• Journal of Trauma and Injury
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• v.20 no.2
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• pp.72-76
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• 2007

Purpose: The purpose of this clinical trial was to evaluate the fixation method for treating alveolar fractures in an emergency department. Methods: The efficiency of using the fixation method was judged on the basis of clinical criteria. Stability, occlusion state, bleeding amount after fixation, operation time, and difficulties during procedural operation were recorded. Results: Eight patients were enrolled in this study. In all instances, the fixation method was effective in bleeding control. Each patient had a noticeable decrement in bleeding. A wire was used for four of the eight patients, and nylon strings was used for the others. The average operation time was 6.3 minutes for the wire patients and 2.8 minutes for the Nylon string patients. No specific problem was identified during the procedural operation. However, the difference in the fixation material influenced the effectiveness of the procedure, the operation time, and the satisfaction of the doctor. Conclusion: In the emergency department, the fixation method using wire or nylon string in the treatment of alveolar fractures is effective in bleeding control

• Journal of Gastric Cancer
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• v.19 no.3
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• pp.290-300
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• 2019

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ${\geq}II$) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.