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New anti-mesenteric delta-shaped stapled anastomosis: Technical report with short-term postoperative outcomes in patients with Crohn’s disease

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2592-2601页

作者： Jong Lyul Lee Yong Sik Yoon Hyun Gu Lee Young Il kim Min Hyun kim chan wook kim In Ja Park Seok-Byung Lim chang Sik Yu Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Surgery Gangdong Kyung Hee University HospitalSeoul 05278South Korea

BACKGROUND Medical treatment for Crohn’s disease(CD)has continuously improved,which has led to a decrease in surgical recurrence *** these advancements,25%of patients will undergo repeat intestinal *** of CD com-monly occurs on the mesentery side of the anastomosis *** To compare the new anti-mesenteric side-to-side delta-shaped stapled anasto-mosis(DSA)with the conventional stapled functional end-to-end anastomosis(CSA).METHODS This retrospective study included CD patients who underwent ileo-ileal or ileo-colic anastomosis between January 2020 and December *** DSA technique employed a stapler to maintain the concept of anti-mesentery side-to-side ana-stomosis by performing a 90°vertical closure of the open window compared with the CSA *** the corner where the open window is closed,the DSA avoids forming a pouch and creates an anastomosis resembling a delta shape within the intestinal *** compared demographics,preoperative condition,operative findings,and operative outcomes for the two *** The study included 175 patients,including 92 in the DSA group and 83 in the CSA *** two groups were similar in baseline characteristics,preoperative medical treatment,and operative findings except for the Montreal classification *** 30-days postoperative complication rate was signi-ficantly lower in the DSA group compared with the CSA group(16.3%vs 32.5%,P=0.009).Ileus incidence was significantly lower in the DSA group than in the CSA group(4.3%vs 14.5%,P=0.033),and the hospital stay was shorter in the DSA group than in the CSA group(5.67±1.53 days vs 7.39±3.68 days,P=0.001).CONCLUSION The DSA technique was feasible and showed comparable postoperative outcomes with lower short-term complic-ations compared with the CSA *** studies on CD recurrence and long-term complications are warranted.

关键词： Crohn’s disease Surgery Anastomosis Complication Recurrence

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Postoperative changes of manometry after restorative proctocolectomy in Korean ulcerative colitis patients

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World Journal of Gastroenterology 2017年第31期23卷 5780-5786页

作者： se heon oh yong sik yoon jong lyul lee chan wook kim in ja park seok-byung lim chang sik yu jin cheon kim department of surgery division of colon and rectal surgery university of ulsan college of medicine asan medical center

To investigate the changes of postoperative anal sphincter function and bowel frequency in Korean patients with ulcerative colitis (UC). METHODSA total of 127 patients with UC who underwent restorative proctocolectomy (RPC) during 20 years were retrospectively analyzed. The parameters of anal manometry and bowel frequency were compared according to the 6-mo intervals until 24 mo postoperatively. Manometry was used to measure the maximal squeezing pressure (MSP) and maximal resting pressure (MRP). RESULTSMSP decreased after surgery until 6 mo (157 to 142 mmHg); thereafter, it improved and was recovered to and maintained at the preoperative value at 12 mo postoperatively (142-170 mmHg, P changes of manometry and bowel frequency after restorative proctocolectomy in Korean patients with UC were not different from those in Western patients with UC.

关键词： Ulcerative colitis Surgery Treatment outcome Manometry Bowel frequency Restorative proctocolectomy

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Intestinal endometriosis:Diagnostic ambiguities and surgical outcomes

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World Journal of Clinical Cases 2019年第4期7卷 441-451页

作者： Jun Woo Bong chang Sik Yu Jong Lyul Lee chan wook kim Yong Sik Yoon In Ja Park Seok-Byung Lim Jin Cheon kim Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of Medicine and Asan Medical Center

