Objective： We described the applicability and evaluated the advantages of improved laparoscopic transanal pull-through （ILTPT） for low-rectal cancer resection. Materials： ILTPT was performed in 4 patients. Five or...Objective： We described the applicability and evaluated the advantages of improved laparoscopic transanal pull-through （ILTPT） for low-rectal cancer resection. Materials： ILTPT was performed in 4 patients. Five or 4 ports were used. After isolation and section of the inferior mesenteric vessels, the rectum and sigmoid colon was mobilized. Total mesorectal excision and dissection of the distal rectum from the puborectalis muscle was carried out under laparoscopic guidance. The sigmoid colon and rectum were exteriorized via the anus. The rectum was divided proximally. Next, a purse-string suture was placed in the proximal segment, and the distal end of the sigmoid colon was returned to the pelvic cavity. The distal rectum was divided with Curved cutter staplermade by Jonson-Jonson company. Dislodging specimen, the continuity of the intestinal tract was restored using PROXIMATE ILS Curved and Straight Intraluminal Staplers CDH29/33 （Ethicon） through the rectum. Results： None of the cases were converted to open surgery. Average operation time was 180 min （range, 160-210 min）. No blood loss or any other complications were noted. Average postoperative stay was 9 days. Complications such as necrosis, anastomotic leakage and stricture, and genitoudnary disorders were not found in any of the patients at the 1 m follow-up. Conclusion： This report suggests that ILTPT is feasible and safe in Anus-Conserving Operation for low Rectal Cancer without auxiliary incision. If only we hold the applicability of ILTPT less trauma, more beautiful.展开更多
An improved nonlinear adaptive switching control method is presented to relax the assumption on the higher order nonlinear terms of a class of discrete-time non-affine nonlinear systems. The proposed control strategy ...An improved nonlinear adaptive switching control method is presented to relax the assumption on the higher order nonlinear terms of a class of discrete-time non-affine nonlinear systems. The proposed control strategy is composed of a linear adaptive controller, a neural network(NN) based nonlinear adaptive controller and a switching mechanism. An incremental model is derived to represent the considered system and an improved robust adaptive law is chosen to update the parameters of the linear adaptive controller. A new performance criterion of the switching mechanism is designed to select the proper controller. Using this control scheme, all the signals in the system are proved to be bounded. Numerical examples verify the effectiveness of the proposed algorithm.展开更多
基金Supported by a grant from the foundation of Department of Health of Jiangxi Province (No.20086002)
文摘Objective： We described the applicability and evaluated the advantages of improved laparoscopic transanal pull-through （ILTPT） for low-rectal cancer resection. Materials： ILTPT was performed in 4 patients. Five or 4 ports were used. After isolation and section of the inferior mesenteric vessels, the rectum and sigmoid colon was mobilized. Total mesorectal excision and dissection of the distal rectum from the puborectalis muscle was carried out under laparoscopic guidance. The sigmoid colon and rectum were exteriorized via the anus. The rectum was divided proximally. Next, a purse-string suture was placed in the proximal segment, and the distal end of the sigmoid colon was returned to the pelvic cavity. The distal rectum was divided with Curved cutter staplermade by Jonson-Jonson company. Dislodging specimen, the continuity of the intestinal tract was restored using PROXIMATE ILS Curved and Straight Intraluminal Staplers CDH29/33 （Ethicon） through the rectum. Results： None of the cases were converted to open surgery. Average operation time was 180 min （range, 160-210 min）. No blood loss or any other complications were noted. Average postoperative stay was 9 days. Complications such as necrosis, anastomotic leakage and stricture, and genitoudnary disorders were not found in any of the patients at the 1 m follow-up. Conclusion： This report suggests that ILTPT is feasible and safe in Anus-Conserving Operation for low Rectal Cancer without auxiliary incision. If only we hold the applicability of ILTPT less trauma, more beautiful.
基金Supported by the National Natural Science Foundation of China(61333010,21376077,61203157)the Natural Science Foundation of Shanghai(14ZR1421800)State Key Laboratory of Synthetical Automation for Process Industries(PAL-N201404)
文摘An improved nonlinear adaptive switching control method is presented to relax the assumption on the higher order nonlinear terms of a class of discrete-time non-affine nonlinear systems. The proposed control strategy is composed of a linear adaptive controller, a neural network(NN) based nonlinear adaptive controller and a switching mechanism. An incremental model is derived to represent the considered system and an improved robust adaptive law is chosen to update the parameters of the linear adaptive controller. A new performance criterion of the switching mechanism is designed to select the proper controller. Using this control scheme, all the signals in the system are proved to be bounded. Numerical examples verify the effectiveness of the proposed algorithm.
