• 한국간담췌외과학회지
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• 제28권3호
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• pp.302-314
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• 2024

This study aimed to compare outcomes of hand-sewn and stapler closure techniques of pancreatic stump in patients undergoing distal pancreatectomy (DP). Impact of stapler closure reinforcement using mesh on outcomes was also evaluated. Literature search was carried out using multiple data sources to identify studies that compared hand-sewn and stapler closure techniques in management of pancreatic stump following DP. Odds ratio (OR) was determined for clinically relevant postoperative pancreatic fistula (POPF) via random-effects modelling. Subsequently, trial sequential analysis was performed. Thirty-two studies with a total of 4,022 patients undergoing DP with hand-sewn (n = 1,184) or stapler (n = 2,838) closure technique of pancreatic stump were analyzed. Hand-sewn closure significantly increased the risk of clinically relevant POPF compared to stapler closure (OR: 1.56, p = 0.02). When stapler closure was considered, staple line reinforcement significantly reduced formation of such POPF (OR: 0.54, p = 0.002). When only randomized controlled trials were considered, there was no significant difference in clinically relevant POPF between hand-sewn and stapler closure techniques (OR: 1.20, p = 0.64) or between reinforced and standard stapler closure techniques (OR: 0.50, p = 0.08). When observational studies were considered, hand-sewn closure was associated with a significantly higher rate of clinically relevant POPF compared to stapler closure (OR: 1.59, p = 0.03). Moreover, when stapler closure was considered, staple line reinforcement significantly reduced formation of such POPF (OR: 0.55, p = 0.02). Trial sequential analysis detected risk of type 2 error. In conclusion, reinforced stapler closure in DP may reduce risk of clinically relevant POPF compared to hand-sewn closure or stapler closure without reinforcement. Future randomized research is needed to provide stronger evidence.

• Human Ecology Research
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• 제60권2호
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• pp.273-287
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• 2022

(K)Hanbok, which is Korea's traditional clothing, differs from the Chinese Hanfu or Japanese Kimono. This study aims to understand the fundamental differences between (K)Hanbok and Hanfu. The Goryeo Dynasty (K)Hanbok, which was particularly popular in China, was established because the Ming Dynasty Hanfu and Chinese fashion were considerably influenced by the 'Koryo Yang'. Firstly, while (K)Hanbok is bulky, Hanfu of the Han Dynasty is characterized by forming a slim silhouette. Due to the climate of the Northern Hemisphere, (K)Hanbok shows a rich silhouette comprising multiple layers of inner pants and a pleated skirt over a voluminous underskirt. On the other hand, the Han's Hanfu creates a straight silhouette in the form of a wrap, revealing the contours of the body. The pleated skirt of the (K)Hanbok can use six to twelve width fabrics, depending on the social position; however, the Hanfu of the Han is a skirt without any pleats. Secondly, the clothing patterns, which have various shapes, are totally different in how they are made and sewn. The Korean (K)Hanbok is a two-piece separate, whereas the Chinese Hanfu style is a one-piece with a skirt. The short length of the (K)Hanbok jacket has a Sup which is cut and pasted allowing the front closure to overlap. Nevertheless, the Hanfu of the Han does not have this Sup because it is of a wrap-around, one-piece style and has an exceptionally large front, and wraps around at the waist which extends to the sides. Thirdly, the (K)Hanbok jacket has separate string Gorums for fastening, and an additional belt around the waist; however, in the case of Gorum, it is unnecessary for a wrapping style of Hanfu. Fourthly, Koreans as an agricultural horse-riding people, basically wore the trousers attached a comfortable gusset, while the Chinese Hanfu had no pants, but the Chinese wore Gaedanggo pants which exposed the hips, inevitably during the Warring States period.