Transthoracic single-port-assisted laparoscopic gastrectomy versus laparoscopic transhiatal approach for Siewert type II adenocarcinoma of the esophagogastric junction: a single-center retrospective study.

BACKGROUND: The surgical approach for patients with Siewert type II AEG remains controversial. Several studies have described a new laparoscopic radical resection approach of Siewert type II AEG through the left diaphragm. However, the technical safety and feasibility of the new surgical approach compared with the transhiatal approach have not yet been tested. STUDY DESIGN: We retrospectively reviewed patients with AEG who underwent TSLG and LTH operations in the Guangdong Provincial Hospital of Chinese Medicine between January 2017 and April 2021. Histologically confirmed AEG and D2 lymphadenectomy with curative R0 patients were included, and patients with Siewert I/III AEG or distant metastasis were excluded. Blood loss, the amount of harvested lymph node, and complications related to surgery were evaluated. RESULTS: A total of 99 patients with Siewert type II AEG were analyzed, 44 in the TSLG group and 55 in the LTH group. There was no difference in clinicopathological features between the two groups. The more harvested lymph node (23.33 ± 11.41 vs. 32.18 ± 12.85, p < 0.01), lower mediastinal lymph node (1.07 ± 2.08 vs. 3.25 ± 3.31, p < 0.01), and longer proximal margin length (3.08 ± 1.19 vs. 4.47 ± 0.95 cm, p < 0.01) were observed in the TSLG group. The rate of cure (R0 gastrectomy) in the TSLG group was higher than that in the LTH group (100% vs. 89.09%, p = 0.03). CONCLUSION: The TSLG approach is associated with improved surgical views, simplified lymphatic dissection in the inferior mediastinum, and more reliable margins. TSLG surgery may be an effective addition to LTH surgery, particularly when lower mediastinal lymph node metastases are suspected.

The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis.

Introduction The objective of this study was to assess the efficacy of telerehabilitation for patients after total knee arthroplasty (TKA) compared with face-to-face rehabilitation. Methods Medline, SCOPUS, Google Scholar, EMBASE, Springer, Science Direct, and Cochrane databases were searched electronically. Relevant journals and references of studies included were hand-searched for randomized controlled trials (RCTs) regarding the efficacy of telerehabilitation on functional recovery in patients after TKA. Two reviewers independently performed data extraction and quality assessment. Data were analysed using RevMan 5.3 software and Stata 12.0 software. Results Four RCTs involving 442 patients were included in the meta-analysis. Overall, compared with face-to-face rehabilitation, telerehabilitation could achieve comparable pain relief (mean difference = 0.52; 95% confidence interval (CI) = -0.20 to 1.24; p = 0.16) and better Western Ontario and McMaster Universities Osteoarthritis Index improvement (mean difference = 1.13; 95% CI = 0.23 to 2.02; p = 0.014). In addition, telerehabilitation treatment resulted in a significantly higher extension range ( p < 0.00001) and quadriceps strength ( p = 0.0002) than face-to-face rehabilitation. Discussion Telerehabilitation should be recommended for patients after TKA because of its comparable pain control and better improvement of functional recovery as compared to face-to-face rehabilitation.

A web-based GPS system for displacement monitoring and failure mechanism analysis of reservoir landslide.

It is important to monitor the displacement time series and to explore the failure mechanism of reservoir landslide for early warning. Traditionally, it is a challenge to monitor the landslide displacements real-timely and automatically. Globe Position System (GPS) is considered as the best real-time monitoring technology, however, the accuracies of the landslide displacements monitored by GPS are not assessed effectively. A web-based GPS system is developed to monitor the landslide displacements real-timely and automatically in this study. And the discrete wavelet transform (DWT) is proposed to assess the accuracy of the GPS monitoring displacements. Wangmiao landslide in Three Gorges Reservoir area in China is used as case study. The results show that the web-based GPS system has advantages of high precision, real-time, remote control and automation for landslide monitoring; the Root Mean Square Errors of the monitoring landslide displacements are less than 5 mm. Meanwhile, the results also show that a rapidly falling reservoir water level can trigger the reactivation of Wangmiao landslide. Heavy rainfall is also an important factor, but not a crucial component.