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Is fascial closure required for a 12-mm trocar?A comparative study on trocar site hernia with long-term follow up

World Journal of Clinical Cases 2023年第2期11卷 357-365页

作者： Santi Krittiyanitsakun Chawisa Nampoolsuksan Thikhamporn Tawantanakorn Tharathorn Suwatthanarak Nicha Srisuworanan Voraboot Taweerutchana Thammawat Parakonthun chainarong phalanusitthepha Jirawat Swangsri Thawatchai Akaraviputh Asada Methasate Vitoon Chinswangwatanakul Atthaphorn Trakarnsanga Minimally Invasive Surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

BACKGROUND Despite the infrequency of trocar site hernias(TSHs),fascial closure continues to be recommended for their prevention when using a≥10-mm *** To identify the necessity of fascial closure for a 12-mm nonbladed trocar incision in minimally invasive colorectal *** Between July 2010 and December 2018,all patients who underwent minimally invasive colorectal surgery at the Minimally Invasive Surgery Unit of Siriraj Hospital were retrospectively *** patients underwent cross-sectional imaging for TSH *** characteristics were *** rates of TSH and postoperative results were *** Of the 254 patients included,70(111 ports)were in the fascial closure(closed)group and 184(279 ports)were in the nonfascial closure(open)*** median follow up duration was 43 *** follow up,three patients in the open group developed TSHs,whereas none in the closed group developed the condition(1.1%vs 0%,P=0.561).All TSHs occurred in the right lower *** whose drains were placed through the same incision had higher rates of TSHs compared with those without the *** open group had a significantly shorter operative time and lower blood loss than the closed *** Routine performance of fascial closure when using a 12-mm nonbladed trocar may not be ***,further prospective studies with cross-sectional imaging follow-up and larger sample size are needed to confirm this finding.

关键词： Trocar site hernia Port site hernia Fascial closure Laparoscopic colorectal surgery Nonbladed trocar

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Surgical strategies for challenging common bile duct stones in the endoscopic era: A comprehensive review of current evidence

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 305-317页

作者： Tharathorn Suwatthanarak Vitoon Chinswangwatanakul Asada Methasate chainarong phalanusitthepha Minoru Tanabe Keiichi Akita Thawatchai Akaraviputh Minimally Invasive Surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok Noi 10700BangkokThailand Graduate School of Medical and Dental Sciences Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan Department of Hepatobiliary and Pancreatic Surgery Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan Department of Clinical Anatomy Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan

While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered *** evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable *** review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical *** selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal *** surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also ***,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment *** review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks.

关键词： Choledocholithiasis Common bile duct stone Difficult common bile duct stone Common bile duct exploration Laparoscopic common bile duct exploration

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Endoscopic features of early-stage signet-ring-cell carcinoma of the stomach

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 741-746页

作者： chainarong phalanusitthepha Kevin L Grimes Haruo Ikeda Hiroki Sato Chiaki Sato Chananya Hokierti Haruhiro Inoue Digestive Disease Center Showa University Koto-Toyosu Hospital Minimally Invasive Surgery Unit Division of General Surgery Department of Surgery Faculty of Medicine Siriraj HospitalMahidol University

AIM: To identify the features of early signet ring cell gastric carcinoma using magnification endoscopy with narrow band imaging(NBI).METHODS: A retrospective review was conducted of 12 cases of early signet ring cell gastric carcinoma who underwent treatment in a single institution between January 2009 and April 2013. All patients had magnification endoscopy with NBI and indigo carmine contrast to closely examine the mucosal architecture, including the microvasculature and arrangement of gastric pits. Histologic examination of the final endoscopic submucosal dissection or gastrectomy specimen was performed and compared with the endoscopic findings to identify patterns specific to signet ring cell ***: Twelve patients with early signet ring cell gastric carcinoma were identified; 75% were male, and average age was 61 years. Most of the lesions were stage T1a(83%), while the remainder were T1b(17%). The mean lesion size was 1.4 cm2. On standard endoscopy, all 12 patients had a pale, flat lesion without any evidence of mucosal abnormality such as ulceration, elevation, or depression. On magnification endoscopywith NBI, all of the patients had irregularities in the glands and microvasculature consistent with early gastric cancer. In addition, all 12 patients exhibited the "stretch sign", an elongation or expansion of the architectural structure. Histologic examination of the resected specimens demonstrated an expanded and edematous mucosal layer infiltrated with tumor ***: The "stretch sign" appears to be specific for signet ring cell carcinoma and may aid in the early diagnosis and treatment of this aggressive pathology.

