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Laparoscopic complete mesocolic excision: West meets East

World Journal of Gastroenterology 2014年第39期20卷 14301-14307页

作者： Carina F K Chow seon hahn kim Division of Colorectal Surgery Departmentof SurgeryRoyal Brisbane and Women’s HospitalBrisbaneQueensland 4029 Australia Department of General Surgery Mater Hospital South Brisbane Brisbane Queensland 4101 Australia Department of Surgery University of Queensland Brisbane Queensland 4072 Australia Colorectal Division Department of SurgeryKorea University Anam Hospital Anam-dongSeongbuk-gu Seoul 136-705 South Korea

Complete mesocolic excision is a relatively new concept in western literature. It follows the same concept of total mesorectal excision and units’ routinely performing complete mesocolic excisions have good pathological results as well as good improvements in overall survival, disease free survival and local recurrence. And yet unlike total mesorectal excision, uptake in the West has been relatively slow with many units sceptical of the true benefits gained by taking up a more technically challenging and potentially more morbid procedure when there is a paucity of literature to support these claims. This article reviews complete mesocolic excision for colon cancer, attempting to identify the risks and benefits of the technique and particularly looking at the reasons why its uptake has not been universal. It also discusses the similarities of a complete mesocolic excision to a colon resection with a D3 lymphadenectomy as well as the role of a laparoscopic approach to this technique. Considering a D3 lymphadenectomy has been the standard of care for stage II and III colon cancers in many of our Asian neighbours for over 20 years, combining this data with data on complete mesocolic excision may provide enough evidence to support or refute the need for complete mesocolic excisions. Maybe there might be lessons to be learnt from our colleagues in the east.

关键词： Complete mesocolic excision Colorectal surgery Laparoscopy Colonic neoplasms D3 lymphadenectomy

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Clinical characteristics of patients in their forties who underwent surgical resection for colorectal cancer in Korea

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World Journal of Gastroenterology 2021年第25期27卷 3901-3912页

作者： Chang Sin Lee Se-Jin Baek Jung-Myun Kwak Jin kim seon-hahn kim Department of Surgery Korea University College of MedicineSeoul 02841South Korea

BACKGROUND The proportion of young patients with colorectal cancer(CRC),especially in their 40s,is increasing *** To confirm the clinical characteristics of such patients,we planned a study comparing them to patients in their 30s and *** Patients undergoing primary resection for CRC,patients in their 30s,40s and 50s were included in the *** and tumor characteristics,and perioperative and oncologic outcomes were *** Most clinical characteristics of 451(10.5%)patients in their 40s were more similar to those of patients in their 30s than those in their *** pathology data,there were more metastatic lesions(30s vs 40s vs 50s;17.5%vs 21.1%vs 14.9%,P=0.012)in patients in their *** was a trend toward less frequent K-ras mutations among patients in their 40s(48.5%vs 33.3%vs 44.5%,P=0.064).The proportion of patients receiving postoperative chemotherapy was also significantly greater among patients in their 40s(58.3%vs 63.9%vs 56.3%,P=0.032).Five-year overall survival(OS)and disease-free survival(DFS)did not differ between the three groups(5-year OS,92.2%vs 89.8%vs 92.2%,P=0.804;5-year total DFS,98.6%vs 95.7%vs 96.1%,P=0.754;5-year local DFS,98.6%vs 94.3%vs 94.9%,P=0.579;5-year systemic DFS,86.4%vs 87.9%vs 86.4%,P=0.908).CONCLUSION Patients with CRC in their 40s showed significantly more numerous metastatic *** oncologic outcome of stage 1-3 patients in their 40s was not inferior compared to that of those in their 30s and 50s.

关键词： Colorectal neoplasm Young age Hereditary cancer Sporadic cancer Screening

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Bowel function and quality of life after minimally invasive colectomy with D3 lymphadenectomy for right-sided colon adenocarcinoma

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World Journal of Gastroenterology 2020年第33期26卷 4972-4982页

作者： Ki-Myung Lee Se-Jin Baek Jung-Myun Kwak Jin kim seon-hahn kim Department of Surgery Korea University College of MedicineSeoul 02841South Korea

BACKGROUND Changes in bowel function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal *** particular,there are concerns about bowel function after right-sided colectomy with complete mesocolic excision,which has become popular in the *** To evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon *** Functional data from patients who underwent minimally invasive right-sided colectomy for colon cancer from October 2017 to September 2018 were prospectively *** outcomes were evaluated preoperatively and at 3,6,12,and 18 mo *** Prior to surgery,57 patients answered the questionnaire,and 47 responded at three months,52 at 6 mo,52 at 12 mo,and 25 at 18 mo *** scales of quality of life and bowel function improved significantly over *** persisted to a high degree throughout the period without a significant change over *** use of medications for defecation was about 10%over the entire ***(P=0.023)and fecal frequency(P<0.001)increased,and bowel dysfunction group(P=0.028)was more common among patients taking *** six months,resected bowel and colon lengths were significantly different as a risk factor between the dysfunction group and the no dysfunction group[odd ratio(OR):1.095,P=0.026;OR:1.147,P=0.031,respectively]in univariate analysis,but not in multivariate *** Despite D3 lymphadenectomy,most bowel symptoms improved over time after right-sided colectomy using a minimally invasive approach,and continuous medication was needed in only approximately 10%of patients.

