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Comparison of totally laparoscopic total gastrectomy using an endoscopic linear stapler with laparoscopic-assisted total gastrectomy using a circular stapler in patients with gastric cancer: a single-center experience

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World Journal of Gastroenterology 2017年第48期23卷 8553-8561页

作者： Chung sik Gong byung sik kim Hee Sung kim department of gastric surgery asan medical centeruniversity of ulsan college of medicine

AIM To evaluate the safety and efficacy of totally laparoscopic total gastrectomy(TLTG) with esophagojejunostomy using a linear stapler compared with laparoscopic-assisted total gastrectomy(LATG) using a circular stapler in gastric cancer *** We retrospectively reviewed 687 patients who underwent laparoscopic total gastrectomy for gastric cancer at a single institution from August 2008 to August 2014. The patients were divided into two groups according to the type of operation: 421 patients underwent TLTG and 266 underwent LATG. Clinicopathologic characteristics and surgical outcomes in the two groups were compared and *** The TLTG group had higher mean ages at the time of operation(57.78 ± 11.20 years and 55.69 ± 11.96 years,P = 0.020) and more histories of abdominal surgery(20.2% and 12.4%,P = 0.008) compared with the LATG group. Surgical outcomes such as intraoperative and postoperative transfusions,combined operations,pain scores and administration of analgesics,and complications were similar between the two groups. However,compared with the LATG group,the TLTG group required a shorter operation time(149 min vs 170 min,P < 0.001),had lower postoperative hematocrit change(3.49% vs 4.04%,P = 0.002),less intraoperative events(3.1% vs 10.2%,P < 0.001),less intraoperative anastomosis events(2.4% vs 7.1%,P = 0.003),faster postoperative recovery such as median time to first flatus(3.30 d vs 3.60 d,P < 0.001),faster median commencement of soft diet(4.30 d vs 4.60 d,P < 0.001) and shorter length of postoperative hospital stay(6.75 d vs 7.02 d,P = 0.005). CONCLUSION The intracorporeal method for reconstruction of esophagojejunostomy using a linear stapler may be considered a feasible procedure comparing with extracorporeal anastomosis using circular stapler because TLTG is simpler and more straightforward than LATG. Therefore,TLTG can be recommended as an appropriate procedure for gastric cancer.

关键词： Totally laparoscopic total gastrectomy Laparoscopic-assisted total gastrectomy Gastric cancer

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Use of a clinical pathway in laparoscopic gastrectomy for gastric cancer

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World Journal of Gastroenterology 2015年第48期21卷 13507-13517页

作者： Hee Sung kim Sun Oak kim byung sik kim Department of Gastric Surgery Asan Medical CenterUlsan University School of Medicine Department of Clinical Epidemiology and Biostatistics Asan Medical CenterUlsan University School of Medicine

AIM: To evaluate the implementation of a clinical pathway and identify clinical factors affecting the clinical pathway for laparoscopic ***: A standardized clinical pathway for gastric cancer(GC) patients was developed in 2001 by the GC surgery team at the Asan Medical Center. We reviewed the collected data of 4800 consecutive patients treated using the clinical pathway following laparoscopic gastrectomy with lymph node dissection for GC involving intracorporeal and extracorporeal anastomosis. The patients were treated between August 2004 and October 2013 in a single institution. To evaluate the rate of completion and risk factors affecting dropout from the clinical pathway, we used a multivariate logistic regression ***: The overall completion rate of the clinical pathway for laparoscopic gastrectomy was 84.1%(n = 4038). In the comparison between groups of intracorporeal anastomosis and extracorporeal anastomosis patients, the completion rates were 8 3. 8 8 %(n = 1 7 4 0) a n d 8 4. 3 6 %(n = 2 0 7 1), respectively, showing no statistically significant difference. The main reasons for dropping out were postoperative complications(n = 463, 9.7%) and the need for patient observation(n = 299, 6.2%). Among the discharged patients treated using the clinical pathway, the number of patients who were readmitted within 30 d due to postoperative complications was 54(1.1%). In a multivariate analysis, the intraoperative events(OR = 2.558) were the most predictable risk factors for dropping out of the clinical pathway. Additionally, being male(OR = 1.459), advanced age(OR = 1.727), total gastrectomy(OR = 2.444), combined operation(OR = 1.731), and ASA score(OR = 1.889) were significant risk factors affecting the dropout rate from the clinical ***: Laparoscopic gastrectomy appears to be a good indication for the application of a clinical pathway. For successful application, patients with risk factors should be managed carefully.

