 4.77 mm for ICA and 31.70 ± 15.71 mm for IMA, whereas group B had 49.93 ± 20.29 mm for ICA and 67.24 ± 28.71 mm for IMA. Shorter lengths were obtained in group A, by a mean difference of 35.66 mm(χ~2 = 27.38, P < 0.001),which was significant for all types of colectomies. Except for a 5.85 ± 4.71 mm difference for right colectomies, all the ligations from group A significantly reached their potential height(0.26 ± 12.18 mm from D2 PLL; χ~2 = 0.005, P = 0.944).Apart from three left colectomies, group B failed to reach D2 PLL, by a mean difference of 32.14 ± 26.15 mm(χ~2 = 21.77, P < 0.001). The calculated improvement potentials were significantly shorter in group A than in group B, by a mean of 31.88 mm(χ~2= 22.13, P < 0.001). The large spread of results in group B showed that there is significant variability(P = 0.004) when compared to standard surgery. Significant correlations were found between stump length, specimen length and number of lymph nodes(P = 0.018 and P = 0.008 respectively). No statistical difference was found between observers' measurements(P = 0.866).CONCLUSION Arterial stump monitoring is a significant step in defining surgical quality, as longer stumps contain residual mesocolic tissue and correlate with major prognostic factors. | Cristian Livadaru Stefan Morarasu Tudor Cristian Frunza Florina A Ghitun Elena Florina Paiu-Spiridon Florina Sava Cristina Terinte Dan Ferariu Sorinel Lunca Gabriel Mihail Dimofte | 2019 | World Journal of Gastrointestinal Oncology2019，11，3： | 2 |
| 2 | Dynamic model- ing of a dual clearance squeeze film damper:Part I test rigand dynamic model with one damper显示文摘 | Moraru L Keith T G Jr Dimofte F | 2003 | Tribology Trans- actions2003，46，2： | 1 |
| 3 | Dynamic model- ing of a dual clearance squeeze film damper: Part II 显示文摘 | Moraru L Keith T G Jr Dimofte F | 2006 | Tribology Transactions2006，49，4： | 1 |
| 4 | A stability analysis for a hydrodynamic three-wave journal bearing显示文摘 | Ene N M Dimofte F Keith J T G | 2008 | Tribology International2008，41，5： | 1 |
| 5 | Calculation of the Flow in High-Speed Gas Bearings Including Inertia Effects Using the CE/SE Method显示文摘 | Sorin Cioc Theo G Keith JR Florin Dimofte | 2004 | Trib Trans2004，47，： | 1 |
| 6 | Adrenal schwannoma 显示文摘 | Tarcoveanu E Dimofte G Bradea C | 2009 | JSLS2009，13，1： | 1 |
| 7 | A stability analysis for a hydrodynamic three-wave journal bearing 显示文摘 | Ene N M Dimofte F Keith Jr T G | 2008 | Tribology International2008，41，： | 1 |
| 8 | Proton beam versus photon beam dose to the heart and left anterior descending artery for left-sided breast cancer显示文摘 | Lin LL Vennarini S Dimofte A | 2013 | Int Radiat Oncol Biol Phys2013，87，2： | 1 |
| 9 | Laparoscopic management of gastrointestinal stromal turnouts显示文摘 | T?rcoveanu E Dimofte G Vasilescu A | 2010 | Acta Chir Belg2010，110，3： | 1 |
| 10 | Wave journal bearing with compressible lubricant Part 2 : a comparison of the Wave hearing with a groove beating and a lobe bearing 显示文摘 | DIMOFTE F | 1995 | Tribology Transactions1995，38，2： | 1 |
| 11 | Computation of pressurized gas bearings using the CE/SE method显示文摘 | CIOC S DIMOFTE F KEITH T | 2003 | STLE Tribology Transactions2003，46，1： | 1 |
| 12 | The correlation of genetic markers with anatomoclinical and histopathological forms in Hirschsprung's disease 显示文摘 | Broasc V Ciobotaru C Dimofte I | 2010 | Rom J Morphol Embryol2010，51，2： | 1 |
| 13 | Ad schema incongruity as elicitor of ethnic self-awareness and differential advertising response 显示文摘 | Dimofte V Forehand R Deshpand6 R | 2003 | Journal of Advertising2003，32，4： | 1 |
| 14 | Laparoscopic management of gastrointestinal stromal turnouts 显示文摘 | Tarcoveanu E Dimofte G Vasilescu A | 2010 | Acta Chir Belg2010，110，3： | 1 |
| 15 | Dynamic modeling of a dual clearance squeeze film damper:Part Ⅰ test rig and dynamic model with one damper显示文摘 | Moraru L Keith T G Jr Dimofte F | 2003 | Tribology Transactions2003，46，2： | 1 |
| 16 | Global Brands in the United States : How Consumer Ethnicity Medi-ates the Global Brand Effect 显示文摘 | Claudiu V Dimofte Johny K Johansson Richard P Bagozzi | 2010 | Journal of International Market-ing2010，18，3： | 1 |
| 17 | Dynamic modeling of a dual clearance squeeze film damper:Part Ⅱ 显示文摘 | Moraru L Keith T G Dimofte F | 2006 | Tribology Transactions2006，49，4： | 1 |
| 18 | Waved journal bearing concept (Evaluating steady- state and dynamic performance with a potential active control alternative) 显示文摘 | Dimofte F | 1993 | American Society of Mechanical Engineers Design Engineering Division (Publication) DE1993，60，： | 1 |
| 19 | Wave journal bearing with compressible lubricant: Part I: the wave bearing concept and a comparison to the plain circular bearing 显示文摘 | Dimofte F | 1995 | STLE Tribology Transactions1995，38，1： | 1 |
| 20 | Wave journal bearing with compressible lubricant: Part II: a comparison of the wave bearing with a wave-groove bearing and a lobe bearing 显示文摘 | Dimofte F | 1995 | STLE Tribology Transactions1995，38，2： | 1 |
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