关键词： Colonic neoplasm Right colectomy Bowel function D3 lymphadenectomy Complete mesocolic excision Quality of life

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Expression of protein S100A4 is a predictor of recurrence in colorectal cancer

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World Journal of Gastroenterology 2010年第31期16卷 3897-3904页

作者： Jung Myun Kwak Hyun Joo Lee seon hahn kim Han Kyeom kim Young Jae Mok Young Tae Park Jong Sang Choi Hong Young Moon Department of Surgery Korea University Anam Hospital Department of Pathology Korea University Guro Hospital Department of Surgery Korea University Guro Hospital Department of Gastroenterology Korea Uni-versity Guro Hospital

AIM: To investigate the prognostic significance of S100A4 expression in colorectal cancer and its correlation with expression of E-cadherin and p53. METHODS: A cohort of archival formalin-fixed paraff inembedded specimens was selected from 127 patients with colorectal cancer who underwent surgical resection between April 2000 and March 2004 at the Department of Surgery, Korea University Guro Hospital. The expression of protein S100A4 was evaluated according to the proportion of positively stained cancer cells. In each case, three core biopsies with a diameter of 2 mm were punched out and positioned in a recipient paraff in array block. Four-μm sections of these tissue array blocks were used for immunohistochemical analysis of protein S100A4, E-cadherin, and p53. Clinicopathological data were based on the original histopathologic reports and clinical records of patients. RESULTS: In normal colorectal mucosa, protein S100A4 immunoreactivity was clearly absent in both cytoplasm and nucleus. However, positive immunoreactivity of protein S100A4 was detected in 45 (35.4%) of the tumor cases. There was no significant association between positive immunoreactivity of protein S100A4 and clinicopathological parameters such as tumor differentiation or TNM stage, and also no correlation between the reactivity and E-cadherin or p53 expression. However, positive immunoreactivity of protein S100A4 was found to be associated with tumor recurrence (P = 0.004), and was also associated with significantly worse overall survival in the Kaplan-Meyer survival analysis (P = 0.044). After adjustment for tumor differentiation, tumor depth and nodal status, however, it failed to achieve statistical significance (P = 0.067). CONCLUSION: The expression of protein S100A4 is associated with tumor recurrence and poor overall survival in patients with colorectal cancer.

关键词： S100A4 E-cadherin p53 Prognostic factor Colorectal cancer

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Can trans-anal reinforcing sutures after double stapling in lower anterior resection reduce the need for a temporary diverting ostomy?

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World Journal of Gastroenterology 2013年第32期19卷 5309-5313页

作者： Se-Jin Baek Jin kim Jungmyun Kwak seon-hahn kim Department of Surgery Korea University College of Medicine

AIM:To evaluate trans-anal reinforcing sutures in low anterior resection using the double-stapled anastomosis technique for primary rectal cancers performed at a single ***:The data of patients who received transanal reinforcing sutures were compared with those of patients who did not receive them after low anterior *** who underwent laparoscopic low anterior resection and the double-stapled anastomosis technique for primary rectal cancer between January2008 and December 2011 were included in this *** with no anastomosis,a hand-sewn anastomosis,high anterior resection,or preoperative chemoradiation were *** primary outcomes measured were the incidence of postoperative anastomotic complications and placement of a diverting ***:Among 110 patients,the rate of placement of a diverting ileostomy was significantly lower in the suture group(SG)compared with the non-suture control group(CG)[SG,n=6(12.8%);CG,n=19(30.2%),P=0.031].No significant difference was observed in the rate of anastomotic leakage[SG,n=3(6.4%);CG,n=5(7.9%)].CONCLUSION:Trans-anal reinforcing sutures may reduce the need for diverting ileostomy.A randomized prospective study with a larger population should be performed in the future to demonstrate the efficacy of trans-anal reinforcing sutures.

