No abstract available.
Adenomatous Polyposis Coli*

BACKGROUND: The laparoscopic cholecystectomy has become the treatment of choice for the majority of patients with cholecystopathy. The objectives of this study were to evaluate the safety and the efficacy of the laparoscopic cholecystectomy by reviewing of the case histories of three hundred ten consecutive patients treated with a laparoscopic cholecystectomy. METHODS: We retrospectively analyzed the initial 310 laparoscopic cholecystectomies performed at the Department of General Surgery, Sun General Hospital, from May 1993 to December 1998. Sex, age, associated diseases, previous history of abdominal operation, duration of operation, reason for conversion to open cholecystectomy, hospital stay, and postoperative complications were analyzed. RESULTS: The postoperative diagnosis was chronic cholecystitis in 213 patients, acute cholecystitis in 53 patients, cholesterolosis in 17 patients, gallbladder (GB) empyema in 13 patients, acalculous cholecystitis in 9 patients, and gallbladder carcinomas in 3 patients. The common associated diseases were diabetes mellitus and hypertension. The mean durations of operation, diet, and hospital stay were 77.6 minutes. 1.2 days, and 5 days, respectively. The mean numbers of drainages and injected analgesics were 0.8 and 1.6, respectively. Conversion to an open cholecystectomy was necessary in 8 of the 310 patients (2.6%) who underwent a laparoscopic cholecystectomy either because of severe adhesion (n=6), difficulty with anatomic identification in Calot's triangle (n=1), or severe GB empyema (n=1). The overall postoperative complication rate was 2.6% (8/310). A laparotomy was not required for the treatment of bleeding (5 cases) and residual stones (2 cases). There was no bile duct injury. One patient who had a cerebral infarction died of a cerebrovascular accident. CONCLUSION: We conclude that for benign cholecystopathy the laparoscopic cholecystectomy can be safe and feasible treatment with low morbidity.
Acalculous Cholecystitis ; Analgesics ; Bile Ducts ; Cerebral Infarction ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute ; Diabetes Mellitus ; Diagnosis ; Diet ; Empyema ; Gallbladder ; Hemorrhage ; Hospitals, General ; Humans ; Hypertension ; Laparotomy ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Solar System ; Stroke

PURPOSE: Colonoscopy is a safe and commonly used method for the screening of colon cancer, but sometimes major complications, such as, colonic perforation or hemorrhage occur during the procedure. The aim of this study was to compare the surgical outcomes of laparoscopic and open surgery for colon perforation after colonoscopy. METHODS: A retrospective review of patient records was performed on 25 patients with iatrogenic colon perforation during colonoscopy during the 7-year period from January 2005 to June 2012. Demographic data, operative procedures, operation times, postoperative complications, hospital course, and morbidities in the laparoscopic surgery group (LG) and open surgery group (OG) were compared. RESULTS: Seventeen of the 25 patients underwent laparoscopic surgery (68%) and 8 patients open surgery (32%). The most common surgical methods were primary repair in the LG, and Hartmann's operation in the OG. Average time to first flatus was 2.9 days in the LG and 4.5 days in the OG, and average times to first meals were 4.5 days and 5 days, respectively. Mean hospital stays were 10.8 days in the LG and 17 days in the OG. After surgery, complications occurred in two patients in the LG, but no complication occurred in the OG. CONCLUSION: Laparoscopic repair for iatrogenic colonic perforation during colonoscopy seems to be useful and safe surgical method in early period after perforation. However, open surgery is also needed for the delayed cases after perforation.
Colon* ; Colonic Neoplasms ; Colonoscopy* ; Flatulence ; Hemorrhage ; Humans ; Intestinal Perforation ; Laparoscopy ; Length of Stay ; Mass Screening ; Meals ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

BACKGROUND: The increase of smoking prevalence in adolescents Is serious problem because of physical and psychological influences furthermore, fixation of smoking habit. This study is aimed at providing applicable basic information to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and its related factors. METHODS: 835 students from one senior high school in Taegu completed a self administerd questionnaire during school hours in May, 1996. 813 questionnaires with adequate responses were analyzed using SPSS/PC program. All students were asked class years, school satisfaction, school performance score, number of their three best friends who smoke, smoking status of their fathers, religion, allowance, alcoholic drinks, addicting drug use, Zung's self-rating depression scale(SDS) and Zung's self-rating anxiety scale(SAS), Smokers were asked amount of smoking, motives for smoking, when they started smoking, Fagerstrom score. RESULTS: Of the 813 students in the sample 135(16.6%) were current smokers. About the amount of smoking, 59.3% smoked less than 5 cigarettes/day. About the motives of smoking, 34.8% started smoking through the solicitation by friends or for making friends. About when they started smoking, 52.6% started smoking before entrance into senior high school. The related factor with smoking Included class years, school satisfaction, school performance score, numbers of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, SDS. Predictor of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance. The related factors of nicotine dependency were amount of smoking, allowance, when they started smoking. Predictor of nicotine dependency were amount of smoking, number of three best friends who smoke. CONCLUSIONS: The related factors with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, and SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance.
Adolescent ; Alcoholics ; Anxiety ; Daegu* ; Depression ; Drinking ; Education ; Fathers ; Friends ; Humans ; Male* ; Nicotine ; Prevalence ; Smoke* ; Smoking* ; Surveys and Questionnaires