关键词： Signet ring cells Early gastric cancer Magnification endoscopy Narrow band imaging Stretchsign Endoscopic submucosal dissection

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Critical Top Tension for Static Equilibrium Configuration of A Steel Catenary Riser

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China Ocean Engineering 2014年第6期28卷 829-842页

作者： chainarong ATHISAKUL Karun KLAYCHAM Somchai CHUCHEEPSAKUL Department of Civil Engineering Faculty of Engineering King Mongkut’s University of Technology Thonburi

This paper aims to present the critical top tension for static equilibrium configurations of a steel catenary riser（SCR） by using the finite element method. The critical top tension is the minimum top tension that can maintain the equilibrium of the SCR. If the top tension is smaller than the critical value, the equilibrium of the SCR does not exist. If the top tension is larger than the critical value, there are two possible equilibrium configurations. These two configurations exhibit the nonlinear large displacement. The configuration with the smaller displacement is stable, while the one with larger displacement is unstable. The numerical results show that the increases in the riser＇s vertical distances, horizontal offsets, riser＇s weights, internal flow velocities, and current velocities increase the critical top tensions of the SCR. In addition, the parametric studies are also performed in order to investigate the limit states for the analysis and design of the SCR.

关键词： critical top tension finite element method large displacement steel catenary riser static equilibrium

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Ancient Materials and Substitution Materials Used in Thai Historical Masonry Structure Preservation

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Journal of Renewable Materials 2021年第2期9卷 179-204页

作者： Natthanan Wonganan chainarong Athisakul Peerasit Mahasuwanchai Weerachart Tangchirapat Raktipong Sahamitmongkol Sutat Leelataviwat Department of Civil Engineering Faculty of EngineeringKing Mongkut’s University of Technology ThonburiBangkok10140Thailand

The historical structures of Thailand are some of the most fascinating ancient sites in *** architectures reveal past cultures,traditions,knowledge,and *** materials are the major materials used to construct the historical structures in *** of the essential problem of Thai historical structure preservation is a shortage of engineering properties data for the structural stability ***,the in-depth engineering properties and the suitable substitution materials for Thai historical preservation are rarely ***,the engineering properties of the ancient masonry materials have to be explored together with the development of suitable substitute *** paper presents the physical and engineering properties of ancient materials and substitution materials for the preservation of Thailand’s historical *** ancient materials,including brick and mortar,are collected from historical places in the Bangkok and Ayutthaya *** physical and engineering properties of the masonry materials,such as the chemical composition,mineralogical composition,density,porosity,absorption,water vapor transmission,compressive strength,and modulus of elasticity,were evaluated in the *** ash was used as a pozzolanic material to partially replace the slaked lime to restore the historical *** binder to sand ratio was controlled at 1:3 by *** slaked lime was substituted by fly ash at the rates of 10–30%by weight of *** engineering properties of the substitution mortars were also evaluated and compared with the ancient masonry materials.A masonry prism was also constructed to evaluate the compressive strength and the modulus of elasticity of the masonry *** physical and engineering properties of the ancient masonry materials obtained in this study can be included in a database for the preservation of Thailand’s historical masonry *** use of fly ash to partially replace the

关键词： Ancient masonry materials engineering properties fly ash historical structures of Thailand substitution materials

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Hexahydrocurcumin enhances inhibitory effect of 5-fluorouracil on HT-29 human colon cancer cells

