检索结果-南通市图书馆

Long-term outcome of stem cell transplantation with and without anti-tumor necrotic factor therapy in perianal fistula with Crohn’s disease

引用

World Journal of Stem Cells 2024年第3期16卷 257-266页

作者： Min Young Park Yong sik Yoon Jae Ha Park Jong Lyul Lee chang sik yu Division of Colon and Rectal Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722South Korea Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Stem cell transplantation is a promising therapeutic option for curing perianal fistula in Crohn’s disease(CD).Anti-tumor necrotic factor(TNF)therapy combined with drainage procedure is effective as well.However,previous studies are limited to proving whether the combination treatment of biologics and stem cell transplantation improves the effect of fistula closure.AIM This study aimed to evaluate the long-term outcomes of stem cell transplantation and compare Crohn’s perianal fistula(CPF)closure rates after stem cell transplantation with and without anti-TNF therapy,and to identify the factors affecting CPF closure and recurrence.METHODS The patients with CD who underwent stem cell transplantation for treating perianal fistula in our institution between Jun 2014 and December 2022 were enrolled.Clinical data were compared according to anti-TNF therapy and CPF closure.RESULTS A total of 65 patients were included.The median age of females was 26 years(range:21-31)and that of males was 29(44.6%).The mean follow-up duration was 65.88±32.65 months,and complete closure was observed in 50(76.9%)patients.The closure rates were similar after stem cell transplantation with and without anti-TNF therapy(66.7%vs 81.6%at 3 year,P=0.098).The patients with fistula closure had short fistulous tract and infrequent proctitis and anorectal stricture(P=0.027,0.002,and 0.008,respectively).Clinical factors such as complexity,number of fistulas,presence of concurrent abscess,and medication were not significant for closure.The cumulative 1-,2-,and 3-year closure rates were 66.2%,73.8%,and 75.4%,respectively.CONCLUSION Anti-TNF therapy does not increase CPF closure rates in patients with stem cell transplantation.However,both refractory and non-refractory CPF have similar closure rates after additional anti-TNF therapy.Fistulous tract length,proctitis,and anal stricture are risk factors for non-closure in patients with CPF after stem cell transplantation.

关键词： Crohn’s disease Anus Fistula Stem cell transplantation Tumor necrosis factor-alpha inhibitors Infliximab

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Short- and long-term outcomes of surgical treatment in patients with intestinal Behcet’s disease

引用

World Journal of Gastrointestinal Surgery 2024年第2期16卷 429-437页

BACKGROUND Behcet’s disease(BD),a chronic vasculitic disorder affecting multiple organs,is characterized by recurrent oral and genital ulcers,arthritis,vasculitis,and intes-tinal ulcers.Although intestinal involvement of BD is common in East Asia,the efficacy and long-term outcomes of surgical treatment of intestinal BD still remain to be established.AIM To evaluate the postoperative clinical course of intestinal BD and determine factors associated with its recurrence.METHODS Data from patients who underwent surgical treatment for intestinal BD between January 2010 and August 2021 were retrospectively reviewed.Patients’demo-graphics,clinical features,postoperative course,complications,and follow-up data were evaluated.RESULTS We analyzed 39 surgeries in 31 patients.The mean patient age was 45.1 years,and the mean interval between the diagnosis of intestinal BD and surgical treatment was 4.9 years(range 1.0-8.0 years).The most common indication for surgery was medical intractability(n=16,41.0%),followed by fistula or abscess(n=11,28.2%).Laparoscopic approaches were used in 19 patients(48.7%),and 5 patients(12.8%)underwent emergency surgeries.The most common surgical procedure was ileocecal resection(n=18,46.2%),followed by right colectomy(n=11,28.2%).A diverting stoma was created in only one patient(2.6%).During a mean follow-up period of 45(range 8-72)months,eight cases(20.5%)of recurrence in five patients required reoperation.The interval between operations was 12.1 months(range 6.3-17.8 mo).Four patients(10.3%)experienced recurrence within 1 year postoperatively,and all eight recurrences occurred within 2 years of the initial surgery.The reoperation rates at 1 and 3 years were 10.3%and 20.5%,respectively.A redo ileocolic anastomosis was performed in all recurrent cases.In multivariate Cox regression analysis,emergency surgery[hazard ratio(HR)9.357,95%confidence interval(CI):1.608-54.453,P=0.013]and elevated C-reactive protein(CRP)levels(HR 1.154,95%CI:1.002–1.328,P=0.047),but not medication use,were predictors

关键词： Behcet syndrome Intestinal General surgery Recurrence Risk factors

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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 carcinoma.We evaluated the cumulative incidence,time to development,and risk factors associated with ileal pouch adenoma.AIM To evaluate the cumulative incidence,time to development,and risk factors associated with pouch adenoma.METHODS 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 included.The mean follow-up period was 88 mo.RESULTS Pouch adenomas were found in 24(25.3%)patients,with a median time of 52 mo to their first formation.Tubular adenomas were detected in most patients(95.9%).There were no high-grade dysplasia or malignancies.Of the 24 patients with pouch adenomas,13 had all detected adenomas removed.Among the 13 patients who underwent complete adenoma removal,four(38.5%)developed recurrence.Among 11(45.8%)patients with numerous polyps within the pouch,seven(63.6%)exhibited progression of pouch adenoma.The cumulative risks of pouch adenoma development at 5,10,and 15 years after pouch surgery were 15.2%,29.6%,and 44.1%,respectively.Severe 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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensityscore matching analysis