关键词： Clinical pathway Laparoscopic gastrectomy Gastric cancer Extracorporeal anastomosis Intracorporealanastomosis

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Optimal proximal resection margin distance for gastrectomy in advanced gastric cancer

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World Journal of Gastroenterology 2020年第18期26卷 2232-2246页

作者： Amy kim Beom Su kim Jeong Hwan Yook byung sik kim Division of Stomach Surgery Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Surgery Korea University Medical Center Ansan HospitalAnsanGyeonggi-do 15355South Korea

BACKGROUND The conventional guidelines to obtain a safe proximal resection margin(PRM)of5-6 cm during advanced gastric cancer(AGC)surgery are still applied by many surgeons across the *** recent studies have raised questions regarding the need for such extensive resection,but without reaching *** study was designed to prove that the PRM distance does not affect the prognosis of patients who undergo gastrectomy for *** To investigate the influence of the PRM distance on the prognosis of patients who underwent gastrectomy for *** Electronic medical records of 1518 patients who underwent curative gastrectomy for AGC between June 2004 and December 2007 at Asan Medical Center,a tertiary care center in Korea,were reviewed retrospectively for the *** demographics and clinicopathologic outcomes were compared between patients who underwent surgery with different PRM distances using one-way ANOVA and Fisher’s exact test for continuous and categorical variables,*** influence of PRM on recurrence-free survival and overall survival were analyzed using Kaplan-Meier survival analysis and Cox proportional hazard *** The median PRM distance was 4.8 cm and 3.5 cm in the distal gastrectomy(DG)and total gastrectomy(TG)groups,*** cohorts in the DG and TG groups were subdivided into different groups according to the PRM distance;≤1.0 cm,1.1-3.0 cm,3.1-5.0 cm and>5.0 *** DG and TG groups showed nostatistical difference in recurrence rate(23.5%vs 30.6%vs 24.0%vs 24.7%,P=0.765)or local recurrence rate(5.9%vs 6.5%vs 8.4%vs 6.2%,P=0.727)according to the distance of *** both groups,Kalpan-Meier analysis showed no statistical difference in recurrence-free survival(P=0.467 in DG group;P=0.155 in TG group)or overall survival(P=0.503 in DG group;P=0.155 in TG group)according to the PRM *** analysis using Cox proportional hazard model revealed that in both groups,there was no significant differ

关键词： Stomach neoplasms Gastrectomy Margins of excision Prognosis Recurrence

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Totally laparoscopic total gastrectomy using the modified overlap method and conventional open total gastrectomy:A comparative study

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World Journal of Gastroenterology 2021年第18期27卷 2193-2204页

作者： Chang Seok Ko Nam Ryong Choi byung sik kim Jeong Hwan Yook Min-Ju kim Beom Su kim Department of Surgery Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Clinical Epidemiology and Biostatistics Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea

BACKGROUND Although several methods of totally laparoscopic total gastrectomy(TLTG)have been *** best anastomosis technique for LTG has not been *** To investigate the effectiveness and surgical outcomes of TLTG using the modified overlap method compared with open total gastrectomy(OTG)using the circular stapled *** We performed 151 and 131 surgeries using TLTG with the modified overlap method and OTG for gastric cancer between March 2012 and December *** and oncological outcomes were compared between groups using propensity score *** addition,we analyzed the risk factors associated with postoperative *** Patients who underwent TLTG were discharged earlier than those who underwent OTG[TLTG(9.62±5.32)vs OTG(13.51±10.67),P<0.05].Time to first flatus and soft diet were significantly shorter in TLTG *** pain scores at all postoperative periods and administration of opioids were significantly lower in the TLTG group than in the OTG *** significant difference in early,late and esophagojejunostomy(EJ)-related complications or 5-year recurrence free and overall survival between *** analysis demonstrated that body mass index[odds ratio(OR),1.824;95%confidence interval(CI):1.029-3.234,P=0.040]and American Society of Anaesthesiologists(ASA)score(OR,3.154;95%CI:1.084-9.174,P=0.035)were independent risk factors of early ***,age was associated with≥3 Clavien-Dindo classification and EJrelated *** Although TLTG with the modified overlap method showed similar complication rate and oncological outcome with OTG,it yields lower pain score,earlier bowel recovery,and *** should perform total gastrectomy cautiously and delicately in patients with obesity,high ASA scores,and older ages.