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World Journal of Gastroenterology 2012年第19期18卷 2383-2389页

作者： Khanitta Srimuangwong chainarong Tocharus Pornphrom Yoysungnoen Chintana Apichart Suksamrarn Jiraporn Tocharus Department of Anatomy Faculty of Medical ScienceNaresuan UniversityPhitsanulok 65000Thailand Department of Anatomy Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Division of Physiology Faculty of MedicineThammasat UniversityRangsit CampusPathumthani 12120Thailand Department of Chemistry Faculty of ScienceRamkhamhaeng UniversityBangkok 10240Thailand Department of Physiology Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand

AIM： To investigate the ability of hexahydrocurcumin （HHC） to enhance 5-fluorouracil （5-FU） in inhibiting the growth of HT-29 cells by focusing on cyclooxygenase （COX）-2 expression.METHODS： Antiproliferative effects of HHC and 5-FU, alone and in combination, on growth of HT-29 human colon cancer cells were assessed using 5-diphenyltetrazolium bromide （MTT） reduction assay. In combinationtreatment, low doses of 5-FU were used combined with various concentrations of HHC to minimize the toxic- ity and side effects of 5-FU. The therapeutic effects of these drugs on down-regulation of COX-2 mRNA and protein expression were examined using semi-quantitative reverse transcription-polymerase chain reaction （RT-PCR） and Western blotting analysis.RESULTS： Ml-I- reduction assay indicated that HHC alone markedly decreased the viability of HT-29 human colon cancer cells compared to control. Semi-quantitative RT-PCR analysis indicated that HHC is a selective COX-2 inhibitor. This finding was supported by the ob- servation that HHC significantly down-regulates COX-2 mRNA expression compared to the control （control： 100.05% ± 0.03% vs HHC： 61.01% ± 0.35%, P 〈 0.05） but does not alter COX-1 mRNA. In combined treatment, addition of HHC to a low dose of 5-FU exerts a synergistic effect against the growth of HT-29 cells by markedly reducing cell viability to a greater degree than monotherapy. Semi-quantitative RT-PCR indicated that 5-FU at the concentration of 5 pmol/L in combina- tion with HHC at the concentration of 25 pmol/L signifi- cantly down-regulates COX-2 mRNA expression when compared with values in cells treated with 5-FU or HHC alone （HHC ＋ 5-FU： 31.93% ± 5.69%, 5-FU： 100.66% ± 4.52% vs HHC： 61.01% ±0.35%, P 〈 0.05）.CONCLUSION： HHC together with 5-FU exerts a synergistic effect and may prove chemotherapeutically useful in treating human colon cancer.

关键词： Colon cancer Hexahydrocurcumin 5-Fluo-rouracil Combination treatment Cyclooxygenase-2 Synergistic effect

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Effects of hexahydrocurcumin in combination with 5-fluorouracil on dimethylhydrazine-induced colon cancer in rats

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World Journal of Gastroenterology 2012年第47期18卷 6951-6959页

作者： Khanitta Srimuangwong chainarong Tocharus Jiraporn Tocharus Apichart Suksamrarn Pornphorm Yoysungnoen Chintana Department of Anatomy Faculty of Medical ScienceNaresuan UniversityPhitsanulok 65000Thailand Department of Anatomy Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Physiology Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Chemistry Faculty of ScienceRamkhamhaeng UniversityBangkok 10240Thailand Division of Physiology Faculty of MedicineThammasat UniversityRangsit CampusPathumthani 12120Thailand