引用

World Journal of Gastroenterology 2021年第41期27卷 7159-7172页

作者： Shin Jeong Pak Young Il Kim Yong sik Yoon Jong Lyul Lee Jung Bok Lee chang sik yu Department of Colon and Rectal Surgery 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 Laparoscopic ileocolic resection(LICR)is the preferred surgical approach for primary ileocolic Crohn’s disease(CD)because it has greater recovery benefits than open ICR(OICR).AIM To compare short-and long-term outcomes in patients who underwent LICR and OICR.METHODS Patients who underwent ICR for primary CD from 2006 to 2017 at a single tertiary center specializing in CD were included.Patients who underwent LICR and OICR were subjected to propensity-score matching analysis.Patients were propensityscore matched 1:1 by factors potentially associated with 30-d perioperative morbidity.These included demographic characteristics and disease-and treatment-related variables.Factors were compared using univariate and multivariate analyses.Long-term surgical recurrence-free survival(SRFS)in the two groups was determined by the Kaplan-Meier method and compared by the log-rank test.RESULTS During the study period,348 patients underwent ICR,211 by the open approach and 137 laparoscopically.Propensity-score matching yielded 102 pairs of patients.The rate of postoperative complication was significantly lower(14%versus 32%,P=0.003),postoperative hospital stay significantly shorter(8 d versus 13 d,P=0.003),and postoperative pain on day 7 significantly lower(1.4 versus 2.3,P<0.001)in propensity-score matched patients who underwent LICR than in those who underwent OICR.Multivariate analysis showed that postoperative complications were significantly associated with preoperative treatment with biologics[odds ratio(OR):3.14,P=0.01]and an open approach to surgery(OR:2.86,P=0.005).The 5-and 10-year SRFS rates in the matched pairs were 92.9%and 83.3%,respectively,with SRFS rates not differing significantly between the OICR and LICR groups.The performance of additional procedures was an independent risk factor for surgical recurrence[hazard ratio(HR):3.28,P=0.02].CONCLUSION LICR yielded better short-term outcomes and postoperative recovery than OICR,with no differences in long-term outcomes.LICR may provide greater benefits in

关键词： Crohn’s disease Laparoscopic Surgery Postoperative complications Recurrence Propensity score Retrospective study

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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

AIM To investigate the changes of postoperative anal sphincter function and bowel frequency in Korean patients with ulcerative colitis(UC).METHODS A 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).RESULTS MSP decreased after surgery until 6 mo(157 to 142 mm Hg); thereafter, it improved and was recovered to and maintained at the preoperative value at 12 mo postoperatively(142-170 mm Hg, 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 大肠炎外科治疗结果 Manometry 肠频率补药 proctocolectomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Intestinal endometriosis:Diagnostic ambiguities and surgical outcomes

引用

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 diagnose.AIM To analyze patients in whom intestinal endometriosis was diagnosed after surgical treatments, and to evaluate the clinical characteristics of preoperatively misdiagnosed cases.METHODS 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 outcomes.RESULTS 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 endometriosis.CONCLUSION 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 should be included in the differential diagnosis.

关键词： Endometriosis Intestinal endometriosis Diagnosis Surgery Treatment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Current issues in locally advanced colorectal cancer treated by preoperative chemoradiotherapy

引用

World Journal of Gastroenterology 2014年第8期20卷 2023-2029页

作者： In Ja Park chang sik yu Department of Colon and Rectal Surgery Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 138-736South Korea

In patients with locally advanced rectal cancer,preoperative chemoradiotherapy has proven to significantly improve local control and cause lower treatmentrelated toxicity compared with postoperative adjuvant treatment.Preoperative chemoradiotherapy followed by total mesorectal excision or tumor specific mesorectal excision has evolved as the standard treatment for locally advanced rectal cancer.The paradigm shift from postoperative to preoperative therapy has raised a series of concerns however that have practical clinical implications.These include the method used to predict patients who will show good response,sphincter preservation,the application of conservative management such as local excision or"wait-and-watch"in patients obtaining a good response following preoperative chemoradiotherapy,and the role of adjuvant chemotherapy.This review addresses these current issues in patients with locally advanced rectal cancer treated by preoperative chemoradiotherapy.

关键词： Colorectal cancer Rectal cancer Preoperative chemo

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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 used.In general,MSI is known as a more accurate screening test than IHC.AIM 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 deficiency.METHODS We retrospectively analyzed patients with CRC who underwent curative surgery between 2015 and 2017 at a tertiary referral center.Both IHC with four antibodies and MSI tests were routinely performed.The 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 deficiency.RESULTS 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%,respectively.The 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,respectively.CONCLUSION 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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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) patients.METHODS 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 mo.RESULTS During the follow-up period, 66 patients(25.4%) underwent a second operation for disease recurrence.At 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： Crohns 疾病复发风险因素

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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 controversial.AIM To evaluate the long-term survival benefit of ACTx in patients with ypT0–1 rectal cancer after PCRT and surgical resection.METHODS We identified rectal cancer patients who underwent PCRT followed by surgical resection at the Asan Medical Center from 2005 to 2014.Patients with ypT0–1 disease and those who received ACTx were included.The 5-year overall survival(OS)and 5-year recurrence-free survival(RFS)were analyzed according to the status of the ACTx.RESULTS 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 groups.cT 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 group.CONCLUSION Oncological outcomes of patients with ypT0–1 rectal cancer who received ACTx after PCRT showed no improvement,regardless of the radicality of resection.Further 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

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：