The Experts below are selected from a list of 7206 Experts worldwide ranked by ideXlab platform
P. P. Grimminger - One of the best experts on this subject based on the ideXlab platform.
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Minimally invasive esophagectomy: clinical evidence and surgical techniques
Langenbeck's Archives of Surgery, 2020Co-Authors: C. Mann, H Lang, F. Berlth, E. Hadzijusufovic, P. P. GrimmingerAbstract:Background Surgical esophagectomy plays a crucial role in the curative and palliative treatment of esophageal cancer. Thereby, minimally invasive esophagectomy (MIE) is increasingly applied all over the world. Combining minimal invasiveness with improved possibilities for meticulous dissection, robot-assisted minimal invasive esophagectomy (Ramie) has been implemented in many centers. Purpose This review focuses on the development of MIE as well as Ramie and their value based on evidence in current literature. Conclusion Although MIE and Ramie are highly complex procedures, they can be performed safely with improved postoperative outcome and equal oncological results compared with open esophagectomy (OE). Ramie offers additional advantages regarding surgical dissection, lymphadenectomy, and extended indications for advanced tumors.
Yoshiharu Sakai - One of the best experts on this subject based on the ideXlab platform.
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Lower Incidence of Postoperative Pulmonary Complications Following Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer: Propensity Score-Matched Comparison to Conventional Minimally Invasive Esophagectomy
Annals of Surgical Oncology, 2020Co-Authors: Shigeru Tsunoda, Kazutaka Obama, Shigeo Hisamori, Tatsuto Nishigori, Ryosuke Okamura, Hisatsugu Maekawa, Yoshiharu SakaiAbstract:Background Whether robot-assisted minimally invasive surgery (Ramie) is more beneficial than conventional minimally invasive surgery (MIE) remains unclear. Methods In total, 165 consecutive patients with esophageal carcinoma who underwent esophagectomy between January 2015 and April 2020 were retrospectively assessed. A 1:1 propensity score matching analysis was performed to compare the short-term outcomes between Ramie and conventional MIE. Results After matching, 45 patients were included in the Ramie and conventional MIE groups. Ramie had a significantly longer total operative time (708 vs. 612 min, P < 0.001) and thoracic operative time (348 vs. 285 min, P < 0.001) than conventional MIE. However, there were no significant differences in terms of oncological outcomes, such as R0 resection rate and number of resected lymph nodes. The overall postoperative morbidity (Clavien–Dindo [C–D] grade II or higher) rate of Ramie and conventional MIE were 51% and 73% ( P = 0.03), respectively, and the severe postoperative morbidity (C–D grade III or higher) rates were 11% and 29% ( P = 0.04), respectively. The incidence rate of recurrent laryngeal nerve palsy was halved in Ramie (7%) compared with conventional MIE (20%) ( P = 0.06). Finally, the pulmonary complication rate (18%) was significantly lower in patients who underwent Ramie than in those who underwent conventional MIE (44%) ( P = 0.006). Conclusions Ramie was safe and feasible, even during the early period of its application at a specialized center. Moreover, it may be a promising alternative to conventional MIE, with better short-term outcomes, including significantly lower incidence of pulmonary complications.
Toshiyoshi Fujiwara - One of the best experts on this subject based on the ideXlab platform.
