PURPOSE: Iliac vein compression is a known culprit of deep vein thrombosis (DVT). In contrast, the compression may prevent the pulmonary embolism (PE). The aim of this study was to evaluate the anatomic and clinical risk factors of PE in patients with lower extremity DVT. METHODS: PE was evaluated using chest computed tomography in patients with lower extremity DVT. The patients were classified into group I (DVT without PE) and group II (DVT with PE) and analyzed to clarify the anatomic and clinical risk factors associated with PE in patients with DVT. As the anatomic factor, the shortest length between the common iliac artery (CIA) and spinal body (SB) was measured. Statistical analyses utilized the multivariable logistic regression model, and receiver operating characteristic (ROC) curve analysis. RESULTS: We examined 114 patients (age; 62.7 ± 16.9 years, 41.7% men) with DVT with/without PE. The prevalence of concurrent DVT with PE was 52.6%. Blood tests showed no difference between the 2 groups. Of all the assessed patients' characteristics, only infection was significantly and independently associated with PE (P = 0.04). The shortest length between CIA and SB was 6.7 ± 3.5 mm in group I and 11.3 ± 3.7 mm in group II (P < 0.001). ROC curve analysis showed that 7.6 mm was the cut-off value for the anatomic risk of PE. CONCLUSION: Infection was significantly associated with concurrent DVT and PE. The shortest length between CIA and SB (<7.6 mm) may prevent PE in patients with DVT.
Hematologic Tests ; Humans ; Iliac Artery ; Iliac Vein ; Logistic Models ; Lower Extremity* ; Prevalence ; Pulmonary Embolism* ; Risk Factors* ; ROC Curve ; Thorax ; Venous Thrombosis*

Purpose: After the initiation of national health insurance coverage in 2019, the number of metabolic bariatric surgeries (MBSs) in Korea has been increasing. Despite evidence regarding its efficacy, many candidates are hesitant regarding surgery for the treatment of severe obesity. This study interviewed patients who received MBS to further understand potential barriers and increase the accessibility of MBS. Materials and Methods: Eight interviewees who received MBS after 2019 participated. The interviews began in mid-July 2022 over approximately a month. Each one-on-one interview lasted a few hours and was done in person. The interviews were transcribed, and the results were analyzed based on grounded theory. Results: This study focused on the quality of life before and after MBS. On a scale of 1 to 10, all patients had a high degree of satisfaction in quality of life after surgery (average score: 8.9, sleeve gastrectomy: 8.8, and bypass surgery: 9). Scores did not differ depending on procedure type, but factors that caused satisfaction and dissatisfaction were distributed differently between the 2 procedures. Conclusion Quality of life is significantly improved for patients undergoing MBS despite discomfort after surgery. Further promotion of the understanding of obesity as a chronic progressive disease is needed for both surgical candidates and the public to increase acceptance of MBS.

PURPOSE: Stoma takedown is a frequently performed procedure with considerable postoperative morbidities. Various skin closure techniques have been introduced to reduce surgical site infections. The aim of this study was to assess postoperative outcomes after stoma takedown during a long-term follow-up period. METHODS: Between October 2006 and December 2015, 84 consecutive patients underwent a colostomy or ileostomy takedown at our institution. Baseline characteristics and perioperative outcomes were analyzed through retrospective reviews of medical records. RESULTS: The proportion of male patients was 60.7%, and the mean age of the patients was 59.0 years. The overall complication rate was 28.6%, with the most common complication being prolonged ileus, followed by incisional hernia, anastomotic leakage, surgical site infection, anastomotic stenosis, and entero-cutaneous fistula. The mean follow-up period was 64.3 months. The univariate analysis revealed no risk factors related to overall complications or prolonged ileus. CONCLUSION: The postoperative clinical course and long-term outcomes following stoma takedown were acceptable. Stoma takedown is a procedure that can be performed safely.
Anastomotic Leak ; Colostomy ; Constriction, Pathologic ; Fistula ; Follow-Up Studies* ; Humans ; Ileostomy ; Ileus ; Incisional Hernia ; Male ; Medical Records ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Skin ; Surgical Wound Infection