关键词： Laparoscopic surgery Gastrectomy Anastomosis Stomach neoplasms Totally laparoscopic total gastrectomy

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Evaluation of the relationship between dietary factors,CagA-positive Helicobacter pylori infection,and RUNX3 promoter hypermethylation in gastric cancer tissue

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World Journal of Gastroenterology 2013年第11期19卷 1778-1787页

作者： Yan-Wei Zhang Sang-Yong Eom Dong-Hyuk Yim Young-Jin Song Hyo-Yung Yun Joo-Seung Park Sei-Jin Youn byung-sik kim Yong-Dae kim Heon kim Department of Preventive Medicine and Medical Research Institute College of MedicineChungbuk National UniversityCheongju 361-763South Korea Department of Surgery College of MedicineChungbuk National UniversityCheongju 361-763South Korea Department of Surgery College of MedicineEulji UniversityDaejon 461-713South Korea Department of Internal Medicine College of MedicineChungbuk National UniversityCheongju 361-763South Korea Department of Surgery Asan Medical CenterCollege of MedicineUlsan UniversitySeoul 138-736South Korea

AIM:To evaluate the relationship among Helicobacter pylori(***) infection,CagA status,and dietary factors with RUNX3 promoter ***:Gastric cancer tissue samples were collected from 184 South Korean *** patients were interviewed following a semi-quantitative food frequency *** average frequencies of intake and portion sizes of 89 common food items were documented,and total intakes of calories,nutrients,vitamins,and minerals were calculated for each *** was extracted from gastric cancer tissue samples,and amplification of the HSP60 gene was performed to detect *** *** polymerase chain reaction(PCR) was used to detect the presence of the CagA ***3 gene expression was measured by reverse transcription-PCR,and RUNX3 methylation status was evaluated by methylation-specific *** odds ratios(ORs) and 95%CI associated with RUNX3 promoter hypermethylation status were estimated for each of the food groups,lifestyle factors,and the interaction between dietary and lifestyle factors with CagA status of *** ***:Overall,164 patients(89.1%) were positive for *** DNA,with the CagA gene detected in 59(36%) of these ***-positive *** all,106(57.6%) patients with gastric cancer demonstrated CpG island hypermethylation at the RUNX3 ***3 expression was undetectable in 52(43.7%) of the 119 gastric cancer tissues sampled.A high consumption of eggs may increase the risk of RUNX3 methylation in gastric cancer patients,having a mean OR of 2.15(range,1.14-4.08).A significantly increased OR of 4.28(range,1.19-15.49) was observed with a high consumption of nuts in patients with CagA-positive *** *** intakes of carbohydrate,vitamin B1,and vitamin E may decrease the risk of RUNX3 methylation in gastric cancer tissue,particularly in CagA-or ***-negative infection,with OR of 0.41(0.19-0.90),0.42(0.20-0.89),and 0.29(0.13-0.62),respectively.A high consumpt

关键词： Gastric cancer RUNX3 Helicobacter pylori CagA Dietary factors

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Hurst’s Memory for Chaotic, Tree Ring, and SOI Series

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Applied Mathematics 2014年第1期5卷 175-195页

作者： byung-sik kim Hung-Soo kim Sun-Hong Min Department of Civil Engineering Inha University Incheon South Korea Department of Urban Environmental Prevention Engineering School of Disaster Prevention Kangwon National University Gangwon South Korea

