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Does this baby have a tail?: a case of congenital isolated perineal lipoma presenting as human pseudo-tail.

Soo Hong KIM ; Yong Hoon CHO ; Hae Young KIM

Annals of Surgical Treatment and Research.2016;90(1):53-55. doi:10.4174/astr.2016.90.1.53

A pseudo-tail is defined as a tail-like lesion in the lumbosacrococcygeal region that is not a true tail but one caused by disease. Perineal lipoma is one of the conditions that may present as a pseudo-tail. Congenital perineal lipoma is a rare disease and in particular, isolated congenital perineal lipoma without other anomalies is extremely rare. Here we report a case of congenital isolated perineal lipoma presenting as a pseudo-tail and also include a literature review of the condition.
Humans* ; Infant ; Lipoma* ; Rare Diseases ; Tail*

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Currarino triad with Mullerian duct anomaly in mother and daughter without MNX1 gene mutation.

Soo Hong KIM ; Se Hyun PAEK ; Hyun Young KIM ; Sung Eun JUNG ; Kwi Won PARK

Annals of Surgical Treatment and Research.2016;90(1):49-52. doi:10.4174/astr.2016.90.1.49

The Currarino triad is a unique complex of congenital caudal anomalies, including anorectal malformation, sacral bony defect and presacral mass. This triad may be associated with Mullerian duct anomalies, such as duplication of the vagina and uterus. Each of these diseases has a familial tendency and sometimes coexist within families. But, when coexisting in familial cases, nearly all reported cases revealed mutations of the motor neuron and pancreas homeobox 1 (MNX1) gene. Familial cases of Currarino triad combined with Mullerian duct anomaly without MNX1 gene mutation are very rare. Here we report cases of mother and daughter, who had Currarino triad and Mullerian duct anomaly without MNX1 gene mutation, along with a brief literature review.
Genes, Homeobox ; Humans ; Mothers* ; Motor Neurons ; Mullerian Ducts ; Nuclear Family* ; Pancreas ; Uterus ; Vagina

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Reliability and validity of Korean version of modified: Yale preoperative anxiety scale.

Kyuwhan JUNG ; Mi Hyang IM ; Jeong Min HWANG ; Ah Young OH ; Moon Seok PARK ; Woo Jin JEONG ; Seong Chan KIM ; Sun Woo JUNG ; Hyejin SOHN ; Mi Ok YOON ; Mi Suk JANG ; Suk Bae MOON

Annals of Surgical Treatment and Research.2016;90(1):43-48. doi:10.4174/astr.2016.90.1.43

PURPOSE: The modified Yale Preoperative Anxiety Scale (mYPAS) was developed for evaluating the level of preoperative anxiety in children. The purpose of this study was to develop a Korean version of the mYPAS (K-mYPAS) and to establish its validity and reliability based on the Korean preoperative pediatric patients. METHODS: K-mYPAS was made through stringent back-translation procedure. Total enrolled 102 patients answered questionnaires of Korean version of State-Trait Anxiety Inventory for Children (K-STAIC), and were videotaped for 2 to 5 minutes before induction of anesthesia. Three observers of experienced psychiatrist, surgeon, and nurse analyzed videotape with K-mYPAS comparing to K-STAIC. The inter- and intraobservers reliability, concurrent and construct validity, sensitivity, specificity, and predictive value were analyzed. RESULTS: The value of Cronbach alpha for interobservers reliability was 0.939 and intraobserver reliability was statistically significant (P < 0.001). Concurrent and construct validity were also statistically significant (P < 0.001 and P < 0.001, respectively). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 81.3%, 91.4%, 81.3%, 91.4%, and 88.2%, respectively. CONCLUSION: The K-mYPAS had good psychometric properties and can be used as a reliable and valid instrument for the assessment of preoperative anxiety in children.
Anesthesia ; Anxiety* ; Child ; Humans ; Psychiatry ; Psychometrics ; Reproducibility of Results* ; Sensitivity and Specificity ; Videotape Recording

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Outcomes for patients with HCV after liver transplantation in Korea: a multicenter study.

