No abstract available.
Crohn Disease*

No abstract available.
Tuberculosis*

No abstract available.
Colorectal Neoplasms* ; Neoplasm Metastasis*

No abstract available.
Duodenum*

Gastric duplication is an extremely rare disease that is commonly encountered during the first and the second decades. It is usually located in the greater curvature and forms a complete cystic structure. It usually presents non-specific post-prandial abdominal discomfort or is free of symptoms. Its significance is that it is associated with gastric malignancy or gastric ulcer and is difficult to differentiate from gastric submucosal tumor. We recently encountered an unusual case of gastric duplication, which developed in a 29-year-old man whose chief complaint was chronic abdominal discomfort. With a preoperative impression of gastric submucosal tumor, we explored his abdomen and found the gastric duplication located in the greater curvature side and performed a wedge resection. He was uneventfully discharged on the 12th postoperative day.
Abdomen ; Adult ; Humans ; Rare Diseases ; Stomach ; Stomach Ulcer

We have performed a retrospective analysis of 42 patients with Crohn's disease operated at the Department of Surgery, Seoul National University College of Medicine between 1978 and 1997. The most frequently involved site was ileocecum(40.5%) and small bowel(40.5%), whereas the large bowel and anorectum occupied only 2.4% and 7.1% rutspectively. In 39 patients with bowel involvement, 35 patients(90%) required resection as primary surgical operations(small bowel 18, right colon 11, ileocecum 6). The remaining 7 patients underwent intaabdominal abscess drainage(2), perianal abscess drainage(2), appendectomy(1), and exploration only(1). Two cases of small bowel resection were combined with multiple stricturoplasties. After mean follow-up period of 46 months(range 1~180, median 22 months) after primary operation, the cumulative reoperative recurrence rate was 25% at 3 years,47% at 5 years, and 79% at 10 years, respectively. The ileocecal type had higher cumulative reoperative recurrence rate than small bowel type(50% compared to 34% at 5 years). The age at symptom onset, age at time of first operation, duration between symptom onset and operation, and the indication for operation had no effect on reoperative recurrence rate. Despite short follow-up period and limited number of patients, our results confirmed that Crohn's disease is associated with high rate of recurrence requiring re-operations.
Abscess ; Colon ; Crohn Disease ; Follow-Up Studies ; Humans ; Recurrence ; Retrospective Studies ; Seoul

PURPOSE: Recurrent gastric cancer has a very poor prognosis due to its diagnostic difficulties, variant recurrence patterns and no effective treatment modalities. In this study, we retrospectively analyzed treatment results of the recurrent gastric cancer. MATERIALS AND METHODS: We reviewed 1,286 patients who had taken radical surgery for primary gastric cancers and were diagnosed to have recurrences of their primary diseases. According to the medical records, we retrospectively analyzed the gross features, histologic types and TNM stages of primary gastric cancers. The symptoms, diagnostic modalities, durations, recurrence patterns, treatments and prognoses of recurrent diseases were also reviewed. RESULTS: The median survival time of total recurrent gastric cancer patients was 6.8 months. Ldegrees Co-regional and distant recurrences had better results than peritoneal and mixed recurrences (p<0.01). Curative resection of recurrent cancer was done in only 1.6% (18 cases in ldegrees Co-regional recurrence and 4 cases in distant recurrence), but in these cases, significant survival gain (5 year survival rate: 30.5%) was found compared to other treatment modalities (p<0.01). In multivariate analysis, the type of first operation, TNM stage, duration till recurrence, recurrence pattern, and treatment modality of recurrence were meaningful for the survival time after recurrence. CONCLUSION: In selective cases, recurrent gastric cancer had an effective treatment modality and was expected to have prolonged survival. Therefore, a careful diagnosis and an active treatment of the patients who have the recurrent gastric cancers should be done, especially for the ldegrees Co-regional recurrence.
Diagnosis ; Humans ; Medical Records ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms* ; Survival Rate

Purpose : Early colorectal cancer is defined as the depth of tumor invasion limited to mucosa or submucosa regardless of the presence or absence of lymph node metastasis. We performed a retrospective study to determine the chronological changes in frequencies of early colorectal cancer and clinicopathologic differences between early colorectal cancer (ECC) and advanced colorectal cancer (ACC). Methods : We reviewed hospital records of the patients with colorectal cancer operated between January 1990 and December 1995. We classified the patients into two groups, ECC and ACC, according to the depth of tumor invasion and compared the clinicopathologic characteristics. Results : Fifty eight patients (5.2%) were diagnosed with early colorectal cancer among 1113 colorectal cancer patients operated at the same period. The frequency of ECC has increased from 1.9% in 1970~1989 to 5.2% in 1990~1995. The average age of patients with ECC at the time of surgery was 55.8 compared to 56.5 for patients with ACC group (p>0.05). Most patients (72.4%) with ECC had bleeding symptoms and majority of the ECCs were located in the rectum (72.4%). The mean size of tumors was 2.6 cm in its greatest diameter and was significantly smaller than that of ACC (5.7 cm). Compared to ACC, ECC had better histologic differentiation and fewer lymph node metastases (p<0.05). Thirty six of the ECC patients underwent bowel resection and remaining 22 underwent local excision. After a mean follow up period of 39.1 months (range 2~81months), recurrence was detected in one case. There was no death during the follow up period. Conclusion : The frequency of ECC has increased recently. Compared to patients with ACC, patients with ECC had more favorable clinicopathologic characteristics and better outcome. In selected patients, minimal operation can be applied without compromising the clinical outcome.
Colorectal Neoplasms* ; Follow-Up Studies ; Hemorrhage ; Hospital Records ; Humans ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies

