Journal Detail Information

1

Cite

Share

Single port laparoscopic repair of sigmoid colon perforation during colonoscopy.

Jung Ho PARK ; Sang Woo LIM ; Sung Eun KIM ; Min Jung KIM ; Hyoung Chul PARK

Annals of Surgical Treatment and Research.2017;93(5):284-286. doi:10.4174/astr.2017.93.5.284

Colonic perforation during colonoscopy is a rare but lethal complication. Recently, it is usually managed with laparoscopic approach. Here we present our experience of single incision laparoscopic repair for sigmoid colon perforation during colonoscopy. A 57-year-old male patient presented with an acute sigmoid colon perforation event during diagnostic colonoscopy. Emergency operation was performed with transumbilical single incision laparoscopic exploration. The perforated site of sigmoid colon was primarily repaired with the curved endoscopic linear stapler. The patient was discharged after 5 days uneventfully. Single port laparoscopic repair is a safe and feasible method for the management of acute colonoscopic perforation during diagnostic colonoscopy.
Colon ; Colon, Sigmoid* ; Colonoscopy* ; Emergencies ; Humans ; Laparoscopy ; Male ; Methods ; Middle Aged

2

Cite

Share

Small bowel obstruction caused by cryptorchidism in an adult.

Chang Woo KIM ; Gyeong Eun MIN ; Suk Hwan LEE

Annals of Surgical Treatment and Research.2017;93(5):281-283. doi:10.4174/astr.2017.93.5.281

Small bowel obstruction (SBO) is a common complication after abdominal surgery, and can occur due to many reasons. However, cryptorchidism can cause SBO in patients with no history of abdominal surgery. We report the case of a 67-year-old man with SBO caused by adhesions between an undescended testis and the terminal ileum.
Adult* ; Aged ; Cryptorchidism* ; Humans ; Ileum ; Intestinal Obstruction ; Male

3

Cite

Share

Cutaneous metastasis: a rare phenomenon of colorectal cancer.

Dan Yang WANG ; Feng YE ; Jian Jiang LIN ; Xiao XU

Annals of Surgical Treatment and Research.2017;93(5):277-280. doi:10.4174/astr.2017.93.5.277

Cutaneous metastases from colorectal cancer are extremely rare and generally appear several years after diagnosis or resection of the primary tumor. Although this phenomenon is uncommon, it is very important and often indicates a poor prognosis. We present a case of a 76-year-old female patient with multiple cutaneous metastatic nodules on the back, just 1 month after resection of rectal cancer. Unfortunately, the patient gave up the follow-up treatment due to her age and poor physical condition; she died 3 months later. In view of its rarity of occurrence and lack of experience in treatment, we reviewed the literature and report as follows.
Aged ; Colorectal Neoplasms* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Neoplasm Metastasis* ; Prognosis ; Rectal Neoplasms

4

Cite

Share

Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker.

Haemin LEE ; Im Kyung KIM ; Man Ki JU

Annals of Surgical Treatment and Research.2017;93(5):272-276. doi:10.4174/astr.2017.93.5.272

PURPOSE: Predicting the need for surgical intervention among patients with intestinal obstruction is challenging. The delta neutrophil index (DNI) has been suggested as a useful marker of immature granulocytes, which indicate an infection or sepsis. In this study, we evaluated the impact of the DNI as an early predictor of operation among patients with intestinal obstruction. METHODS: A total of 171 patients who were diagnosed with postoperative intestinal obstruction were enrolled in this study. Medical records, including data for the initial CRP level, WBC count, and DNI were reviewed. Receiver operating characteristic (ROC) curves were generated to clarify the optimal DNI cutoff values for predicting an operation. RESULTS: Among the 171 patients, 38 (22.2%) needed surgical intervention. The areas under the initial CRP, WBC, and DNI ROC curves were 0.460, 0.449, and 0.543, respectively. The optimal cutoff value for predicting further surgical intervention according to the initial DNI level was 4.3%. The accuracy of the cutoff value was 74.9%, the sensitivity was 23.7%, and the specificity was 89.5% (positive predictive value, 23.7%; negative predictive value, 89.5%). In the multivariate analysis, initial DNI levels ≥ 4.3% were significantly associated with surgical intervention (odd ratio, 3.092; 95% confidence interval, 1.072–8.918; P = 0.037). CONCLUSION: The initial DNI level in patients with intestinal obstruction may be a useful predictor for determining the need for surgical intervention.
Granulocytes ; Humans ; Intestinal Obstruction* ; Medical Records ; Multivariate Analysis ; Neutrophils* ; ROC Curve ; Sensitivity and Specificity ; Sepsis

5

Cite

Share

Histopathologic risk factors for lymph node metastasis in patients with T1 colorectal cancer.