Jong Man KIM ; Kwang Woong LEE ; Gi Won SONG ; Bo Hyun JUNG ; Hae Won LEE ; Nam Joon YI ; Choon Hyuck David KWON ; Shin HWANG ; Kyung Suk SUH ; Jae Won JOH ; Suk Koo LEE ; Sung Gyu LEE

Annals of Surgical Treatment and Research.2016;90(1):36-42. doi:10.4174/astr.2016.90.1.36

PURPOSE: HCV-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT. RESULTS: The 1-, 3-, and 5-year overall survival rates were 78.8%, 75.3%, and 73.1%, respectively. Excluding the cases of hospital mortality (n = 23), 169 patients were evaluated for patient survival. Most patients were genotype 1 (n = 111, 65.7%) or genotype 2 (n = 42, 24.9%). The proportion of living donors for LT (n = 135, 79.9%) was higher than that of deceased donors (deceased donor liver transplantation [DDLT], n = 34, 20.1%). The median donor and recipient ages were 32 years and 56 years, respectively. Twenty-eight patients (16.6%) died during the observation period. Seventy-five patients underwent universal prophylaxis and 15 received preemptive therapy. HCV recurrence was detected in 97 patients. Recipients who were older than 60, received DDLT, used cyclosporine, or suffered acute rejection had lower rates of survival. CONCLUSION: Patent survival rates of HCV patients after LT in Korea were comparable with other countries.
Cyclosporine ; Genotype ; Hepacivirus ; Hospital Mortality ; Humans ; Immunosuppression ; Korea* ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Recurrence ; Retrospective Studies ; Survival Rate ; Tacrolimus ; Tissue Donors

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Laparoscopic para-aortic lymph node dissection for patients with primary colorectal cancer and clinically suspected para-aortic lymph nodes.

Sung Ho SONG ; Soo Yeun PARK ; Jun Seok PARK ; Hye Jin KIM ; Chun Seok YANG ; Gyu Seog CHOI

Annals of Surgical Treatment and Research.2016;90(1):29-35. doi:10.4174/astr.2016.90.1.29

PURPOSE: Treatment of patients with para-aortic lymph node metastasis from colorectal cancer is controversial. The goal of this study was to investigate the technical feasibility of laparoscopic intrarenal para-aortic lymph node dissection in patients with colorectal cancer and clinically suspected para-aortic lymph node dissection. METHODS: The inclusion criteria for the laparoscopic approach were patients with infrarenal para-aortic lymph node metastasis from colorectal cancer. Patients who had any other distant metastatic lesion or metachronous para-aortic lymph node metastasis were excluded from this study. Perioperative outcomes and survival outcomes were analyzed. RESULTS: Between November 2004 and October 2013, 40 patients underwent laparoscopic para-aortic lymph node dissection. The mean operating time was 192.3 +/- 68.8 minutes (range, 100-400 minutes) and the mean estimated blood loss was 65.6 +/- 52.6 mL (range, 20-210 mL). No patient required open conversion. The postoperative complication rate was 15.0%. Sixteen patients (40.0%) had pathologically positive lymph nodes. In patients with metastatic para-aortic lymph nodes, the 3-year overall survival rate and disease-free survival rate were 65.7% and 40.2%, respectively. CONCLUSION: The results of our study suggest that a laparoscopic approach for patients with colorectal cancer with metastatic para-aortic lymph nodes can be a reasonable option for selected patients.
Colorectal Neoplasms* ; Disease-Free Survival ; Humans ; Laparoscopy ; Lymph Node Excision* ; Lymph Nodes* ; Neoplasm Metastasis ; Postoperative Complications ; Survival Rate

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Impact of postoperative complications on clinical and economic consequences in pancreatic surgery.

Filip CECKA ; Bohumil JON ; Eva CERMAKOVA ; Zdenek SUBRT ; Alexander FERKO

Annals of Surgical Treatment and Research.2016;90(1):21-28. doi:10.4174/astr.2016.90.1.21

PURPOSE: Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs. METHODS: In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed. RESULTS: The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists > or = 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs. CONCLUSION: Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.
Delivery of Health Care ; Health Care Costs ; Hospital Costs ; Hospital Mortality ; Humans ; Length of Stay ; Mortality ; Multivariate Analysis ; Pancreatectomy ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Postoperative Complications* ; Risk Factors

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Stereotactic vacuum-assisted breast biopsy under lateral decubitus position.

