Purpose: This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer. Methods: This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars. Results: No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient. Conclusion The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.

The Korean Enhanced Recovery After Surgery (ERAS) Committee within the Korean Society of Surgical Metabolism and Nutrition was established to develop ERAS guidelines tailored to the Korean context. This guideline focuses on creating the most current evidence-based practice guidelines for ERAS purposes, based on systematic reviews. All key questions targeted randomized controlled trials exclusively, and if fewer than 2 were available, studies employing propensity score matching were also included. Recommendations for each key question were marked with strength of recommendation and level of evidence following internal and external review processes by the committee.

Background: s/Aims: Liver transplantation (LT) is now a critical, life-saving treatment for patients with liver cirrhosis or hepatocellular carcinoma. Despite its significant benefits, biliary complications (BCs) continue to be a major cause of postoperative morbidity.This study evaluates the fluorescence intensity (FI) of the common bile duct (CBD) utilizing near-infrared indocyanine green (ICG) imaging, and examines its association with the incidence of BCs within three months post-LT. Methods: This investigation analyzed data from nine living donor LT (LDLT) recipients who were administered 0.05 mg/kg of ICG prior to bile duct anastomosis. Real-time perfusion of the CBD was recorded for three minutes using an ICG camera, and FI was quantified using Image J (National Institutes of Health). Key parameters assessed included F max, F1/2 max, T1/2 max, and the slope (F max/ T max) to evaluate the fluorescence response. Results: BCs occurred in two out of nine patients. These two patients exhibited the longest T1/2 max values, which were linked with lower slope values, implicating a potential relationship between extended T1/2 max, reduced slope, and the occurrence of postoperative BCs. Conclusions The study indicates that ICG fluorescence imaging may serve as an effective tool for assessing bile duct perfusion in LDLT patients. While the data suggest that an extended T1/2 max and lower slope may correlate with an increased risk of BCs, further validation through larger studies is required to confirm the predictive value of ICG fluorescence imaging in this setting.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic brought stringent social distancing measures, resulting in changes to daily routines such as increased time at home, remote learning, altered meal schedules, and reduced physical activity. Therefore, we aimed to investigate the impact of the COVID-19 lockdown on glycemic control among pediatric patients with type 1 diabetes. Methods: This study retrospectively analyzed the medical records of 47 pediatric patients with type 1 diabetes who visited Ajou University Hospital before and after the lockdown. To analyze the effects of the lockdown on glycemic control, we examined the change in glycated hemoglobin (HbA1c) levels before and after the lockdown. Results: Among 47 patients, 23 (49%) were female and the average age before the lockdown as of March 2020 was 11.65±3.03 years. The mean HbA1c levels were 8.22%±1.69% and 7.86%±1.57% before and after the lockdown, respectively, showing better glycemic control during the lockdown (P=0.001). The decrease in HbA1c was more significant in subjects with higher pre-lockdown HbA1c levels, older patients, and individuals not using continuous glucose monitoring or continuous subcutaneous insulin infusion. However, from a long-term perspective, HbA1c levels at 3 years and 1 year before and after the lockdown were not significantly different. Conclusion This study demonstrated the beneficial effect of intensive social distancing for COVID-19 on blood glucose control in pediatric patients with type 1 diabetes mellitus. Furthermore, changes due to the lockdown had a more pronounced effect on patients with existing poor glycemic control.

Purpose: The results of the TAILORx trial have shown that premenopausal patients with intermediate Oncotype Dx (ODx) recurrence score of 16–25 may benefit from adjuvant chemotherapy. In addition, the clinicopathological features showed the information complementary to ODx results. However, the characteristics may vary depending on menopausal status even in the same score. This study aimed to analyze the differences in the clinical characteristics by menopausal status. Methods: This study conducted a retrospective analysis of 756 patients with estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and node-negative breast cancer who underwent the ODx test from July 2013 to December 2020 at the Severance Hospital. Results: Of the 756 patients, 261 patients were postmenopausal, and 495 were premenopausal. The premenopausal patients with a midrange ODx had similar clinicopathological features as compared to those with a high ODx. Conversely, the postmenopausal patients with a midrange ODx did not show significantly different clinicopathological features from those with a low ODx, whereas a difference was seen as compared to those with a high ODx. Conclusion In this study, unlike the postmenopausal patients, some of the clinicopathological characteristics of the premenopausal patients with a midrange ODx were closer to those with a high ODx than those with a low ODx. In the premenopausal patients with a midrange ODx, considering the baseline characteristic itself, there was a significant difference between those with a low ODx when compared with postmenopausal patients. Therefore, more aggressive treatment decisions may be helpful in premenopausal patients with a midrange ODx.