Ryun Kyong HA ; Kyung Su HAN ; Dae Kyung SOHN ; Byung Chang KIM ; Chang Won HONG ; Hee Jin CHANG ; Jong Hee HYUN ; Min Jung KIM ; Sung Chan PARK ; Jae Hwan OH

Annals of Surgical Treatment and Research.2017;93(5):266-271. doi:10.4174/astr.2017.93.5.266

PURPOSE: Evaluating the risk of lymph node metastasis (LNM) is critical for determining subsequent treatments following endoscopic resection of T1 colorectal cancer (CRC). This study analyzed histopathologic risk factors for LNM in patients with T1 CRC. METHODS: This study involved 745 patients with T1 CRC who underwent endoscopic (n = 97) or surgical (n = 648) resection between January 2001 and December 2015 at the National Cancer Center, Korea. LNM in endoscopically resected patients, which could not be evaluated directly, was estimated indirectly based on follow-up results and histopathologic reports of salvage surgery. The relationships of depth of submucosal invasion, histologic grade, budding, vascular invasion, and background adenoma with LNM were evaluated statistically. RESULTS: Of the 745 patients, 91 (12.2%) were found to be positive for LNM. Univariate and multivariate analyses identified deep submucosal invasion (P = 0.010), histologic high grade (P < 0.001), budding (P = 0.034), and vascular invasion (P < 0.001) as risk factors for LNM. Among the patients with one, two, three, and four risk factors, 6.0%, 18.7%, 36.4%, and 100%, respectively, were positive for LNM. CONCLUSION: Deep submucosal invasion, histologic high grade, budding, and vascular invasion are risk factors for LNM in patients with T1 colorectal cancer. If any of these risk factors are present, additional surgery following endoscopic resection should be determined after considering the potential risk of LNM and each patient's situation.
Adenoma ; Colonoscopy ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Korea ; Lymph Nodes* ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Metastasis* ; Risk Factors*

6

Cite

Share

Three-year result of efficacy for type 2 diabetes mellitus control between laparoscopic duodenojejunal bypass compared with laparoscopic Roux-en-Y gastric bypass.

Dong Jin KIM ; Kwang Yeol PAIK ; Mee Kyoung KIM ; Eungkook KIM ; Wook KIM

Annals of Surgical Treatment and Research.2017;93(5):260-265. doi:10.4174/astr.2017.93.5.260

PURPOSE: The mechanism by which bariatric surgery facilitates diabetic control is still unknown. Duodenojejunal bypass supports the foregut theory; however, its efficacy when used alone is not yet established. METHODS: During the period from January 2008 to December 2009, patients who underwent laparoscopic duodenojejunal bypass (LDJB) or laparoscopic Roux-en-Y gastric bypass (LRYGB) for type 2 diabetes mellitus (T2DM) with or without morbid obesity were included. Patients who had a follow-up for less than 3 years were excluded. Patient baseline characteristics, change of body weight, body mass index (BMI), glycosylated hemoglobin (HbA1c), and diabetic treatments were analyzed. RESULTS: In total, 8 LDJB and 20 LRYGB patients were analyzed. The LDJB group had more number of male patients than the LRYGB group (LDJB 75% vs. LRYGB 30%, P = 0.030). Baseline BMI in the LRYGB group was higher than in the LDJB group (LDJB 27.0 ± 2.5 vs. LRYGB 32.6 ± 3.4, P < 0.001). Age, DM duration, baseline HbA1c, and C-peptide levels were similar. Longer operation time was needed to perform LDJB (LDJB 367.5 ± 120.2 vs. LRYGB 232.9 ± 41.1, P < 0.001), but no differences were observed in the hospital stay and complication rate between the 2 groups. At the third year of follow-up, the T2DM remission rate was observed in 40% of patients in the LRYGB group and 12.5% of patients in the LDJB group. CONCLUSION: LDJB is not an effective method for controlling T2DM compared with LRYGB. Foregut theory may not be the main mechanism of diabetic control during bariatric surgery.
Bariatric Surgery ; Body Mass Index ; Body Weight ; C-Peptide ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Follow-Up Studies ; Gastric Bypass* ; Hemoglobin A, Glycosylated ; Humans ; Laparoscopy ; Length of Stay ; Male ; Methods ; Obesity, Morbid

7

Cite

Share

En bloc transplantation of horseshoe kidney in Korea.

Jun Bae BANG ; Jae Myeong LEE ; Chang Kwon OH ; Kyo Won LEE ; Jae Berm PARK ; Sung Joo KIM ; Su Hyung LEE

Annals of Surgical Treatment and Research.2017;92(3):168-172. doi:10.4174/astr.2017.92.3.168

Transplantation of the horseshoe kidney can be performed en bloc or split into 2 grafts according to the vascular anomaly and the existence of the urinary collecting system in isthmus. From 2011 to 2014, there were 3 horseshoe kidney transplantations in Korea and transplantations were performed at 2 different centers. The transplantations were carried out successfully for all recipients without complications. All recipients have shown good graft kidney function after transplantation. No severe complication was revealed during follow-up period. We described the surgical technique used in the en bloc method to overcome various vascular anomalies and difficulties in choosing cannulation site and postoperative complications. En bloc transplantation of a horseshoe kidney is a useful strategy for patients with end-stage renal disease, and can provide favorable outcomes compared to the transplantation of a normal kidney.
Catheterization ; Follow-Up Studies ; Fused Kidney* ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Korea* ; Methods ; Postoperative Complications ; Transplants

8

Cite

Share

Encapsulating peritoneal sclerosis in liver transplant recipients: a report of 2 cases.