Hurst’s memory that roots in early work of the British hydrologist H.E. Hurst remains an open problem in stochastic hydrology. Today, the Hurst analysis is widely used for the hydrological studies for the memory and characteristics of time series and many methodologies have been developed for the analysis. So, there are many different techniques for the estimation of the Hurst exponent (H). However, the techniques can produce different characteristics for the persistence of a time series each other. This study uses several techniques such as adjusted range, rescaled range (RR) analysis, modified rescaled range (MRR) analysis, 1/f power spectral density analysis, Maximum Likelihood Estimation (MLE), detrended fluctuations analysis (DFA), and aggregated variance time (AVT) method for the Hurst exponent estimation. The generated time series from chaos and stochastic systems are analyzed for the comparative study of the techniques. Then, this study discusses the advantages and disadvantages of the techniques and also the limitations of them. We found that DFA is the most appropriate technique for the Hurst exponent estimation for both the short term memory and long term memory. We analyze the SOI (Southern Oscillations Index) and 6 tree-ring series for USA sites by means of DFA and the BDS statistic is used for nonlinearity test of the series. From the results, we found that SOI series is nonlinear time series which has a long term memory of H = 0.92. Contrary to earlier work, all the tree ring series are not random from our analysis. A certain tree ring series show a long term memory of H = 0.97 and nonlinear property. Therefore, we can say that the SOI series has the properties of long memory and nonlinearity and tree ring series could also show long memory and non-linearity.

关键词： Hurst’s Memory DFA Chaotic Series Tree-Ring Series SOI BDS Statistic

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Dietary vitamin D intake and vitamin D related genetic polymorphisms are not associated with gastric cancer in a hospital-based case-control study in Korea

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The Journal of Biomedical Research 2018年第4期32卷 257-263页

作者： Sang-Yong Eom Dong-Hyuk Yim Dae-Hoon kim Hyo-Yung Yun Young-Jin Song Sei-Jin Youn Taisun Hyun Joo-Seung Park byung sik kim Yong-Dae kim Heon kim Departments of Preventive Medicine and Medical Research Institute College of Medicine Departments of Preventive Medicine and Surgery College of Medicine Departments of Preventive Medicine and Internal Medicine College of Medicine Dartment of Food and Nutrition Chungbuk National UniversityCheongju 28644Korea Department of Surgery College of MedicineEulji UniversityDaejon 301746Korea Department of Surgery Asan Medical CenterCollege of MedicineUlsan UniversitySeoul 138736Korea

There have been few studies on the association between vitamin D levels and gastric cancer in Asian populations,but no studies have been performed on the interactions between vitamin D intake and polymorphisms in the vitamin D *** effects of vitamin D intake,vitamin D related genetic polymorphisms,and their association with the incidence of gastric cancer were investigated in a hospital case-control study,including 715 pairs of newly diagnosed gastric cancer patients and controls matched for age and *** between vitamin D intake and plasma vitamin D concentrations were also assessed in a subset of *** statistically significant difference was observed in the dietary intake of vitamin D between the patients and controls,nor were there any evident associations between vitamin D intake and risk of gastric cancer in multivariate *** D intake significantly correlated with the circulating 25-hydroxyvitamin D levels,but not with the active form of the vitamin,1,25-dihydroxyvitamin *** were no statistically significant interactions between vitamin D intake,and VDR or TXNIP *** study suggests that dietary vitamin D intake is not associated with gastric cancer risk,and the genetic polymorphisms of vitamin D-related genes do not modulate the effect of vitamin D with respect to gastric carcinogenesis.

关键词： gastric cancer vitamin D vitamin D receptor gene-environment interaction

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Risk of gastric cancer is associated with PRKAA1 gene polymorphisms in Koreans

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World Journal of Gastroenterology 2014年第26期20卷 8592-8598页

作者： Yong-Dae kim Dong-Hyuk Yim Sang-Yong Eom Sun In Moon Hyo-Yung Yun Young-Jin Song Sei-Jin Youn Taisun Hyun Joo-Seung Park byung sik kim Jong-Young Lee Hee Kwan Won Heon kim Department of Preventive Medicine College of MedicineChungbuk National University Department of Surgery College of MedicineChungbuk National University Department of Internal Medicine College of MedicineChungbuk National University Department of Food and Nutrition Chungbuk National University Department of Surgery College of MedicineEulji University Department of Surgery Asan Medical CenterCollege of MedicineUlsan University Center for Genome Science National Institute of Health Department of Internal Medicine Division of Endocrinology and MetabolismSchool of MedicineKonyang University

AIM: To evaluate the association between genetic polymorphisms of the gene encoding AMP-activated protein kinase (PRKAA1) and the risk of gastric cancer.