BACKGROUND Endometriosis is a common disease for women of reproductive age. However,when it involves intestines, it is difficult to diagnose preoperatively because its symptoms overlap with other diseases and the results of evaluations can be unspecific. Thus it is important to know the clinical characteristics of intestinal endometriosis and how to exactly *** To analyze patients in whom intestinal endometriosis was diagnosed after surgical treatments, and to evaluate the clinical characteristics of preoperatively misdiagnosed *** We retrospectively reviewed the pathologic reports of 30 patients diagnosed as having intestinal endometriosis based on surgical specimens between January2000 and December 2017. We reviewed their clinical characteristics and surgical *** Twenty-three(76.6%) patients showed symptoms associated with endometriosis,with dysmenorrhea being the most common(n = 9, 30.0%). Thirteen patients(43.3%) had a history of pelvic surgeries. Ten patients(33.3%) had a history of treatment for endometriosis. Only 4 patients(13.3%) had a diagnosis of endometriosis based on endoscopic biopsy findings. According to preoperative evaluations, 13 patients(43.3%) had an initial diagnosis of pelvic endometriosis and 17 patients(56.6%) were misdiagnosed as having other diseases. The most common misdiagnosis was submucosal tumor in the large intestine(n = 8, 26.7%),followed by malignancies of the colon/rectum(n = 3, 10.0%) and ovary(n = 3,10.0%). According to the Clavien-Dindo classification, 5 complications were grade I or II and 2 complications were grade IIIa. The median follow-up period was 26.9(0.6-132.1) mo, and only 1 patient had a recurrence of *** Intestinal endometriosis is difficult to diagnose preoperatively because it mimics various intestinal diseases. Thus, if women of reproductive age have ambiguous symptoms and signs with nonspecific radiologic and/or endoscopic findings,intestinal endometriosis sho

关键词： Endometriosis Intestinal endometriosis Diagnosis Surgery Treatment

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Cumulative incidence and risk factors for pouch adenomas associated with familial adenomatous polyposis following restorative proctocolectomy

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World Journal of Gastroenterology 2022年第30期28卷 4152-4162页

作者： Hyo Seon Ryu chang Sik Yu Young Il kim Jong Lyul Lee chan wook kim Yong Sik Yoon In Ja Park Seok-Byung Lim Jin Cheon kim Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND The emergence of restorative total proctocolectomy has significantly reduced the lifetime colorectal cancer risk associated with familial adenomatous polyposis(FAP).However,adenomas may develop in the ileal pouch over time and may even progress to *** evaluated the cumulative incidence,time to development,and risk factors associated with ileal pouch *** To evaluate the cumulative incidence,time to development,and risk factors associated with pouch *** In this retrospective,observational study conducted at a tertiary center,95 patients with FAP who underwent restorative proctocolectomy at our center between 1989 and 2018 were consecutively *** mean follow-up period was 88 *** Pouch adenomas were found in 24(25.3%)patients,with a median time of 52 mo to their first *** adenomas were detected in most patients(95.9%).There were no high-grade dysplasia or *** the 24 patients with pouch adenomas,13 had all detected adenomas *** the 13 patients who underwent complete adenoma removal,four(38.5%)developed *** 11(45.8%)patients with numerous polyps within the pouch,seven(63.6%)exhibited progression of pouch *** cumulative risks of pouch adenoma development at 5,10,and 15 years after pouch surgery were 15.2%,29.6%,and 44.1%,*** colorectal polyposis(with more than 1000 polyps)was a significant risk factor for pouch adenoma development(hazard ratio,2.49;95% confidence interval:1.04-5.96;P=0.041).CONCLUSION Pouch adenomas occur at a fairly high rate in association with FAP after restorative proctocolectomy,and a high colorectal polyp count is associated with pouch adenoma development.

关键词： Adenomatous polyposis coli Familial adenomatous polyposis Adenoma Intestinal polyps Proctocolectomy,restorative Ileal pouch anal anastomosis

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Cost-effective screening using a two-antibody panel for detecting mismatch repair deficiency in sporadic colorectal cancer

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World Journal of Clinical Cases 2021年第24期9卷 6999-7008页

