Purpose: Although numerous studies have identified potential risk factors for ipsilateral lymphedema development in patients with breast cancer following axillary node dissection, the risk factors for lymphedema in patients undergoing sentinel node biopsy without axillary dissection remain unclear. In this study, we aimed to determine the real-world incidence and risk factors for lymphedema in such patients. Methods: We conducted a single-center, retrospective review of medical records of patients with breast cancer who underwent sentinel node biopsy alone. The development cohort (5,051 patients, January 2017–December 2020) was analyzed to identify predictors of lymphedema, and a predictive model was subsequently created. A validation cohort (1,627 patients, January 2014–December 2016) was used to validate the model. Results: In the development cohort, 49 patients (0.9%) developed lymphedema over a median follow-up of 56 months, with most cases occurring within the first three years post-operation.Multivariate analysis revealed that a body mass index (BMI) of 30 kg/m2 or above, radiation therapy (RTx), chemotherapy, and more than three harvested lymph nodes significantly predicted lymphedema. The predictive model showed an area under the curve of 0.824 for systemic chemotherapy, with the number of harvested lymph nodes being the most significant factor. Patients were stratified into four risk groups, showing lymphedema incidences of 3.3% in the highest-risk group and 0.1% in the lowest-risk group. In the validation cohort, the incidences were 1.7% and 0.2% for the highest and lowest risk groups, respectively. Conclusion The lymphedema prediction model identifies RTx, chemotherapy, BMI ≥ 30 kg/m2 , and more than three harvested lymph nodes as significant risk factors. Although the overall incidence is low, the risk is notably influenced by the extent of lymph node removal and systemic therapies. The model’s high negative predictive value supports its application in designing tailored lymphedema surveillance programs for early intervention.

Purpose: Although numerous studies have identified potential risk factors for ipsilateral lymphedema development in patients with breast cancer following axillary node dissection, the risk factors for lymphedema in patients undergoing sentinel node biopsy without axillary dissection remain unclear. In this study, we aimed to determine the real-world incidence and risk factors for lymphedema in such patients. Methods: We conducted a single-center, retrospective review of medical records of patients with breast cancer who underwent sentinel node biopsy alone. The development cohort (5,051 patients, January 2017–December 2020) was analyzed to identify predictors of lymphedema, and a predictive model was subsequently created. A validation cohort (1,627 patients, January 2014–December 2016) was used to validate the model. Results: In the development cohort, 49 patients (0.9%) developed lymphedema over a median follow-up of 56 months, with most cases occurring within the first three years post-operation.Multivariate analysis revealed that a body mass index (BMI) of 30 kg/m2 or above, radiation therapy (RTx), chemotherapy, and more than three harvested lymph nodes significantly predicted lymphedema. The predictive model showed an area under the curve of 0.824 for systemic chemotherapy, with the number of harvested lymph nodes being the most significant factor. Patients were stratified into four risk groups, showing lymphedema incidences of 3.3% in the highest-risk group and 0.1% in the lowest-risk group. In the validation cohort, the incidences were 1.7% and 0.2% for the highest and lowest risk groups, respectively. Conclusion The lymphedema prediction model identifies RTx, chemotherapy, BMI ≥ 30 kg/m2 , and more than three harvested lymph nodes as significant risk factors. Although the overall incidence is low, the risk is notably influenced by the extent of lymph node removal and systemic therapies. The model’s high negative predictive value supports its application in designing tailored lymphedema surveillance programs for early intervention.

Purpose: Although numerous studies have identified potential risk factors for ipsilateral lymphedema development in patients with breast cancer following axillary node dissection, the risk factors for lymphedema in patients undergoing sentinel node biopsy without axillary dissection remain unclear. In this study, we aimed to determine the real-world incidence and risk factors for lymphedema in such patients. Methods: We conducted a single-center, retrospective review of medical records of patients with breast cancer who underwent sentinel node biopsy alone. The development cohort (5,051 patients, January 2017–December 2020) was analyzed to identify predictors of lymphedema, and a predictive model was subsequently created. A validation cohort (1,627 patients, January 2014–December 2016) was used to validate the model. Results: In the development cohort, 49 patients (0.9%) developed lymphedema over a median follow-up of 56 months, with most cases occurring within the first three years post-operation.Multivariate analysis revealed that a body mass index (BMI) of 30 kg/m2 or above, radiation therapy (RTx), chemotherapy, and more than three harvested lymph nodes significantly predicted lymphedema. The predictive model showed an area under the curve of 0.824 for systemic chemotherapy, with the number of harvested lymph nodes being the most significant factor. Patients were stratified into four risk groups, showing lymphedema incidences of 3.3% in the highest-risk group and 0.1% in the lowest-risk group. In the validation cohort, the incidences were 1.7% and 0.2% for the highest and lowest risk groups, respectively. Conclusion The lymphedema prediction model identifies RTx, chemotherapy, BMI ≥ 30 kg/m2 , and more than three harvested lymph nodes as significant risk factors. Although the overall incidence is low, the risk is notably influenced by the extent of lymph node removal and systemic therapies. The model’s high negative predictive value supports its application in designing tailored lymphedema surveillance programs for early intervention.

