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ERRATUM: Correction of funding statement in ACKNOWLEDGEMENTS section. Effectiveness of thymoquinone, zeolite, and platelet-rich plasma in model of corrosive oesophagitis induced in rats.

Gökhan KARACA ; Oktay AYDIN ; Faruk PEHLIVANLI ; Canan ALTUNKAYA ; Hafize UZUN ; Osman GÜLER

Annals of Surgical Treatment and Research.2017;93(2):118-118. doi:10.4174/astr.2017.93.2.118

The funding statement in ACKNOWLEDGEMENTS section was misprinted unintentionally. The funding statement in ACKNOWLEDGEMENTS should be corrected as “This study was supported by the Kırıkkale University Scientific Research Projects Commission, Kırıkkale, Turkey (2014-69).”

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Grey Turner's and Cullen's signs induced by spontaneous hemorrhage of the abdominal wall after coughing.

Zhe FAN ; Yingyi ZHANG

Annals of Surgical Treatment and Research.2017;93(2):115-117. doi:10.4174/astr.2017.93.2.115

Grey Turner's and Cullen's signs are rare clinical signs, which most appear in patients with severe acute pancreatitis. The present patient complained of abdominal pain after coughing. However, contrast-enhanced CT revealed a hemorrhage of the abdominal wall. Therefore, spontaneous hemorrhage of the abdominal wall was diagnosed. The patient recovered through immobilization and hemostasis therapy. This case report and literature review aims to remind clinicians of manifestations and treatment of spontaneous hemorrhage.
Abdominal Pain ; Abdominal Wall* ; Cough* ; Hemorrhage* ; Hemostasis ; Humans ; Immobilization ; Pancreatitis ; Tomography, X-Ray Computed

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Gastric cancer in pregnancy: is laparoscopic gastrectomy with lymph node dissection feasible and safe?.

Amer Saeed ALSHAHRANI ; Moon Won YOO

Annals of Surgical Treatment and Research.2017;92(1):51-53. doi:10.4174/astr.2017.92.1.51

Gastric cancer with pregnancy is rare and usually presents in late and advanced stage. Standard interventions in diagnosing, staging and treatment of cancer may be harmful for the fetus. The treatment of cancer in pregnancy should not differ significantly from the treatment in nonpregnant women. There have been case reports of open gastrectomy for gastric cancer in pregnancy. We present a case of early gastric cancer in a 37-year-old pregnant woman treated with laparoscopic distal gastrectomy with lymph node dissection with no postoperative complications. Laparoscopic distal gastrectomy with lymph node dissection seems to be feasible and safe in pregnancy for a mother and a fetus.
Adult ; Female ; Fetus ; Gastrectomy* ; Humans ; Laparoscopy ; Lymph Node Excision* ; Lymph Nodes* ; Mothers ; Postoperative Complications ; Pregnancy* ; Pregnant Women ; Stomach Neoplasms*

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Cystic duct variation detected by near-infrared fluorescent cholangiography during laparoscopic cholecystectomy.

Nam Seok KIM ; Hyeong Yong JIN ; Eun Young KIM ; Tae Ho HONG

Annals of Surgical Treatment and Research.2017;92(1):47-50. doi:10.4174/astr.2017.92.1.47

Near-infrared fluorescent cholangiography (NIRFC) is an emerging technique for easy intraoperative recognition of biliary anatomy. We present a case of cystic duct variation detected by NIRFC which had a potential risk for biliary injury if not detected. A 32-year-old female was admitted to the Seoul St. Mary's Hospital for surgery for an incidental gallbladder polyp. We performed laparoscopic cholecystectomy with NIRFC. In fluorescence mode, a long cystic duct and an accessory short hepatic duct joining to the cystic duct were found and the operation was completed safely. The patient recovered successfully. NIRFC is expected to be a promising procedure that will help minimize biliary injury during laparoscopic cholecystectomy.
Adult ; Cholangiography* ; Cholecystectomy, Laparoscopic* ; Cystic Duct* ; Female ; Fluorescence ; Gallbladder ; Hepatic Duct, Common ; Humans ; Polyps ; Seoul

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Usefulness of intraopertive ultrasonography during directional atherectomy using SilverHawk/TurboHawk system.