作者： Jong Beom kim Young Il kim Yong Sik Yoon Jihun kim Seo Young Park Jong Lyul Lee chan wook kim In Ja Park Seok-Byung Lim chang Sik Yu Jin Cheon kim Division of Colon and Rectal Surgery University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Pathology University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Clinical Epidemiology and Biostatistics University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND The microsatellite instability(MSI)test and immunohistochemistry(IHC)are widely used to screen DNA mismatch repair(MMR)deficiency in sporadic colorectal cancer(CRC).For IHC,a two-antibody panel of MLH1 and MSH2 or four-antibody panel of MLH1,MSH2,PMS2,and MSH6 are *** general,MSI is known as a more accurate screening test than *** To compare two-and four-antibody panels of IHC in terms of accuracy and cost benefit on the basis of MSI testing for detecting MMR *** We retrospectively analyzed patients with CRC who underwent curative surgery between 2015 and 2017 at a tertiary referral *** IHC with four antibodies and MSI tests were routinely *** sensitivity and specificity of a fourand two types of two-antibody panels(PMS2/MSH6 and MLH1/MSH2)were compared on the basis of MSI testing for detecting MMR *** High-frequency MSI was found in 5.5%(n=193)of the patients(n=3486).The sensitivities of the four-and two types of two-antibody panels were 97.4%,92.2%,and 87.6%,*** specificities of the three types of panels did not differ significantly(99.6%for the four-antibody and PMS2/MSH6 panels,99.7%for the MLH1/MSH2 panel).Based on Cohen's kappa statistic(κ),four-and twoantibody panels were in almost perfect agreement with the MSI test(κ>0.9).The costs of the MSI test and the four-and two-antibody panels of IHC were approximately$200,$160,and$80,*** Considering the cost of the four-antibody panel IHC compared to that of the twoantibody panel IHC,a two-antibody panel of PMS2/MSH6 might be the best choice in terms of balancing cost-effectiveness and accuracy.

关键词： Adenocarcinoma DNA mismatch repair Immunochemistry Monoclonal antibody Microsatellite instability Cost-effectiveness

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Clinical assessment and identification of immuno-oncology markers concerning the 19-gene based risk classifier in stage Ⅳ colorectal cancer

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World Journal of Gastroenterology 2019年第11期25卷 1341-1354页

作者： Jong Lyul Lee Seon Ae Roh chan wook kim Yi Hong Kwon Ye Jin Ha Seon-Kyu kim Seon-Young kim Dong-Hyung Cho Yong Sung kim Jin Cheon kim Department of Surgery University of Ulsan College of Medicine Institute of Innovative Cancer Research Asan Medical Center Medical Genomics Research Center Korea Research Institute of Bioscience and Biotechnology School of Life Sciences Kyungpook National University

BACKGROUND Genomic profiling of tumors has contributed to the understanding of colorectal cancer(CRC), facilitating diagnosis, prognosis and selection of treatments,including targeted regimens. A report suggested that a 19-gene-based risk classifier(TCA19) was a prognostic tool for patients with stage III CRC. The survival outcomes in patients with stage IV CRC are still poor and appropriate selection of targeted therapies and immunotherapies is *** To assess clinical implication of TCA19 in patients with stage IV CRC, and to identify TCA19 with involvement in *** A retrospective review of the medical records of 60 patients with stage IV CRC was conducted, assessing clinicopathological variables and progression-free survival(PFS). TCA19 gene expression was determined by quantitative polymerase chain reaction(qPCR) in matched normal and tumor tissues taken from the study cohort. Expression of potential immune-oncology regulatory proteins and targets was examined by immunohistochemistry(IHC), western blot, immunofluorescence staining in tissues from a validation cohort of 10 patients, and in CRC cell lines co-cultured with monocyte in *** In the patients with TCA19 score higher than the median, the PFS rates of eight patients who received the targeted regimens were significantly higher than the PFS rates of four patients who received 5-fluorouracil-based regimen(P = 0.041).In multivariate analysis, expression of signaling lymphocytic activation molecule family, member 7(SLAMF7) and triggering receptor expressed on myeloid cells 1(TREM1) was associated with PFS in the 60-patient cohort. After checking another 10 validate set, the expression of the IHC, the level of real-time qPCR,and the level of western blot were lower for SLAMF7 and higher for TREM7 in primary and metastatic tumors than in normal tissues. In CRC cells expressing SLAMF7 that were co-cultured with a monocytic cell line, levels of CD 68 and CD73 were significant

关键词： Colorectal cancer Prognosis Immunotherapy Signaling lymphocytic activation molecule family,member 7 Triggering receptor expressed on myeloid cells 1