PURPOSE: Fournier's gangrene is a potentially fatal infectious necrotizing fasciitis of the scrotum, penis, and perineal region. If not recognized early, this process will extend along the fascia plane to the lower abdominal and back regions, causing severe morbidity and even mortality. The aims of this study were to investigate the clinical characteristics and to evaluate the outcome of our experience with 16 cases of Fournier's gangrene. METHODS: Clinical data from 16 patients with the diagnosis of Fournier's gangrene, who were treated at Gil Medical Center from January 1995 until October 2001, were analyzed retrospectively. RESULTS: The patients consisted of 14 men and 2 women, with an average age of 62 years. The potential ports of entry for the causative bacteria included the anorectum (75.0%), the urinary tract (18.8%), and the skin (6.3%). Predisposing factors included diabetes mellitus (62.5%), alcoholism (6.3%), steroid use (6.3%), malignancy (6.3%), and ulcerative colitis (6.3%). Escherichia coli and Staphylococcus aureus were most commonly identified in bacterial cultures. All patients were treated with a broad spectrum antibiotics and serial surgical debridement. Twelve patients had fecal diversions, and five patients had urinary diversions. Three patients underwent orchiectomies. One patient (6.3%) died due to sepsis. CONCLUSIONS: The management of this infectious entity should be aggressive with early recognition. Patients with Fournier's gangrene need prompt extirpation of all nonviable tissue and a cystostomy or a colostomy when necessary. A broad-spectrum antimicrobial regimen and aggressive debridement are mandatory.
Alcoholism ; Anti-Bacterial Agents ; Bacteria ; Causality ; Colitis, Ulcerative ; Colostomy ; Cystostomy ; Debridement ; Diabetes Mellitus ; Diagnosis ; Escherichia coli ; Fascia ; Fasciitis, Necrotizing ; Female ; Fournier Gangrene* ; Humans ; Male ; Mortality ; Orchiectomy ; Penis ; Retrospective Studies ; Scrotum ; Sepsis ; Skin ; Staphylococcus aureus ; Urinary Diversion ; Urinary Tract

PURPOSE: The aims of this study were to assess the oncologic safety of laparoscopic colorectal surgery compared to that of conventional open surgery and to compare the disease-free survival (DFS) rates between laparoscopic and open colorectal surgery for radical treatment of colorectal cancer. METHODS: From January 2001 to December 2005, 583 patients underwent laparoscopic or conventional open surgery. To address only radical treatment of colorectal cancer, we excluded subjects who had undergone emergency or palliative operation. Four hundred ninety patients were identified for this study. The laparoscopic (LG) and open group (OG) had 74 and 166 patients, respectively, for colon cancer, and 92 and 158 patients, respectively, for the rectal cancer. RESULTS: No difference was noted in the lengths of the distal margins of the resected bowels between the LG and the OG for rectal cancer (P>0.05). In addition, no significant difference was found in DFS rates between the LG and the OG for both colon and rectal cancer (P>0.05). CONCLUSIONS: The laparoscopic technique does not seem to present any disadvantages and is safe and feasible for the treatment of colorectal cancer. No difference was found between laparoscopic and open surgery in terms of DFS for colorectal cancer.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Colorectal Surgery ; Disease-Free Survival ; Emergencies ; Humans ; Laparoscopy ; Rectal Neoplasms