Yoong Seok PARK ; Seon Hee HEO ; Dong Ho HYUN ; Young Soo DO ; Hong Suk PARK ; Kwang Bo PARK ; Young Wook KIM ; Yang Jin PARK ; Chul Hyung LEE ; Dong Ik KIM

Annals of Surgical Treatment and Research.2017;92(1):42-46. doi:10.4174/astr.2017.92.1.42

PURPOSE: Directional atherectomy (DA) was introduced for the management of infrainguinal arterial stenosis or occlusive lesions. The procedure success rate in the DEFINITIVE LE study was determined using radiologic imaging. The aim of our study was to determine the usefulness of intraoperative ultrasonography (USG) during DA for evaluating the early results of this procedure. METHODS: Patients who underwent DA from January to December 2014 were reviewed retrospectively. Twenty lesions from 14 patients with femoral artery stenosis (>70% stenosis) with short segment occlusive lesions (<2 cm in length) were treated. Among 20 lesions, 3 were treated with the TurboHawk system with a protective device due to lesion calcification. The percentage of stenosis during and after DA was determined with USG. RESULTS: Median follow-up was 5.1 months, and the procedural success rate (<30% stenosis at the end of the procedure) was 100% on angiography, but only 30% on intraoperative USG. On USG, median residual stenosis was 40% (range, 28%–42%) at the end of DA, 40% (range, 30%–55%) at 1 month, 55% (range, 35%–85%) at 6 months, and 64% (range, 60%–100%) at 1 year. There was one dissection, but no cases of perforation, pseudoaneurysm, or thrombosis. Primary patency, which was defined as a peak systolic velocity ratio ≤3.5 with no reintervention at 6 months, was found in 18 lesions (90%), and 11 of 14 patients (78.6%) were free of ischemic symptoms such as claudication at 6 months. CONCLUSION: Our results demonstrated that DA with intraoperative USG is an effective treatment option for short segment occlusive lesions of the femoral artery.
Aneurysm, False ; Angiography ; Atherectomy* ; Constriction, Pathologic ; Femoral Artery ; Follow-Up Studies ; Humans ; Protective Devices ; Retrospective Studies ; Thrombosis ; Ultrasonography*

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Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer.

Mustafa HAKSAL ; Nuri OKKABAZ ; Ali Emre ATICI ; Osman CIVIL ; Yasar OZDENKAYA ; Ayhan ERDEMIR ; Nihat AKSAKAL ; Mustafa ONCEL

Annals of Surgical Treatment and Research.2017;92(1):35-41. doi:10.4174/astr.2017.92.1.35

PURPOSE: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. METHODS: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. RESULTS: Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). CONCLUSION: Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.
Anastomotic Leak ; Constriction, Pathologic ; Hospitalization ; Humans ; Ileostomy* ; Laparoscopy ; Length of Stay ; Male ; Multivariate Analysis ; Rectal Neoplasms* ; Reoperation ; Risk Factors ; Surgical Wound Infection ; Survival Rate

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Intracorporeal esophagojejunostomy using hemi-double-stapling technique after laparoscopic total gastrectomy in gastric cancer patients.

Bandar ALI ; Cho Hyun PARK ; Kyo Young SONG

Annals of Surgical Treatment and Research.2017;92(1):30-34. doi:10.4174/astr.2017.92.1.30

PURPOSE: To present the feasibility and safety of Roux-en-Y esophagojejunostomy using hemi-double-stapling technique after laparoscopic total gastrectomy. METHODS: We reviewed the outcomes from 58 consecutive patients with gastric cancer who underwent laparoscopic total gastrectomy. The clinicopathological characteristics including postoperative complications were examined. RESULTS: The mean age and body mass index were 57.3 ± 9.7 years and 23.7 ± 2.6 kg/m², respectively. The mean overall total operation was 199.8 ± 57.0 minutes. Intraoperative blood loss was 81.6 ± 56.3 mL and there was no open conversion. The patients' hospital stay was a mean 9.6 ± 2 days. The mean proximal margin of the specimens was 2.7 ± 1.8 cm. There were 3 cases (5.1%) of anastomosis leakage, but all were controlled successfully by endoscopic stent. CONCLUSION: The circular HDST technique is simple and reliable without any significant demerits with respect to safety concerns or difficulty of operation.
Body Mass Index ; Gastrectomy* ; Humans ; Length of Stay ; Postoperative Complications ; Stents ; Stomach Neoplasms*

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Is noncurative gastrectomy always a beneficial strategy for stage IV gastric cancer?.

Chang Min LEE ; In Keun CHOI ; Jong Han KIM ; Da Won PARK ; Jun Suk KIM ; Seong Heum PARK

Annals of Surgical Treatment and Research.2017;92(1):23-27. doi:10.4174/astr.2017.92.1.23