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Isolated vaginal metastasis from stage Ⅰ colon cancer: A case report

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World Journal of Clinical Cases 2020年第3期8卷 527-534页

作者： Soon Keun Kwon chang Sik Yu Shin-Wha Lee Jihun kim Inho Song Jong Lyul Lee chan wook kim Yong Sik Yoon In Ja Park Seok-Byung Lim Jin Cheon kim Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Obstetrics and Gynecology University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea Department of Pathology University of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Distant metastasis occasionally occurs in patients who have been diagnosed with colorectal cancer(CRC), but it occurs in a few patients with stage I CRC. The vagina as a metastasis site has also been reported, albeit rarely. Most reported cases of vaginal metastasis(VM) report their origin from advanced CRC. We encountered a patient who was diagnosed with isolated VM originating from stage I colon cancer(T2N0) and herein present the case of this *** SUMMARY A 63-year-old woman visited the outpatient clinic because of a positive result from a stool occult blood test. She underwent laparoscopic anterior resection and was pathologically diagnosed with stage I(T2N0) sigmoid colon cancer. Neither lymphovascular invasion nor perineural invasion was observed. Ten months following the surgery, isolated vaginal metastases were detected on gynecologic examination. The examination was performed due to vaginal spotting. A transvaginal wide excision was performed, and no other adjuvant treatment was provided after discussion with a multidisciplinary team and the ***, a new VM was discovered after 33 mo. An additional transvaginal excision was performed. To date, there has been no evidence of further disease progression. From the time of diagnosis of VM, the patient’s overall survival has been 54 *** VM can occur as a result of early-stage colorectal cancer. Surgeons should consider the possibility of VM following complaints of gynecologic symptoms following surgery.

关键词： Colorectal cancer Stage Ⅰ Vaginal metastasis Isolated metastasis Case report

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Evaluating the benefit of adjuvant chemotherapy in patients with ypT0-1 rectal cancer treated with preoperative chemoradiotherapy

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 1000-1011页

作者： Ye Won Jeon In Ja Park Jeong Eun kim Jin-Hong Park Seok-Byung Lim chan wook kim Yong Sik Yoon Jong Lyul Lee chang Sik Yu Jin Cheon kim Department of Surgery Asan Medical Center and University of Ulsan College of MedicineSeoul 05505South Korea Department of Colon and Rectal Surgery Asan Medical Center and University of Ulsan College of MedicineSeoul 05505South Korea Department of Oncology Asan Medical Center and University of Ulsan College of MedicineSeoul 05505South Korea Department of Radiation Oncology Asan Medical Center and University of Ulsan College of MedicineSeoul 05505South Korea

BACKGROUND Adjuvant chemotherapy(ACTx)is recommended in rectal cancer patients after preoperative chemoradiotherapy(PCRT),but its efficacy in patients in the early post-surgical stage who have a favorable prognosis is *** To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical *** We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to *** with ypT0–1 disease and those who received ACTx were *** 5-year overall survival(OS)and 5-year recurrence-free survival(RFS)were analyzed according to the status of the *** Of 520 included patients,413 received ACTx(ACTx group)and 107 did not(no ACTx group).No significant difference was observed in 5-year RFS(ACTx group,87.9%vs no ACTx group,91.4%,P=0.457)and 5-year OS(ACTx group,90.5%vs no ACTx group,86.2%,P=0.304)between the *** stage was associated with RFS and OS in multivariate analysis[hazard ratio(HR):2.57,95%confidence interval(CI):1.07–6.16,P=0.04 and HR:2.27,95%CI:1.09–4.74,P=0.03,respectively].Furthermore,ypN stage was associated with RFS and OS(HR:4.74,95%CI:2.39–9.42,P<0.00 and HR:4.33,95%CI:2.20–8.53,P<0.00,respectively),but only in the radical resection *** Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement,regardless of the radicality of *** trials are needed to evaluate the efficacy of ACTx in these group of patients.