PURPOSE: This study compared efficacy and safety of a colostomy and stent placement as a palliative management in obstructive colorectal cancer. METHODS: The patients underwent either a colostomy (16 patients) or endoscopic stent placement (14 patients). Patients with metastatic cancer and those who rejected surgery due to their advanced age and poor systemic state were enrolled in this study. RESULTS: The mean age of patients in the colostomy group (CG) and in the stent group (SG) was 61 and 66, respectively. The mean APACHE II score in the CG and SG was 4.5 and 6.9, respectively (P=0.026). The time to the first meal after the procedure was 3.8+/-1.7 days and 1.9+/-0.8 days in the CG and the SG, respectively (P=0.002). The frequency of analgesic injections after the procedure in the CG and SG was 3.7+/-2.8 and 0.2+/-0.4, respectively (P= 0.001). The mean hospital stay in the CG and the SG was 15.8+/-13.9 days and 7.0+/-3.5 days, respectively (P=0.026). The mean healthcare cost in the CG and SG was 6,085,000+/-3,959,683 won and 4,041,000+/-2,487,857 won, respectively (P=0.212). CONCLUSION: No serious complications occurred in the endoscopic stent group. There was a statistically significant difference between the two groups in the time to the first meal, the pain control frequency, and hospital stay after the procedure. Therefore, endoscopic stent placement might be a preferable option for the palliative treatment of patients with obstructive colorectal cancer.
APACHE ; Colorectal Neoplasms* ; Colostomy* ; Health Care Costs ; Humans ; Length of Stay ; Meals ; Palliative Care* ; Stents*

PURPOSE: The aim of this study is to assess the safety and the efficacy of laparoscopic colorectal surgery compared to those of conventional open surgery and to determine the feasibility of laparoscopic colorectal surgery based on oncologic principles. METHODS: From March 2001 to January 2002, 27 consecutive patients were assessed for the possible use of laparoscopic surgery. Thirty patients were included in the open group. Forty-seven patients were included in the laparoscopic group. The decision regarding the suitability of a patient for the procedure was made by the surgeon. RESULTS: Laparoscopic surgery was attempted on 47 patients, and in 31 patients, it was completed successfully. Patients who underwent laparoscopic surgery required a smaller dose of analgesics and had an earlier bowel passage recovery and shorter hospital stay than patients who underwent open surgery. The mean operation times for the open group, the conversion group, and the laparoscopic group were 252 min, 269 min, and 272 min respectively (P>0.05). There was no difference in the number of lymph nodes dissected nor the length of the distal margin of the resected bowel in the case of anterior resection and low anterior resection of the laparoscopic group compared to the open and the conversion groups (P>0.05). Complications in the laparoscopic surgery group were anastomosis site leakage and bowel obstruction. In the open group, wound infection, urinary retention, anastomosis site leakage and bowel obstruction were found. The morbidities of the open group, the conversion group, and the laparoscopic group were 23.3%, 37.5%, and 12.9%, respectively. One mortality was observed in the conversion group. CONCLUSIONS: In this study, there is no evidence that the laparoscopic technique is inadequate for following the cancer surgery principle, So laparoscopic colorectal surgery is a safe and feasible treatment. The overall morbidity and mortality in this study were acceptable. Sufficient lymph node dissection and distal margin of the resected bowel were accomplished with laparoscopic surgery. Further long-term follow up, however, will be necessary to confirm the value of this technique.
Analgesics ; Colorectal Neoplasms ; Colorectal Surgery* ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Urinary Retention ; Wound Infection

PURPOSE: The oncologic outcomes after performing laparoscopic surgery (LS) compared to open surgery (OS) are still under debate and a concern when treating patients with colon cancer. The aim of this study was to compare the long-term oncologic outcomes of LS and OS as treatment for stage III colorectal cancer patients. METHODS: From January 2001 to December 2007, 230 patients with stage III colorectal cancer who had undergone LS or OS in this single center were assessed. Data were analyzed according to intention-to-treat. The primary endpoints were disease-free survival and overall survival. RESULTS: A total of 230 patients were entered into the study (114 patients had colon cancer-33 underwent LS and 81 underwent OS; 116 patients had rectal cancer-44 underwent LS and 72 underwent OS). The median follow-up periods for the colon and rectal cancer groups were 54 and 53 months, respectively. The overall conversion rate was 12.1% (n = 4) for colon cancer, and 4.5% (n = 2) for rectal cancer. Disease-free 5-year survival of colon cancer was 84.3% and 90% in LS group (LG) and OS group (OG), respectively, and that of rectal cancer was 83% and 74.6%, respectively (P > 0.05). Overall 5-year survival for colon cancer was 72.2% and 71.3% for LG and OG, respectively, and that for rectal cancer was 67.6% and 59.2%, respectively (P > 0.05). CONCLUSION: The long-term analyses for oncologic aspects of our study may confirm the safety of LS compared to OS in stage III colorectal cancer patients.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Laparoscopy ; Rectal Neoplasms

Child ; Chin ; Congenital Abnormalities ; Diastema ; Female ; Gyeongsangbuk-do ; Heart ; Humans ; Hyoid Bone ; Incisor ; Jaw ; Lip ; Mandible ; Manubrium ; Mesoderm ; Neck ; Parturition ; Pregnancy ; Shock ; Surgery, Oral ; Tongue ; Transplants