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.

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.

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.

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.

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.

Purpose: Endoscopic treatment and laparoscopic surgery are minimally invasive options for early treatment of colorectal cancer, however, more evidence of the long-term outcomes between the two procedures is needed to guide clinical decisions. Therefore, this study aimed to compare the oncologic outcomes between endoscopic and laparoscopic treatment for early colorectal cancer. Methods: The study group included 60 patients who underwent endoscopic treatment and 38 patients who underwent laparoscopic surgery for early colorectal adenocarcinoma between January 2010 and December 2013 at a single study site. Results: Histopathological diagnoses showed that 43 (78.3%) carcinomas in the endoscopic submucosal dissection group were mucosal to sm1, 13 (21.7%) were sm2 or deeper, and 17 high-risk cases (28.3%) in the endoscopic group underwent additional surgery. The median operation time, time to sips of water, and length of hospital stay were significantly shorter in the endoscopic group than in the laparoscopic group. The overall survival rates of patients in the endoscopic group and laparoscopic groups were 91.5% and 87.4%, respectively (P=0.391), and the disease-free survival rates were 90.4% and 87.4% (P=0.614), respectively. Systemic recurrences occurred in two patients (1.6%) in the endoscopic group and one patient (2.0%) in the laparoscopic group. Local recurrence combined with systemic recurrence in one patient (0.8%) in the endoscopic group. Conclusion Endoscopic resection for early colorectal cancer can be performed safely with better short-term outcomes and comparable longterm oncological outcomes compared to laparoscopic surgery.

Objectives: We aimed to evaluate the clinical and psychological factors influencing depressive symptoms in children and adolescents with epilepsy. Methods: We administered self-reported questionnaires assessing children’s depressive symptoms (Children’s Depression Inventory, CDI) and anxiety (Revised Children’s Manifest Anxiety Scale, RCMAS) to children and adolescents with epilepsy (n=87, age range=6–17 years). We asked their parents to complete questionnaires on epilepsy-related variables, parental stress (Questionnaire on Resources and Stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), family functioning (Family Adaptability and Cohesion Evaluation Scale, FACES), children’s attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children’s behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise multiple regression analysis was performed to identify predictive variables affecting depressive symptoms. Results: Family adaptability (r=-0.240, p=0.026), family cohesion (r=-0.381, p<0.001), children’s attention problems (r=0.290, p=0.006), children’s anxiety (r=0.714, p<0.001), children’s behavioral problems (r=0.371, p<0.001), parental anxiety (r=0.320, p=0.003), and parental stress (r=0.335, p=0.002) were significantly correlated with children’s depressive symptoms. Children’s anxiety (β=0.655, p<0.001) and parental stress (β=0.198, p=0.013) were significantly related to their depressive symptoms (adjusted R 2 =0.539). Conclusion Clinicians should detect and manage children’s anxiety and parental stress, which may affect depressive symptoms in children and adolescents with epilepsy.

Objectives: ：The aim of this study was to investigate the impact of clinical and psychological factors on the parental stress of children and adolescents with epilepsy. Methods: ：Children and adolescents with epilepsy (n=90, age range=6-17 years) completed questionnaires on epilepsy-related variables, children’s depressive symptoms (Children’s Depression Inventory, CDI), children’s anxiety (Revised Children’s Manifest Anxiety Scale, RCMAS) and performed the scale for children’s intelligence (IQ). Parents who have children and adolescents with epilepsy completed questionnaires on parental stress (Questionnaire on Resources and stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), children’s attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children’s behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise regression analysis was performed to determine the significant predictive variables that affect parental stress. Results: ：In the correlational analysis, duration of seizure treatment (r=0.253, p=0.016), children’s IQ (r= -0.544, p<0.001), children’s attention problems (r=0.602, p<0.001), children’s depressive symptoms (r=0.335, p=0.002), children’s anxiety (r=0.306, p=0.004), children’s behavioral problems (r=0.618, p<0.001), and parental anxiety (r=0.478, p<0.001), showed a significant correlation with parental stress. Children’s behavioral problem (β=0.241, p=0.010), children’s IQ (β=-0.472, p<0.001), and parental anxiety (β=0.426, p<0.001) were significantly related to the parental stress (Adjusted R2=0.619). Conclusions ：Clinicians should pay attention to children’s intelligence and behavioral problems and parental anxiety, which affect parental stress with children and adolescents with epilepsy.

OBJECTIVES: The aim of this study was to investigate the impact of clinical and psychological factors on the quality of life of children and adolescents with epilepsy and their families.METHODS: Children and adolescents with epilepsy and their families (n = 63, age range = 6–17 years) completed questionnaires on epilepsy-related variables, quality of life, children's depressive symptoms, children's anxiety, children's behavioral problems, children's attention problems, parental stress, and parental anxiety. Stepwise regression analysis was performed to determine the significant predictive variables that affect quality of life.RESULTS: In the correlational analysis, children's attention problems (r = 0.363, p = 0.004), parental anxiety (r = 0.377, p = 0.003), parental stress (r = 0.564, p < 0.001), and children's behavioral problems (r = 0.503, p < 0.001) showed a significant correlation with quality of life. Parental stress (β = 0.415, p = 0.001, adjusted R² = 0.345) and children's behavioral problems (β = 0.285, p = 0.02, adjusted R² = 0.345) were significantly related to the quality of life.CONCLUSIONS: Clinicians should pay attention to parental stress and children's behavioral problems, which affect quality of life in families with pediatric epilepsy.
Adolescent ; Anxiety ; Child ; Depression ; Epilepsy ; Humans ; Parents ; Problem Behavior ; Psychology ; Quality of Life

OBJECTIVES: The purpose of this study was to investigate the impact of clinical and psychological factors on the self-concept of children and adolescents with epilepsy. METHODS: Children and adolescents with epilepsy (n=60; age range=9–17 years) completed questionnaires about their epilepsy-related variables, self-concept, depressive symptoms, anxiety, family functions, and behavioral problems. The T-test and one-way analysis of variance were used to examine the variables affecting the total self-concept scores. To determine the independent variables by adjusting the significant variables, a stepwise regression analysis was performed. RESULTS: In the correlational analysis, age, depressive symptoms, anxiety, social problems, attention problems, and internalizing problems had significantly negative correlations with self-concept. On the other hand, IQ and family functions showed positive correlations with self-concept. Age (β=−0.177, p=0.015), depressive symptoms (β=−0.487, p<0.001), anxiety (β=−0.298, p=0.008), and attention problems (β= −0.138, p=0.048) were analyzed as independent factors to assess their impact on self-concept, and were found to account for 78.3% of the variance in self-concept by stepwise regression analysis. CONCLUSION: Parents and clinicians should pay attention to improving the self-concept of children and adolescents with epilepsy, especially if they have problems with depression, anxiety, or attention.
Adolescent* ; Anxiety ; Child* ; Depression ; Epilepsy* ; Hand ; Humans ; Parents ; Problem Behavior ; Psychology ; Self Concept ; Social Problems