Kyo Won LEE ; Chan Woo CHO ; Nuri LEE ; Sanghoon LEE ; Jong Man KIM ; Gyu Seong CHOI ; Choon Hyuck David KWON ; Jae Won JOH ; Suk Koo LEE

Annals of Surgical Treatment and Research.2017;92(3):164-167. doi:10.4174/astr.2017.92.3.164

Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction by a thick fibrous membrane wrapping around the small intestine. It is a possible complication after liver transplantation (LT) that can be fatal. This report describes 2 cases of EPS after LT that were successfully treated with surgery, corticosteroids, tamoxifen, and mammalian target of rapamycin inhibitor. After treatment in both cases, the patients were able to start oral feeding and have been symptom free for more than 1 year. These cases suggests that for the management of EPS, surgical treatment is mandatory when the patients present with symptoms of intestinal obstruction or if there are findings suggestive of decreased mural perfusion. Surgery should be accompanied with medical treatment to prevent the relapse of EPS.
Adrenal Cortex Hormones ; Humans ; Intestinal Obstruction ; Intestine, Small ; Liver Transplantation ; Liver* ; Membranes ; Perfusion ; Peritoneal Fibrosis* ; Recurrence ; Sirolimus ; Tamoxifen ; Transplant Recipients*

9

Cite

Share

Radiation hazards to vascular surgeon and scrub nurse in mobile fluoroscopy equipped hybrid vascular room.

Jong Bin KIM ; Jaehoon LEE ; Kihyuk PARK

Annals of Surgical Treatment and Research.2017;92(3):156-163. doi:10.4174/astr.2017.92.3.156

PURPOSE: The aim of the present study was to identify the radiation hazards to vascular surgeons and scrub nurses working in mobile fluoroscopy equipped hybrid vascular operation rooms; additionally, to estimate cumulative cancer risk due to certain exposure dosages. METHODS: The study was conducted prospectively in 71 patients (53 men and 18 women) who had undergone vascular intervention at our hybrid vascular theater for 6 months. OEC 9900 fluoroscopy was used as mobile C-arm. Exposure dose (ED) was measured by attaching optically stimulated luminescence at in and outside of the radiation protectors. To measure X-ray scatter with the anthropomorphic phantom model, the dose was measured at 3 distances (20, 50, 100 cm) and 3 angles (horizontal, upward 45°, downward 45°) using a personal gamma radiation dosimeter, Ecotest CARD DKG-21, for 1, 3, 5, 10 minutes. RESULTS: Lifetime attributable risk of cancer was estimated using the approach of the Biological Effects of Ionizing Radiation report VII. The 6-month ED of vascular surgeons and scrub nurses were 3.85, 1.31 mSv, respectively. The attenuation rate of lead apron, neck protector and goggle were 74.6%, 60.6%, and 70.1%, respectively. All cancer incidences among surgeons and scrub nurses correspond to 2,355 and 795 per 100,000 persons. The 10-minute dose at 100-cm distance was 0.004 mSv at horizontal, 0.009 mSv at downward 45°, 0.003 mSv at upward 45°. CONCLUSION: Although yearly radiation hazards for vascular surgeons and scrub nurses are still within safety guidelines, protection principles can never be too stringent when aiming to minimize the cumulative harmful effects.
Fluoroscopy* ; Gamma Rays ; Humans ; Incidence ; Luminescence ; Male ; Neck ; Prospective Studies ; Radiation, Ionizing ; Surgeons

10

Cite

Share

Laparoscopic resection of retroperitoneal benign neurilemmoma.

Jung Hwan JI ; Joon Seong PARK ; Chang Moo KANG ; Dong Sup YOON ; Woo Jung LEE

Annals of Surgical Treatment and Research.2017;92(3):149-155. doi:10.4174/astr.2017.92.3.149

PURPOSE: The aim of this study was to verify that laparoscopic resection for treating retroperitoneal benign neurilemmoma (NL) is expected to be favorable for complete resection of tumor with technical feasibility and safety. METHODS: We retrospectively analyzed 47 operations for retroperitoneal neurogenic tumor at Yonsei University College of Medicine, Severance Hospital and Gangnam Severance Hospital between January 2005 and September 2015. After excluding 21 patients, the remaining 26 were divided into 2 groups: those who underwent open surgery (OS) and those who underwent laparoscopic surgery (LS). We compared clinicopathological features between the 2 groups. RESULTS: There was no significant difference in operation time, estimated blood loss, transfusion, complication, recurrence, or follow-up period between 2 groups. Postoperative hospital stay was significantly shorter in the LS group versus the OS group (OS vs. LS, 7.00 ± 3.43 days vs. 4.50 ± 2.16 days; P = 0.031). CONCLUSION: We suggest that laparoscopic resection of retroperitoneal benign NL is feasible and safe by obtaining complete resection of the tumor. LS for treating retroperitoneal benign NL could be useful with appropriate laparoscopic technique and proper patient selection.
Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Neurilemmoma* ; Patient Selection ; Recurrence ; Retroperitoneal Neoplasms ; Retrospective Studies

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share