Since 2015, community forests have been promoted in Togo as an alternative to protect areas from degradation and as a means of contributing to forest landscape restoration. The study focuses on the Nakpadjouak Communi...Since 2015, community forests have been promoted in Togo as an alternative to protect areas from degradation and as a means of contributing to forest landscape restoration. The study focuses on the Nakpadjouak Community Forest (NCF) in Tami (Togo, West Africa) which contributes to community forests sustainable management. It aims in (i) mapping forest ecosystems and analysing their dynamic and (ii) characterizing the floristic diversity of the NCF. The ecosystems were mapped and their dynamic was evaluated based on Google Earth images of 2014 and 2020. Floristic and forestry inventories were carried out using the transect technique in a sample of 20 plots of 50 m × 20 m. The NCF was made up mainly by wooded/shrub savannahs (95.37%) and croplands/fallow (4.63%) in 2014. These two land use types undergone changes over the 6 years prior to 2020. By 2020, the NCF had 3 land use types: wooded/shrub savannahs (77.59%), open forest/wooded savannahs (22.23%), and croplands/fallows (0.18%). A total of 89 plant species belonging to 70 genera and 28 families were recorded within the NCF. The dominant species are: Heteropogon contortus (L.) P.Beauv. and Combretum collinum Fresen. followed by Pteleopsissuberosa Engl. & Diels, Annona senegalensis Pers. The most common species are: Lannea acida A.Rich. s.l., A. senegalensis, Vitellaria paradoxa C.F.Gaertner subsp. paradoxa, C. collinum and Acacia dudgeonii Craib ex Holland. Due to its small area of just 40 hectares and its diverse plant life, this community forest of Savannahs Region is a significant biodiversity hotspot and warrants conservation efforts.展开更多
Transanal total mesorectal excision(TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the ...Transanal total mesorectal excision(TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses.展开更多
Background:Although the clinical importance of complete,intact total mesorectal excision(TME)is the widely accepted standard for decreasing local recurrence of rectal cancer,the residual mesorectum still represents a ...Background:Although the clinical importance of complete,intact total mesorectal excision(TME)is the widely accepted standard for decreasing local recurrence of rectal cancer,the residual mesorectum still represents a significant component of resection margin involvement.This study aimed to use a visible intraoperative sign to detect the distal mesorectal end to ensure complete inclusion of the mesorectum and avoid unnecessary over-dissection.Methods:The distal mesorectum end was investigated retrospectively through a review of 124 operative videos at the Union Hospital of Fujian Medical University(Fujian,China)and Cleveland Clinic(Ohio,USA)by two independent surgeons who were blinded to each other.Furthermore,28 cadavers and 44 post-operative specimens were prospectively examined by hematoxylin and eosin(H&E)staining and Masson’s staining to validate and confirm the findings of the retrospective part.Univariate and multivariate analyses were carried out to detect the independent factors that can affect the visualization of the distal mesorectal end.Results:The terminal line(TL)is the distal mesorectal end of the transabdominal and transanal TME(taTME)and appears as a remarkable pearly white fascial structure extending posteriorly from 2 to 10 o’clock.Histopathological examination revealed that the fascia propria of the rectum merges with the presacral fascia at the TL,beyond which the mesorectum ends,with no further downward extension.In the retrospective observation,the TL was seen in 56.6%of transabdominal TME and 56.0%of taTME operations.Surgical approach and tumor distance from the anal verge were the independent variables that directly influenced the detection of the TL(P=0.03 and P=0.01).Conclusion: The TL is a visible sign where the transabdominal TME should end and the taTME should begin. Recognitionof the mesorectal end may impact the certainty of complete mesorectum inclusion. Further clinical trials are needed toconfirm the preliminary findings.展开更多
Background:The aim of this article is to report and discuss a case of lower rectal cancer undergoing endoscopic transanal resection of tumour(ETART)using a transanal minimally invasive surgery(TAMIS)approach.Methods:A...Background:The aim of this article is to report and discuss a case of lower rectal cancer undergoing endoscopic transanal resection of tumour(ETART)using a transanal minimally invasive surgery(TAMIS)approach.Methods:A technical note on a case report.An innovative approach for ETART using TAMIS.Results:This is the first-ever case report of lower rectal cancer treated by ETART using a TAMIS approach.The procedure was completed successfully without any operative or peri-operative complication.Peri-operative flexible sigmoidoscopy confirmed a wide and patent rectal lumen.Conclusion:Use of a TAMIS approach for ETART to remove lower rectal cancer for palliation can be technically very effective compared with conventional ETART,due to the potential advantages of avoiding contaminant fluid spillage,easy access,better visualization compared with conventional ETART,and being user-friendly.The results from larger cohorts of patients undergoing TAMIS ETART are required before recommending the routine use of this technique.However,until then,this approach may be considered as an alternative to conventional ETART.展开更多