Background: Although almost all interventional pulmonologists agree that rigid bronchoscopy is irreplaceable in the field of interventional pulmonology, less is known about the types of diseases that the procedure is used for and what difficulties the operators face during the procedure. The purpose of this study is to evaluate what diseases rigid bronchoscopy is used for, whether it is widely used, and what challenges the operators face in Korea. Methods: We enrolled 14 hospitals in this retrospective cohort of patients who underwent rigid bronchoscopy between 2003 and 2020. An online survey was conducted with 14 operators to investigate the difficulties associated with the procedure. Results: While the number of new patients at Samsung Medical Center (SMC) increased from 189 in 2003–2005 to 468 in 2018–2020, that of other institutions increased from 0 to 238.The proportion of SMC patients in the total started at 100% and steadily decreased to 59.2%.The proportion of malignancy as the indication for the procedure steadily increased from 29.1% to 43.0%, whereas post-tuberculous stenosis (25.4% to 12.9%) and post-intubation stenosis (19.0% to 10.9%) steadily decreased (all P for trends < 0.001). In the online survey, half of the respondents stated that over the past year they performed less than one procedure per month. The fewer the procedures performed within the last year, the more likely collaboration with other departments was viewed as a recent obstacle (Spearman correlation coefficient, r s = −0.740, P = 0.003) and recent administrative difficulties were encountered (r s = −0.616, P = 0.019). Conclusion This study demonstrated that the number of patients undergoing rigid bronchoscopy has been increasing, especially among cancer patients. For this procedure to be used more widely, it will be important for beginners to systematically learn about the procedure itself as well as to achieve multidisciplinary consultation.

Purpose: Perioperative transfusion is reported to be an independent risk factor not only for postoperative complications but also for early recurrence of periampullary carcinoma after pancreaticoduodenectomy (PD). The purpose of this study was to evaluate the safety and efficacy of ferric carboxymaltose (FCM) in reducing the need for perioperative transfusion in iron deficiency anemia patients scheduled for PD. Methods: Twenty-two male patients (hemoglobin [Hb] 7 to <13 g/dL) and 18 female patients (Hb 7 to <12 g/dL) were enrolled in the study group and administered FCM 1–3 weeks before PD. The perioperative transfusion rate was the primary endpoint; morbidity, length of postoperative hospital stay, change in hematological parameters after FCM injection, and adverse effects of FCM were also investigated. Results: The perioperative transfusion rate of the study group was 22.5% (9 of 40). Hb level was significantly higher on the day of the operation compared to baseline (P < 0.001). Levels of Hb, transferrin saturation, and ferritin were higher at the follow-up compared to baseline (P = 0.008, P = 0.033, and P < 0.001, respectively). Conclusions FCM administration was associated with a reduced need for perioperative transfusion and can safely stabilize hematological parameters.

Purpose: Significant improvements have been made in the surgical treatment of rectal cancer with a higher sphinctersaving rate without compromising oncologic results. There have been studies about the quality of life of rectal cancer patients after surgery. However, no study has reported the long-term annual incidence of depression after rectal cancer surgery according to stoma status. The objective of this study was to determine the annual incidence of depression after rectal cancer surgery and the factors affecting it, especially the prevalence of depression according to the presence or duration of a stoma. Methods: Using the Korea National Health Insurance Service database, patients who underwent radical surgery for rectal cancer from 2002 to 2019 were searched. We analyzed the incidence and risk factors of depression in patients who underwent radical surgery for rectal cancer according to stoma status. Results: Annual incidence of depression in rectal cancer patients was decreasing annually for 15 years after surgery. There was no statistically significant difference in the incidence of depression according to the stoma status. However, the diagnosis of depression within 1 year after surgery was statistically significantly increased in the permanent stoma group. Conclusion There was no difference in the overall incidence of depressive disorders among patients with rectal cancer based on their stoma status. However, a permanent stoma seems to increase the incidence in the first year after surgery. Education and intensive assessments of depressive disorders in patients with permanent stoma within 1 year after surgery are needed, particularly for female patients who are under 50 years old.