PURPOSE: Synthetic absorbable monofilaments offer excellent glide characteristics and cause minimal tissue trauma as a result of their smooth monofilament structure and gradual absorption within the healing tissues. For these reasons, these suture materials are commonly used in various surgical fields such as gastroenterology, urology, gynecology, and plastic surgery. The aim of this study was to evaluate the safety and usefulness of a new synthetic absorbable monofilament, Glycoside-epsilon-caprolactone-trimethylene carbonate interpolymer (GCT), in gastrointestinal anastomosis and closure. MATERIALS AND METHODS: We evaluated 55 gastrointestinal anastomoses and closures using GCT (MONOSYNR, B. Braun, Germany) in 47 patients who underwent gastric surgery between December 2001 and May 2002 at Seoul National University Hospital. Patient's characteristics, operative procedure, surgeon's opinion of handling properties of GCT, and suture-related complications were analyzed. RESULTS: There were 34 males and 13 females (M:F= 2.6:1) with an average age of 54.2 years old. Forty-five cases of gastrointestinal anastomosis (20 gastrojejunostomies and 25 jejunojejunostomies) and 10 cases of intestinal closure (7 gastrostomy closures and 3 duodenal stump closures) were performed in 41 cases of stomach cancer, three of peptic ulcer disease, two of GIST, and one MALToma. The handling properties of GCT according to the criteria of knot breaking load, knot security, and placing property were always scored with 7 to 9 points (10=excellent, 1=very poor). Two cases of postoperative complications (3.6%) were noted. One was a leak of the gastrojejunostomy site which was successfully managed conservatively, and the other was a stricture of the gastrojejunostomy site which was managed by reoperation (side-to-side jejunojejunostomy). CONCLUSION: GCT seems to be an applicable suture material for various gastrointestinal anastomoses and closures.
Absorption ; Carbon* ; Constriction, Pathologic ; Female ; Gastric Bypass ; Gastroenterology ; Gastrostomy ; Gynecology ; Humans ; Male ; Peptic Ulcer ; Postoperative Complications ; Reoperation ; Seoul ; Stomach Neoplasms ; Surgery, Plastic ; Surgical Procedures, Operative ; Sutures ; Urology

PURPOSE: We compared the safety of the double-stapling method with that of the hand-sewn method when performing a Billroth I anastomosis (BI) after a radical subtotal gastrectomy. METHODS: Fifty-three (53) patients who received a BI with stapler from February 1998 to April 1999 were compared with 24 patients who received a BI with the hand-sewn method from January 1996 to December 1998. All the patients were divided into three groups according to the type of reconstruction: Group 1 (n=42), double- stapling method, Group 2 (n=11), anastomosis through posterior gastric wall, and Group 3 (n=24), hand- sewn method. The length of the greater curvature, lesser curvature, and proximal margin and the number of resected lymph nodes were compared for radicality, and the incidence of complications was reviewed. ANOVA and the chi-square test were used for the statistical analysis. RESULTS: The mean ages were 55.2+/-10.8, 59.8+/-9.7, and 54.7+/-11.9 years for groups 1, 2, and 3, respectively. The sex ratios were 2.2:1, 1.2:1, and 1.4:1. The lengths (cm) of the greater curvature were 17.2+/-2.5, 18.4+/-2.5, and 18.6+/-3.3, and the lengths of the lesser curvature were 10.4+/-1.5, 10.9+/-1.6, and 10.7+/-2.1; however, the differences were not statistically significant (p>0.05). The lengths of the proximal resection margin were 5.4+/-2.5, 8.2+/-3.3, and 6.0+/-3.2 (p<0.05), and the numbers of resected lymph nodes were 25.3+/-8.3, 19.1+/-5.8, and 32.+/- 13.7 (p<0.01). We experienced no complication in any group, except one case of leakage in the hand-sewn group. CONCLUSION: The double-stapling technique is a safe operative method in BI after a radical subtotal gastrectomy with its very low complication rate. Especially, the so- called Tornado method is a more useful method since it doesn't need a gastrotomy in the remnant stomach.
Gastrectomy* ; Gastric Stump ; Gastroenterostomy* ; Humans ; Incidence ; Lymph Nodes ; Sex Ratio ; Stomach Neoplasms ; Tornadoes