文摘Since 2015, community forests have been promoted in Togo as an alternative to protect areas from degradation and as a means of contributing to forest landscape restoration. The study focuses on the Nakpadjouak Community Forest (NCF) in Tami (Togo, West Africa) which contributes to community forests sustainable management. It aims in (i) mapping forest ecosystems and analysing their dynamic and (ii) characterizing the floristic diversity of the NCF. The ecosystems were mapped and their dynamic was evaluated based on Google Earth images of 2014 and 2020. Floristic and forestry inventories were carried out using the transect technique in a sample of 20 plots of 50 m × 20 m. The NCF was made up mainly by wooded/shrub savannahs (95.37%) and croplands/fallow (4.63%) in 2014. These two land use types undergone changes over the 6 years prior to 2020. By 2020, the NCF had 3 land use types: wooded/shrub savannahs (77.59%), open forest/wooded savannahs (22.23%), and croplands/fallows (0.18%). A total of 89 plant species belonging to 70 genera and 28 families were recorded within the NCF. The dominant species are: Heteropogon contortus (L.) P.Beauv. and Combretum collinum Fresen. followed by Pteleopsissuberosa Engl. & Diels, Annona senegalensis Pers. The most common species are: Lannea acida A.Rich. s.l., A. senegalensis, Vitellaria paradoxa C.F.Gaertner subsp. paradoxa, C. collinum and Acacia dudgeonii Craib ex Holland. Due to its small area of just 40 hectares and its diverse plant life, this community forest of Savannahs Region is a significant biodiversity hotspot and warrants conservation efforts.
文摘Transanal total mesorectal excision(TaTME) is a new and promising approach for the treatment of rectal cancer. Whilst the experience is still limited, there are growing evidences that this approach might overcome the limits of standard low anterior resection. TaTME might help to decrease the conversion rate especially in difficult patients, and to improve the pathological results, while preserving the urogenital function. Evaluation of data from large registries and randomized studies should help to draw firmer conclusions. Beyond these technical considerations, the next challenge seems to be clearly the safe introduction of this approach, motivating the development of dedicated courses.
基金supported by the Chinese Scholarship Council(CSC)[grant number 2017DFH010880].
文摘Background:Although the clinical importance of complete,intact total mesorectal excision(TME)is the widely accepted standard for decreasing local recurrence of rectal cancer,the residual mesorectum still represents a significant component of resection margin involvement.This study aimed to use a visible intraoperative sign to detect the distal mesorectal end to ensure complete inclusion of the mesorectum and avoid unnecessary over-dissection.Methods:The distal mesorectum end was investigated retrospectively through a review of 124 operative videos at the Union Hospital of Fujian Medical University(Fujian,China)and Cleveland Clinic(Ohio,USA)by two independent surgeons who were blinded to each other.Furthermore,28 cadavers and 44 post-operative specimens were prospectively examined by hematoxylin and eosin(H&E)staining and Masson’s staining to validate and confirm the findings of the retrospective part.Univariate and multivariate analyses were carried out to detect the independent factors that can affect the visualization of the distal mesorectal end.Results:The terminal line(TL)is the distal mesorectal end of the transabdominal and transanal TME(taTME)and appears as a remarkable pearly white fascial structure extending posteriorly from 2 to 10 o’clock.Histopathological examination revealed that the fascia propria of the rectum merges with the presacral fascia at the TL,beyond which the mesorectum ends,with no further downward extension.In the retrospective observation,the TL was seen in 56.6%of transabdominal TME and 56.0%of taTME operations.Surgical approach and tumor distance from the anal verge were the independent variables that directly influenced the detection of the TL(P=0.03 and P=0.01).Conclusion: The TL is a visible sign where the transabdominal TME should end and the taTME should begin. Recognitionof the mesorectal end may impact the certainty of complete mesorectum inclusion. Further clinical trials are needed toconfirm the preliminary findings.
文摘Background:The aim of this article is to report and discuss a case of lower rectal cancer undergoing endoscopic transanal resection of tumour(ETART)using a transanal minimally invasive surgery(TAMIS)approach.Methods:A technical note on a case report.An innovative approach for ETART using TAMIS.Results:This is the first-ever case report of lower rectal cancer treated by ETART using a TAMIS approach.The procedure was completed successfully without any operative or peri-operative complication.Peri-operative flexible sigmoidoscopy confirmed a wide and patent rectal lumen.Conclusion:Use of a TAMIS approach for ETART to remove lower rectal cancer for palliation can be technically very effective compared with conventional ETART,due to the potential advantages of avoiding contaminant fluid spillage,easy access,better visualization compared with conventional ETART,and being user-friendly.The results from larger cohorts of patients undergoing TAMIS ETART are required before recommending the routine use of this technique.However,until then,this approach may be considered as an alternative to conventional ETART.