Sang Hyup LEE ; Youn Joo JUNG ; Hyuk Jae JUNG ; Jee Yeon KIM ; Ki Seok CHOO ; Kyung Jin NAM ; Hyun Yul KIM

Annals of Surgical Treatment and Research.2016;90(1):16-20. doi:10.4174/astr.2016.90.1.16

PURPOSE: Stereotactic vacuum-assisted breast biopsy (VAB) has been established as a standard method for histological diagnosis of microcalcification or nonpalpable breast lesions on mammography. Generally, the procedure has been done under the prone position or upright sitting position. We herein attempt to evaluate clinical utility of Stereotactic VAB under lateral decubitus position. METHODS: One hundred six women (mean age, 51.2 years) with mammographically detected microcalcification underwent lateral decubitus positioning VAB using the 8G probe. In all cases, we obtained mammography specimens for identification of microcalcification and postprocedure mammography. We reviewed mean procedure time, pieces of specimen, pathology and follow-up mammography. RESULTS: The procedure took approximately 20 minutes (range, 15-24 minutes). Average number of obtained specimens was 8.5 pieces (range, 6-12 pieces). Microcalcifications were confirmed in both specimen mammography and microscopic slides. Of 106 cases, 10 cases were diagnosed as ductal carcinoma in situ. Additional surgical management was performed. Atypical ductal hyperplasias were found in 8 cases, and fibrocystic changes in 88 cases. CONCLUSION: Stereotactic VAB using the 8G probe under lateral decubitus position does not need a dedicated table, and is easier to maintain the position. Also, this procedure is accurate and safe. Thus, stereotactic VAB using the 8G probe under lateral decubitus position will be a useful method for diagnosis of microcalcification or nonpalpable breast lesions on mammography.
Biopsy* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Mammography ; Pathology ; Prone Position ; Stereotaxic Techniques

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Transanal gauze packing to manage massive presacral bleeding secondary to prescral abscess caused by rectal anastomotic leakage: a novel approach.

Byung Eun YOO ; Dong Won LEE ; Seung Won LEE ; Jung Myun KWAK ; Jin KIM ; Seon Hahn KIM

Annals of Surgical Treatment and Research.2015;88(4):236-239. doi:10.4174/astr.2015.88.4.236

Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis. To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature. We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.
Abscess* ; Anastomotic Leak* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Peritonitis

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Experience of direct percutaneous sac injection in type II endoleak using cone beam computed tomography.

Yoong Seok PARK ; Young Soo DO ; Hong Suk PARK ; Kwang Bo PARK ; Dong Ik KIM

Annals of Surgical Treatment and Research.2015;88(4):232-235. doi:10.4174/astr.2015.88.4.232

Cone beam CT, usually used in dental area, could easily obtain 3-dimensional images using cone beam shaped ionized radiation. Cone beam CT is very useful for direct percutaneous sac injection (DPSI) which needs very precise measurement to avoid puncture of inferior vena cava or vessel around sac or stent graft. Here we describe two cases of DPSI using cone beam CT. In case 1, a 79-year-old male had widening of preexisted type II endoleak after endovascular aneurysm repair (EVAR). However, transarterial embolization failed due to tortuous collateral branches of lumbar arteries. In case 2, a 72-year-old female had symptomatic sac enlargement by type II endoleak after EVAR. However, there was no route to approach the lumbar arteries. Therefore, we performed DPSI assisted by cone beam CT in cases 1, 2. Six-month CT follow-up revealed no sign of sac enlargement by type II endoleak.
Aged ; Aneurysm ; Arteries ; Blood Vessel Prosthesis ; Cone-Beam Computed Tomography* ; Embolization, Therapeutic ; Endoleak* ; Endovascular Procedures ; Female ; Follow-Up Studies ; Humans ; Male ; Punctures ; Vena Cava, Inferior

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Double common bile duct with an ectopic drainage into the stomach.

Jeong Ik PARK ; Sang Hoon OH

Annals of Surgical Treatment and Research.2015;88(4):229-231. doi:10.4174/astr.2015.88.4.229

Double common bile duct (DCBD) is a rare congenital anomaly among biliary anomalies. The anomaly has an important clinical implication because of its association with anomalous pancreaticobiliary ductal union (APBDU) and upper gastrointestinal cancers. In addition, if one of the two common bile ducts is mistaken for the cystic duct during surgery, bile duct injury is likely to occur. Treatment depends on the coexistence of concomitant cancer and APBDU. A 54-year-old male diagnosed of gastric cancer was referred for surgery. During surgery, we incidentally detected bile leak from the tubular structure around the hepatoduodenal ligament. We performed intraoperative cholangiogram by cannulizing into the tubular structure, and confirmed the tubular duct as the accessory bile duct with an ectopic drainage into the stomach, which was connected to the proximal common bile duct. In this study, we report a rare case of DCBD with an ectopic drainage into the stomach and review the literature.
Bile ; Bile Ducts ; Common Bile Duct* ; Cystic Duct ; Drainage* ; Gallstones ; Gastrointestinal Neoplasms ; Humans ; Ligaments ; Male ; Middle Aged ; Stomach Neoplasms ; Stomach*

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