AIM:To investigate the effects of hexahydrocurcumin(HHC),and its combination with 5-fluorouracil(5-FU) on dimethylhydrazine(DMH)-induced colon cancer in ***:Male Wistar rats weighing 100-120 g were used as subject *** crypt foci(ACF),early preneoplastic lesions of colon cancer,were induced by subcutaneous injection of DHM(40 mg/kg) twice a week for two *** the first DMH injection,rats were treated daily with vehicle(n = 12),curcumin(CUR)(50 mg/kg)(n = 12),HHC(50 mg/kg) orally(n = 12),and treated weekly with an intraperitoneal injection of 5-FU(50 mg/kg)(n = 12),or a combination of 5-FU plus CUR(n = 12) and HHC(n = 12) at the same dosage(s) for 16 *** total number of ACF and large ACF were ***(COX)-1 and COX-2 expression were detected by immunohistochemistry in colon *** quantitative data of both COX-1 and COX-2 expression were presented as the percentage of number of positive-stained cells to the total number of cells *** cells in colon tissues were also visualized using the dUTP-biotin nick end labeling *** index(AI) was determined as the percentage of labeled nuclei with respect to the total number of nuclei ***:The total number of ACF was highest in the DMH-vehicle group(1558.20 ± 17.37),however,the number of ACF was significantly reduced by all treatments,5-FU(1231.20 ± 25.62 vs 1558.20 ± 17.37,P < 0.001),CUR(1284.20 ± 25.47 vs 1558.20 ± 17.37,P < 0.001),HHC(1086.80 ± 53.47 vs 1558.20 ± 17.37,P < 0.001),DMH-5-FU + CUR(880.20 ± 13.67 vs 1558.20 ± 17.37,P < 0.001) and DMH-5-FU + HHC(665.80 ± 16.64 vs 1558.20 ± 17.37,P < 0.001).Interestingly,the total number of ACF in the combined treatment groups,the DMH-5-FU + CUR group(880.20 ± 13.67 vs 1231.20 ± 25.62,P < 0.001;880.20 ± 13.67 vs 1284.20 ± 25.47,P < 0.001) and the DMH-5-FU + HHC group(665.80 ± 16.64 vs 1231.20 ± 25.62,P < 0.001;665.80 ± 16.64 vs 1086.80 ± 53.47,P < 0.001) were significantly reduced as compared to 5

关键词： Hexahydrocurcumin Curcumin analog Colon cancer Combination treatment Cyclooxygenase-2 Apoptosis

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In vivo gastric mucosal histopathology using endocytoscopy

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World Journal of Gastroenterology 2015年第16期21卷 5002-5008页

作者： Hiroki Sato Haruhiro Inoue Haruo Ikeda Chiaki Sato chainarong Phlanusittepha Bu'Hussain Hayee Esperanza Grace R Santi Yasutoshi Kobayashi Shin-ei Kudo Digestive Disease Center Showa UniversityNorthern Yokohama Hospital Department of Gastroenterology King’s College Hospital NHS Foundation TrustLondon SE5 9RSUnited Kingdom Department of Gastroenterology De La Salle University Medical Center Kobayashi Internal Medicine Clinic

AIM:To study the ability of endocytoscopy to identify normal gastric mucosa and to exclude Helicobacter pylori(***) ***:Endocytoscopic examination of the gastric corpus and antrum was performed in 70 consecutive *** biopsy specimens were also obtained from the assessed region and multiple *** tests were *** normal endocytoscopy patterns of the corpus and antrum were divided into the normal pit-dominant type(n-Pit) or the normal papilladominant type(n-Pap), respectively characterized as either regular pits with capillary networks or round, smooth papillary structures with spiral *** the other hand, normal mucosa was defined as mucosa not demonstrating histological abnormalities, including inflammation and ***:The sensitivity and specificity of n-Pit for normal mucosa in the gastric corpus were 94.4%and 97.1%,respectively,whereas those of n-Pap for normal mucosa in the antrum were 92.0%and 86.7%,*** positive predictive values of n-Pit and n-Pap for ***-negative tissue were 88.6%and 93.1%,respectively,and their negative predictive values for ***-negative tissues were 42.9%and41.5%,*** inter-observer agreement for determining n-Pit and n-Pap for normal mucosa were0.857 and 0.769,respectively,which is considered ***:N-Pit and n-Pap,seen using EC,are considered useful predictors of normal mucosa and theabsence of *** infection.

关键词： Atrophy Endocytoscopy Gastric mucosa Helicobacter pylori In vivo histopathology

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