Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Purpose: The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH. Methods: A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups. Results: The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867). Conclusion The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Background and Objectives: Ultimaster™, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of Ultimaster™ stents in Korean patients with coronary artery disease. Methods: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. Results: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS).At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. Conclusions The present registry shows that Ultimaster™ stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Purpose: For the treatment of locally advanced rectal cancer (LARC), research on primary lesions with mesorectal fascia (MRF) involvement is lacking. This study analyzed the clinical outcomes and efficacy of dose-escalated neoadjuvant concurrent chemoradiotherapy (NCRT) to patients with LARC involving MRF. Materials and Methods: We retrospectively reviewed 301 patients who were diagnosed with LARC involving MRF and underwent NCRT followed by total mesorectal excision (TME). Patients who received radiotherapy (RT) doses of ≤50.4 Gy were defined as the non-boost group, while ≥54.0 Gy as the boost group. Pathological tumor response and survival outcomes, including intrapelvic recurrence-free survival (IPRFS), distant metastases-free survival (DMFS) and overall survival (OS), were analyzed. Results: A total of 269 patients (89.4%) achieved a negative pathological circumferential resection margin and 104 (34.6%) had good pathological tumor regression grades. With a median follow-up of 32.4 months, IPRFS, DMFS, and OS rates at 5-years were 88.6%, 78.0%, and 91.2%, respectively. In the subgroup analysis by RT dose, the boost group included more advanced clinical stages of patients. For the non-boost group and boost group, 5-year IPRFS rates were 90.3% and 87.0% (p = 0.242), 5-year DMFS rates were 82.0% and 71.3% (p = 0.105), and 5-year OS rates were 93.0% and 80.6% (p = 0.439), respectively. Treatment related toxicity was comparable between the two groups (p = 0.211). Conclusion Although this retrospective study failed to confirm the efficacy of dose-escalated NCRT, favorable IPRFS and pathological complete response was achieved with NCRT followed by TME. Further studies combining patient customized RT dose with systemic therapies are needed.

Purpose: This study was performed to examine the ultrasonography (US) features of normal parathyroid glands (PTGs) that were identified on preoperative US and subsequently confirmed during thyroid surgery. Methods: This retrospective study included a consecutive sample of 161 patients (mean±standard deviation age, 56±14 years; 128 women) with 294 normal PTGs identified on preoperative US PTG mapping and confirmed during thyroidectomy. A presumed normal PTG on US was defined as a small, round to oval, hyperechoic structure in the central neck. These presumed normal PTGs, as identified on preoperative US, were mapped onto thyroid computed tomography images and diagrams of the thyroid gland and neck. During the preoperative real-time US examinations, the location, size, shape, echogenicity, echotexture, and intraglandular vascular flow of the identified presumed PTGs were assessed. These characteristics were compared between superior and inferior PTGs using the generalized estimating equation method. Results: The typical US features of homogeneous hyperechogenicity without intraglandular vascular flow were observed in 267 (90.8%) normal PTGs, while atypical features, including isoechogenicity (1.0%), heterogeneous echotexture with focal hypoechogenicity (5.8%), and intraglandular vascular flow (3.7%), were noted in 27 (9.2%). Inferior PTGs were more frequently identified in posterolateral (36.1% vs. 5.3%) and thyroid pole locations (29.9% vs. 5.3%), and less frequently in posteromedial locations (29.2% vs. 88.0%), compared to superior PTGs (P<0.001 for each comparison). Conclusion Most normal PTGs displayed the typical US features of homogeneous hyperechogenicity without intraglandular vascular flow. However, in rare cases, normal PTGs exhibited atypical features, including isoechogenicity, heterogeneous echotexture with focal hypoechogenicity, and intraglandular vascular flow.

Purpose: This study was performed to examine the ultrasonography (US) features of normal parathyroid glands (PTGs) that were identified on preoperative US and subsequently confirmed during thyroid surgery. Methods: This retrospective study included a consecutive sample of 161 patients (mean±standard deviation age, 56±14 years; 128 women) with 294 normal PTGs identified on preoperative US PTG mapping and confirmed during thyroidectomy. A presumed normal PTG on US was defined as a small, round to oval, hyperechoic structure in the central neck. These presumed normal PTGs, as identified on preoperative US, were mapped onto thyroid computed tomography images and diagrams of the thyroid gland and neck. During the preoperative real-time US examinations, the location, size, shape, echogenicity, echotexture, and intraglandular vascular flow of the identified presumed PTGs were assessed. These characteristics were compared between superior and inferior PTGs using the generalized estimating equation method. Results: The typical US features of homogeneous hyperechogenicity without intraglandular vascular flow were observed in 267 (90.8%) normal PTGs, while atypical features, including isoechogenicity (1.0%), heterogeneous echotexture with focal hypoechogenicity (5.8%), and intraglandular vascular flow (3.7%), were noted in 27 (9.2%). Inferior PTGs were more frequently identified in posterolateral (36.1% vs. 5.3%) and thyroid pole locations (29.9% vs. 5.3%), and less frequently in posteromedial locations (29.2% vs. 88.0%), compared to superior PTGs (P<0.001 for each comparison). Conclusion Most normal PTGs displayed the typical US features of homogeneous hyperechogenicity without intraglandular vascular flow. However, in rare cases, normal PTGs exhibited atypical features, including isoechogenicity, heterogeneous echotexture with focal hypoechogenicity, and intraglandular vascular flow.

Purpose: This study was performed to examine the ultrasonography (US) features of normal parathyroid glands (PTGs) that were identified on preoperative US and subsequently confirmed during thyroid surgery. Methods: This retrospective study included a consecutive sample of 161 patients (mean±standard deviation age, 56±14 years; 128 women) with 294 normal PTGs identified on preoperative US PTG mapping and confirmed during thyroidectomy. A presumed normal PTG on US was defined as a small, round to oval, hyperechoic structure in the central neck. These presumed normal PTGs, as identified on preoperative US, were mapped onto thyroid computed tomography images and diagrams of the thyroid gland and neck. During the preoperative real-time US examinations, the location, size, shape, echogenicity, echotexture, and intraglandular vascular flow of the identified presumed PTGs were assessed. These characteristics were compared between superior and inferior PTGs using the generalized estimating equation method. Results: The typical US features of homogeneous hyperechogenicity without intraglandular vascular flow were observed in 267 (90.8%) normal PTGs, while atypical features, including isoechogenicity (1.0%), heterogeneous echotexture with focal hypoechogenicity (5.8%), and intraglandular vascular flow (3.7%), were noted in 27 (9.2%). Inferior PTGs were more frequently identified in posterolateral (36.1% vs. 5.3%) and thyroid pole locations (29.9% vs. 5.3%), and less frequently in posteromedial locations (29.2% vs. 88.0%), compared to superior PTGs (P<0.001 for each comparison). Conclusion Most normal PTGs displayed the typical US features of homogeneous hyperechogenicity without intraglandular vascular flow. However, in rare cases, normal PTGs exhibited atypical features, including isoechogenicity, heterogeneous echotexture with focal hypoechogenicity, and intraglandular vascular flow.