PURPOSE: The purpose of this study is to suggest a treatment strategy for stage IV gastric cancer by investigating the behavioral difference between initially and recurrent metastatic disease. METHODS: We reviewed the medical records of the patients who underwent chemotherapy alone for metastatic gastric cancer between January 2006 and September 2013. Patients were divided into those who underwent chemotherapy for metastatic disease since initial diagnosis (IM group) and for metastatic recurrence after curative surgery (RM group). Survival and causes of death were compared between the 2 groups, and significant prognostic factors were also investigated. RESULTS: A total of 170 patients were enrolled in this study. Of these patients, 104 were included in the IM group and 66 in the RM group. Overall survival of the IM group did not differ from that of RM (P = 0.569). In the comparison of the causes of death, the IM group had a greater tendency to die from bleeding (P = 0.054) and pneumonia (P = 0.055). In multivariate analysis, bone metastasis (P < 0.001; HR = 2.847), carcinoma peritonei (P = 0.047; HR = 1.766), and the frequency of chemotherapy (P < 0.001; HR = 0.777) were significantly associated with overall survival of IM group. CONCLUSION: Disease-burden mainly contributes to the prognosis of metastatic gastric cancer, although noncurative gastrectomy may be helpful in reducing the mortality of initially metastatic disease. Therefore, disease-burden should be also prioritized in determining the treatment strategies for stage IV gastric cancer.
Cause of Death ; Diagnosis ; Drug Therapy ; Gastrectomy* ; Hemorrhage ; Humans ; Medical Records ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Pneumonia ; Prognosis ; Recurrence ; Stomach Neoplasms*

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Clinical implications of APEX1 and Jagged1 as chemoresistance factors in biliary tract cancer.

Hong Beum KIM ; Won Jin CHO ; Nam Gyu CHOI ; Sung Soo KIM ; Jun Hee PARK ; Hee Jeong LEE ; Sang Gon PARK

Annals of Surgical Treatment and Research.2017;92(1):15-22. doi:10.4174/astr.2017.92.1.15

PURPOSE: Biliary cancer is a highly malignant neoplasm with poor prognosis and most patients need to undergo palliative chemotherapy, however major clinical problem associated with the use of chemotherapy is chemoresistance. So far, we aimed at investigating clinical implications of apurinic/apyrimidinic endodeoxyribonuclease 1 (APEX1) and Jagged1 as chemoresistance factors in biliary tract cancer. METHODS: We used 5 human biliary tract cancer cell lines (SNU-245, SNU-308, SNU-478, SNU-1079, and SNU-1196), and investigated the chemosensitivity of APEX1 and Jagged1 through 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and Western blot. Alternately, the 10 patients of advanced biliary cancer consist of 2 group according to the chemotherapy response examined by immunohistochemistry using APEX1 and Jagged1 antibody, and protein expression level was scored for staining intensity and percent positive cell. RESULTS: The result of MTT assay after APEX1 knockdown showed that strong coexpression of APEX1 and Jagged1 cell line (SNU-245, SNU-1079, and SNU-1196) showed a greater decrease in IC₅₀ of chemotherapeutic agent (5-fluorouracil, gemcitabine and cisplatin). The Western blot analysis of APEX1 and Jagged1 expression in biliary cancer cell lines after APEX1 knockdown definitively demonstrated decreased Jagged1 expression. The APEX1 and Jagged1expression level of immunohistochemistry represented that chemorefractory patients had higher than chemoresponsive patients. CONCLUSION: These results demonstrate that simultaneous high expression of APEX1 and Jagged1 is associated with chemoresistance in biliary cancer and suggest that is a potential therapeutic target for chemoresistance in advanced biliary cancer.
Biliary Tract Neoplasms* ; Biliary Tract* ; Blotting, Western ; Cell Line ; Cisplatin ; Drug Therapy ; Fluorouracil ; Humans ; Immunohistochemistry ; Prognosis

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A comparison of postoperative pain after conventional open thyroidectomy and single-incision, gasless, endoscopic transaxillary thyroidectomy: a single institute prospective study.

Jung Bong KANG ; Eun Young KIM ; Yong Lai PARK ; Chan Heun PARK ; Ji Sup YUN

Annals of Surgical Treatment and Research.2017;92(1):9-14. doi:10.4174/astr.2017.92.1.9

PURPOSE: The aim of this study was to compare postoperative pain between single-incision, gasless, endoscopic transaxillary thyroidectomy (SET), and conventional open thyroidectomy. METHODS: From March to December 2015, patients with thyroid disease underwent total thyroidectomy or lobectomy. Patient's clinical and pathological characteristics, postoperative pain score using visual analog scale (VAS) were compared between the 2 groups. The primary endpoint was postoperative pain evaluated by VAS score and postoperative analgesic use. Operation time and length of postoperative hospital stay were secondary outcome measures. RESULTS: Conventional, open cervical surgery was performed on 30 patients (group O) and SET was performed on 27 patients (group E). Pain scores in shoulder area, which is the ipsilateral side of the tumor location at 1 hour and 24 hours after surgery, were higher in group E patients (P < 0.05). Pain scores 7 days after surgery did not differ between the 2 groups according to the locations (P < 0.05). CONCLUSION: In conclusion, endocrine surgeons should be concerned about immediate higher postoperative pain scores in patients who undergo SET.
Humans ; Length of Stay ; Outcome Assessment (Health Care) ; Pain, Postoperative* ; Prospective Studies* ; Shoulder ; Surgeons ; Thyroid Diseases ; Thyroid Neoplasms ; Thyroidectomy* ; Visual Analog Scale

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