Purpose: Determining the extent of radical lymphadenectomy at clinical early stage is challenging. We aimed to investigate the appropriate extent of lymphadenectomy in clinical early-stage right colon cancer. Methods: Patients with clinical stage 0 or I right colon cancer who underwent curative surgery from January 2007 to December 2021 were included in this retrospective study. The extent of lymph node (LN) metastases based on the distribution of LN metastases (LND: LND1 pericolic nodes, LND2 intermediate nodes, LND3 apical nodes), along with the depth of submucosal (SM) invasion (classed into SM1–3), were analyzed. Results: Of the 348 patients, distribution across pathologic stages was as follows: 30 patients (8.6%) at stage 0, 207 (59.5%) at stage I, 52 (14.9%) at stage II, and 59 (17.0%) at stage III. In pT1 tumor patients, LN metastases varied by SM invasion depth: 3.6% in SM1 (all LND1), 5.1% in SM2 (all LND1), and 17.5% in SM3 (LND1 10%, LND2 5%, LND3 2.5%). For pT2, pT3, and pT4 stages, LN metastasis rates were 16.2% (LND1 11.3%, LND2 3.8%, LND3 1.3%), 39.7% (LND1 28.9%, LND2 8.4%, LND3 2.4%), and 50% (LND1 25%, LND2 25%), respectively. Tumor invasion depth and lymphovascular invasion were identified as significant risk factors for LN metastasis extending to LND2–3. Conclusion Complete mesocolic excision should be considered for right-sided colon cancer because tumor infiltration deeper than SM2 could metastasize to LND2 or further. If preoperative endoscopy confirms SM1 or SM2 invasion, D2 lymphadenectomy could be a limited surgical option.

We report a case of bilateral hand complications following Artecoll injections that were successfully managed with surgical excision and reconstruction using MatriDerm and split-thickness skin grafts. Notably, the patient experienced no postoperative foreign body reactions and achieved excellent functional outcomes, with a complete range of motion at 3.5 years postoperatively. This case underscores the effectiveness of MatriDerm-assisted reconstruction in achieving both functional and aesthetic results.

Liposuction and fat grafting are commonly employed to improve body contouring. While postoperative infections are infrequent, severe complications like necrotizing fasciitis can arise, potentially destroying the aesthetic results. Prevotella bivia is an anaerobic, Gram-negative rod bacterium commonly found in the vaginal mucosa, with increased prevalence in cases of bacterial vaginosis. Infections caused by this species can lead to necrotizing fasciitis or extensive tissue necrosis, necessitating prompt diagnosis during the acute phase. This report presents two severe cases of infection caused by P. bivia following fat harvesting and grafting procedures. These cases required multiple debridements, skin grafts, and fasciotomies for management.

Purpose: Dorsal comminution is widely accepted as a prognostic factor for reduction loss in the nonoperative treatment of distal radius fractures. However, the reliability of measuring dorsal comminution in simple radiographs has not been adequately studied. This study investigated the reliability of dorsal comminution measurements from simple radiographs, based on inter- and intra-rater reliability indices. Methods: We included 40 patients with distal radius fractures who underwent operative treatment from March 2016 to March 2017. We established three definitions for dorsal comminution: first, the rater’s subjective judgment; second, the presence of a free-floating piece of dorsal cortex; and third, the presence of a dorsal cortical defect of 5 mm or greater. Reliability was measured using Fleiss’ or Cohen’s kappa. Results: Based on Cohen’s kappa values, the intra-rater reliability of dorsal comminution assessment demonstrated fair to good agreement. In contrast, inter-rater reliability was generally poor to fair, and subgroup analysis by rater experience revealed poor agreement among less experienced surgeons. Conclusion The radiological predictors of dorsal comminution exhibited overall low reliability, limiting their usefulness in predicting reduction loss in distal radius fractures. A more precise definition of dorsal comminution is necessary, and additional methods, such as computed tomography and artificial intelligence, should be considered to increase reliability.