关键词： Rectal neoplasm Adjuvant chemotherapy ypT0-1 Radical resection Local excision

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Risk factors for postoperative recurrence after primary bowel resection in patients with Crohn's disease

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World Journal of Gastroenterology 2017年第38期23卷 7016-7024页

作者： Kwan Mo Yang chang Sik Yu Jong Lyul Lee chan wook kim Yong Sik Yoon In Ja Park Seok-Byung Lim Sang Hyoung Park Byong Duk Ye Suk-Kyun Yang Jin Cheon kim Division of Colon and Rectal Surgery Department of Surgery University of Ulsan College of Medicine Asan Medical Center De-partment of Gastroenterology University of Ulsan College of Medicine Asan Medical Center

AIM To evaluate the risk factors for postoperative recurrence after primary bowel resection in a cohort of Korean Crohn's disease(CD) *** This study included 260 patients with no history of previous bowel surgery who underwent primary surgery for CD between January 2000 and December 2010 at Asan Medical Center(Seoul, South Korea). The median follow-up period was 101 *** During the follow-up period, 66 patients(25.4%) underwent a second operation for disease *** 1, 5 and 10 years after the first operation, the cumulative rate of surgical recurrence was 1.1%, 8.3% and 35.9% and clinical recurrence occurred in 1.2%, 23.6% and 68.1%, respectively. In multivariate analysis, undergoing an emergency operation was a significant risk factor for surgical recurrence-free survival(SRFS) [HR = 2.431, 95%CI: 1.394-4.240, P = 0.002], as were the presence of perianal disease after the first operation(HR = 1.715, 95%CI: 1.005-2.926, P = 0.048) and history of smoking(HR = 1.798, 95%CI: 1.088-2.969, P = 0.022). The postoperative use of antitumor necrosis factor(TNF) agents reduced SRFS risk(HR = 0.521, 95%CI: 0.300-0.904, P = 0.02).CONCLUSION History of smoking, postoperative perianal disease and undergoing an emergency operation were independent risk factors for surgical recurrence. Using anti-TNF agents may reduce surgical recurrence.

关键词： Crohn’s disease Recurrence Risk factor

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Tetradentate Pt(Ⅱ)complex as a singlet exciton sensitizing host for highly efficient green fluorescent organic light-emitting diodes

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Science China Materials 2024年第8期67卷 2618-2627页

作者： Unhyeok Jo Seung chan kim chan Hee Ryu Kang Mun Lee Jae-Min kim Jun Yeob Lee School of Chemical Engineering Sungkyunkwan University2066Seobu-roJangan-guSuwon-siGyeonggi-do 16419Republic of Korea Department of Chemistry Institute for Molecular Science and Fusion TechnologyKangwon National UniversityChuncheonGangwon 24341Republic of Korea Department of Advanced Materials Engineering Chung-Ang University4726Seodong-daeroDaedeok-myeonAnseong-siGyeonggi-do 17546Republic of Korea SKKU Advanced Institute of Nano Technology Sungkyunkwan University2066Seobu-roJangan-guSuwonGyeonggi 16419Republic of Korea SKKU Institute of Energy Science and Technology Sungkyunkwan University2066Seobu-roJangan-guSuwonGyeonggi 16419Republic of Korea

Efficient green fluorescent organic light-emitting diodes were designed with a phosphorescent metal complex as a singlet exciton sensitizing host(SESH)for achieving high efficiency and low efficiency roll-off through exciton and polaron *** Pt(Ⅱ)complex(Pt-Trz)possessing a tetradentate ligand with a bulky blocking group not only suppresses the severe formation of excimer or dimer itself but also transfers radiative excitons to fluorescent dopant *** SESH assisted fluorescence(SESHF)device with Pt-Trz as the host exhibits the maximum external quantum efficiency of 13.3%and a lower efficiency roll-off compared with exciplex host device which is a general approach for harvesting triplet *** exciton dynamics modeling unravels that the SESHF device effectively utilizes triplet excitons in the host by intersystem crossing and resonance energy transfer from the triplet state of the host to the singlet state of the terminal *** quenching rates of the SESHF device are reduced by 11 times for triplet-triplet annihilation and 1.8 times for tripletpolaron annihilation compared with the exciplex device,which demonstrates that Pt-Trz could be a platform to be used as an efficient host for fluorophores.

关键词： singlet annihilation polaron

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