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Initial introduction of robot-assisted, minimally invasive esophagectomy using the microanatomy-based concept in the upper mediastinum
Surgical Endoscopy, 2020Co-Authors: Yasuhiro Shirakawa, Kazuhiro Noma, Tomoyoshi Kunitomo, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Kazufumi Sakurama, Toshiyoshi FujiwaraAbstract:Background We have recently standardized upper mediastinal lymph node dissection (UMLND) using a microanatomy-based concept in thoracoscopic esophagectomy in the prone position (TEPP), and introduced robot-assisted minimally invasive esophagectomy (Ramie) using the same concept as in TEPP while aiming at solo surgery. The purpose of this study was to investigate the outcomes of Ramie using the microanatomy-based concept in the initial introduction phase. Methods We have performed more than 500 TEPP procedures as minimally invasive esophagectomy (MIE). After performing about 400 cases of MIE, we established a microanatomy-based standardization of UMLND. In October 2018, we introduced Ramie, and have performed 75 procedures in 20 months. Two groups were analyzed: a group after microanatomy-based standardization in TEPP (100 cases after completing 400 cases of TEPP) and a Ramie group (75 cases). Finally, 51 paired cases were matched using a propensity score. Furthermore, the change in postoperative short-term outcome for Ramie in the initial introduction phase was analyzed. Results Although there were no significant differences between the two groups in the number of upper mediastinal lymph nodes dissected, there was a significant decrease ( P = 0.036) in intraoperative blood loss volume with Ramie, representing a definite benefit for patients. The thoracoscopic operative time for Ramie decreased by almost 100 min following less than 50 cases of experience, reaching the same level as that for recent TEPP, but with only one-tenth the operator experience. There were no significant differences in the total postoperative morbidity rate including the recurrent laryngeal nerve palsy rate. Conclusion Ramie has been introduced safely and smoothly using the microanatomy-based concept established in TEPP.
C. Mann - One of the best experts on this subject based on the ideXlab platform.
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Minimally invasive esophagectomy: clinical evidence and surgical techniques
Langenbeck's Archives of Surgery, 2020Co-Authors: C. Mann, H Lang, F. Berlth, E. Hadzijusufovic, P. P. GrimmingerAbstract:Background Surgical esophagectomy plays a crucial role in the curative and palliative treatment of esophageal cancer. Thereby, minimally invasive esophagectomy (MIE) is increasingly applied all over the world. Combining minimal invasiveness with improved possibilities for meticulous dissection, robot-assisted minimal invasive esophagectomy (Ramie) has been implemented in many centers. Purpose This review focuses on the development of MIE as well as Ramie and their value based on evidence in current literature. Conclusion Although MIE and Ramie are highly complex procedures, they can be performed safely with improved postoperative outcome and equal oncological results compared with open esophagectomy (OE). Ramie offers additional advantages regarding surgical dissection, lymphadenectomy, and extended indications for advanced tumors.
Wang Ya-liang - One of the best experts on this subject based on the ideXlab platform.
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Property of TDI Grafting Ramie Fiber Reinforced PE Composites
Polymer Materials Science and Engineering, 2008Co-Authors: Wang Ya-liangAbstract:The graft copolymerization of TDI onto Ramie fibers has been studied using raw Ramie,Ramie yarn,Ramie rope and Ramie fabric as starting materials,the TDI grafting Ramie fiber reinforced PE composite was prepared.The tensile properties and fractography of composites were analyzed by tensile test and SEM.Experimental results show: compare with the un-grafting Ramie fiber,the composite interface adhesion are improved after TDI grafting Ramie fibers,the tensile properties of TDI grafting raw Ramie reinforced PE composite is decreased a little,but the tensile properties of TDI grafting Ramie rope and fabric reinforced PE composites are improve obviously.
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Microstructure and Properties of Ramie Fiber Reinforced LDPE Composites
Materials for Mechanical Engineering, 2008Co-Authors: Wang Ya-liangAbstract:A kind of composite material was prepared by using low density polyethylene(LDPE) resin as matrix,and raw Ramie,Ramie yarn and Ramie cloth as reinforcements.The tensile and thermal properties of the composite material were studied.The results show that the strengthing effect of the raw Ramie is the best and tensile strength of the composite material reinforced by it reaches the maximum value of 91.494 MPa.The strengthing effect of Ramie cloth is the worst.The interfacial properties of the composite material were improved after alkali treatment,and strength and elastic modulus of the comoposite material reinforced by yarn and cloth are improred obviously.The thermal stability of Ramie fiber are increased.
