Objective To investigate the short- and long-term efficacy of membrane anatomy-guided laparoscopic spleen-preserving circumferential splenic hilar lymph node dissection for the treatment of advanced proximal gastric cancer. Methods A retrospective analysis was conducted in 186 patients with advanced proximal gastric cancer who underwent mesenteric anatomy-guided laparoscopic spleen-preserving splenic hilar lymph node dissection for advanced proximal gastric cancer in our center from March 2013 to March 2018. The patients were divided into two groups: one group was the laparoscopic anterior splenic hilar lymph node dissection group which we named L-ASHD , n = 103), while the other group was the laparoscopic circumferential splenic hilar lymph node dissection group which we named L-CSHD , n = 83). Results There was no significant difference in total operative time, intraoperative blood loss, postoperative length of hospital stay, and incidence of postoperative complications, etc. ( P > 0.05). The number of harvested splenic hilar lymph nodes and the number of patients with harvested positive splenic hilar lymph nodes were both higher in the L-CSHD than in the L-ASHD (3.90 ± 2.52 vs. 3.02 ± 3.07, P < 0.05; 19 vs. 9 patients, P < 0.05). The positive rate of lymph nodes behind the splenic hilar was 8.4%. Kaplan–Meier survival curves showed that patients in the L-CSHD had similar OS and DFS compared with those of patients in the L-ASHD. Conclusion Membrane anatomy-guided laparoscopic spleen-preserving circumferential splenic hilar lymph node dissection for advanced proximal gastric cancer is safe and feasible and can help avoid the incomplete dissection of positive lymph nodes. Electronic supplementary material The online version of this article (10.1186/s12957-019-1610-z) contains supplementary material, which is available to authorized users.

Objective: The aim was to investigate the anatomical layers of the specific fascia involved in infrapyloric lymphadenectomy in laparoscopic radical gastrectomy for gastric cancer and to analyze the short-term efficacy of an anatomy-guided surgical approach.Materials and Methods: On the basis of many years of clinical practice in fascial anatomy-guided laparoscopic radical gastrectomy for gastric cancer, we proposed anatomical considerations for infrapyloric lymphadenectomy in this procedure and investigated the anatomy of the mesentery and mesenteric fusion in this region, including the specific starting and ending points and the plane of the operation. We also retrospectively analyzed the clinical data of 265 patients who underwent fascial anatomy-guided infrapyloric lymphadenectomy in laparoscopic radical gastrectomy for gastric cancer from January 2015 to January 2019 and compared the shortterm efficacy between the fascial anatomy-guided laparoscopic infrapyloric lymphadenectomy plus mesogastric excision group and the laparoscopic infrapyloric lymphadenectomy group.

Researchers have proposed various techniques for cloth simulation in the last decades. The crucial problem in interactive animation for cloth is how to speed up simulation with a stable system. In this paper, we describe a realistic and stable scheme for cloth simulation based on mass-spring system. This scheme modifies semi-implicit integration used in cloth simulation system with an efficient damping method. Semi-implicit integration methods have been widely used in dynamic simulation because of acceptable speed and stability. However, internal damping forces are generated with respect to rotational rigid motions, which are only depending on relative velocities. Undesirable change in global movement of dynamic cloth could result in damping artifact. We replace the internal damping forces with an optimal damping method which is based on iterative spring damping but the limit can be computed directly. The method provides simple damping parameter estimation and guarantees conservation of global movement. As a result, complex clothes can be realistically and stably simulated in real time.