关键词： AMP-activated protein kinase Gastric cancer PRKAA1 Single nucleotide polymorphism Case-control study

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ITGA1 polymorphisms and haplotypes are associated with gastric cancer risk in a Korean population

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World Journal of Gastroenterology 2013年第35期19卷 5870-5876页

作者： Dong-Hyuk Yim Yan-Wei Zhang Sang-Yong Eom Sun In Moon Hyo-Yung Yun Young-Jin Song Sei-Jin Youn Taisun Hyun Joo-Seung Park byung sik kim Jong-Young Lee Yong-Dae kim Heon kim Department of Preventive Medicine and Medical Research Institute College of Medicine Chungbuk National University Center for Disease Control and Prevention Department of Surgery College of Medicine Chungbuk National University Department of Internal Medicine College of MedicineChungbuk National University Department of Food and Nutrition Chungbuk National University Department of Surgery College of MedicineEulji University Department of Surgery Asan Medical Center College of Medicine Ulsan University Center for Genome Science National Institute of Health

AIM:To evaluate the association between the geneticpolymorphisms and haplotypes of the ITGA1 gene and the risk of gastric ***:The study subjects were 477 age-and sex-matched case-control *** was performed for 15 single nucleotide polymorphisms(SNPs)in *** associations between gastric cancer and these SNPs and haplotypes were analyzed with multivariate conditional logistic regression *** testing corrections were carried out following methodology for controlling the false discovery ***-based association tests were performed using the versatile gene-based association study(VEGAS)***:In the codominant model,the ORs for SNPs rs2432143(1.517;95%CI:1.144-2.011)and rs2447867(1.258;95%CI:1.051-1.505)were statistically *** the dominant model,polymorphisms of rs1862610 and rs2447867 were found to be significant risk factors,with ORs of 1.337(95%CI:1.029-1.737)and 1.412(95%CI:1.061-1.881),*** the recessive model,only the rs2432143 polymorphism was significant(OR=1.559,95%CI:1.150-2.114).The C-C type of ITGA1 haplotype block 2 was a significant protective factor against gastric cancer in the both codominant model(OR=0.602,95%CI:0.212-0.709,P=0.021)and the dominant model(OR=0.653,95%CI:0.483-0.884).The ITGA1 gene showed a significant gene-based association with gastric cancer in the VEGAS *** the dominant model,the A-T type of ITGA1 haplotype block 2 was a significant risk factor(OR=1.341,95%CI:1.034-1.741).SNP rs2447867 might be related to the severity of gastric epithelial injury due to inflammation and,thus,to the risk of developing gastric ***:ITGA1 gene SNPs rs1862610,rs2432143,and rs2447867 and the ITGA1 haplotype block that includes SNPs rs1862610 and rs2432143 were significantly associated with gastric cancer.

关键词： Integrin ITGA1 Gastric cancer Polymorphism Haplotype

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应用内镜直线型缝合器的腹腔镜食道空肠吻合术：293例经验分析

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中国普通外科杂志 2013年第4期22卷 398-400页

作者： byung sik kim Hee Sung kim 陈泓西李新营韩国蔚山大学医学院峨山医疗中心胃外科部

1引言由于其安全性和有效性，腹腔镜胃切除术正成为一种广泛使用的手术方法用于治疗早期胃癌（EGC）。在2002年推出后，完全腹腔镜胃切除术后应用腔内重建的几种手术方法已被用于提高和改善早期腹腔镜胃切除术的手术治疗效果。

关键词：胃肿瘤胃切除术,腹腔镜食管空肠吻合术视频

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