关键词： Anastomotic leak Low anterior resection Rectal neoplasms Double-stapled anastomotic technique Reinforcement sutures

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Risk factors causing structural sequelae after anastomotic leakage in mid to low rectal cancer

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World Journal of Gastroenterology 2015年第19期21卷 5910-5917页

作者： Woong Bae Ji Jung Myun Kwak Jin kim Jun Won Um seon hahn kim Department of Surgery Korea University College of Medicine

AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal ***: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic ***: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.

关键词： Anastomotic leakage Permanent stoma Leakage sequelae rectal cancer Anastomotic leakagefate

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Current status of robot-assisted gastric surgery

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World Journal of Gastrointestinal Oncology 2011年第10期3卷 137-143页

作者： Se-Jin Baek Dong-Woo Lee Sung-Soo Park seon-hahn kim Department of Surgery Korea University College of MedicineMIS Robotic Surgery Center Korea University Medical Center Korea University Anam Hospital Seoul 136-705South Korea Robotic Surgery Center Korea University Medical Center Division of Upper GI Surgery Department of SurgeryKorea University College of MedicineMIS Division of Colorectal Department of SurgeryKorea University College of MedicineMIS

In an effort to minimize the limitations of laparoscopy,a robotic surgery system was introduced,but its role for gastric cancer is still *** objective of this article is to assess the current status of robotic surgery for gastric cancer and to predict future *** the current study was limited by its small number of patients and retrospective nature,robot-assisted gastrectomy with lymphadenectomy for the treatment of gastric cancer is a feasible and safe procedure for experienced laparoscopic *** studies have reported satisfactory results for postoperative short-term coutcomes,such as:postoperative oral feeding,gas out,hospital stay and complications,compared with laparoscopic surgery;the difference is a longer operation ***,robotic surgery showed a shallow learning curve compared with the familarity of conventional open surgery;after the accumulation of several cases,robotic surgery could be expected to result in a similar operation ***-assisted gastrectomy can expand the indications of minimally invasive surgery to include advanced gastric cancer by improving the ability to perform ***," total" robotic gastrectomy can be facilitated using a robotsewing technique and gastric submucosal tumors near the gastroesophageal junction or pylorus can be resected safely by this novel *** conclusion,robotassisted gastrectomy may offer a good alternative to conventional open or laparoscopic surgery for gastric cancer,provided that long-term oncologic outcomes can be confirmed.

关键词： Robot surgery Stomach Minimally invasive surgery

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Relationship between diversion colitis and quality of life in rectal cancer

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World Journal of Gastroenterology 2013年第4期19卷 542-549页

作者： Dong Nyoung Son Dong Jin Choi Si Uk Woo Jin kim Bo Ra Keom Chul Hwan kim Se Jin Baek seon hahn kim Colorectal Division Department of SurgeryKorea University Anam Hospital Korea University College of Medicine Seoul 136-705South Korea Department of Surgery Sun General HospitalDaejeon 301-747South Korea Department of Surgery Gangseo Song-do HospitalSeoul 139-711South Korea Department of Gastroenterology Korea University Anam Hospital Department of Pathology Korea University Anam Hospital

AIM:To investigated the incidence of diversion colitis(DC) and impact of DC symptoms on quality of life(QoL) after ileostomy reversal in rectal ***:We performed a prospective study with 30 patients who underwent low anterior resection and the creation of a temporary ileostomy for the rectal cancer between January 2008 and July 2009 at the Department of Surgery,Korea University Anam *** participants totally underwent two rounds of the *** first examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom were performed 3-4 mo after the ileostomy *** second examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom and QoL were performed 5-6 mo after the ileostomy *** data were based on the histopathological reports and clinical records of the ***:At the first examination,all of the patients presented with inflammation,which was mild in 15(50%) patients,moderate in 11(36.7%) and severe in 4(13.3%) by endoscopy and mild in 14(46.7%) and moderate in 16(53.3%) by *** the second examination,only 11(36.7%) and 17(56.7%) patients had mild inflammation by endoscopy and histology,*** was no significant difference in DC grade between the endoscopic and the histological findings at first or second *** symptoms detected on the first and second questionnaires were mucous discharge in 12(40%) and 5(17%) patients,bloody discharge in 5(17%) and 3(10%) patients,abdominal pain in 4(13%) and 2(7%) patients and tenesmus in 9(30%) and 5(17%) patients,*** found no correlation between the endoscopic or histological findings and the symptoms such as mucous discharge,bleeding,abdominal pain and tenesmus in both time *** was detected in 9 patients at the second examination;this number correlated with the severity of DC(0%,0%,66.7%,33.3% vs 0%,71.4%,23.8%,4.8%,P = 0.001) and the symptom-related QoL(r =-0.791,P

关键词： Diversion colitis Quality of life Diarrhea Ileostomy Rectal cancer

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Effect of organic mineral supplementation in reducing oxidative stress in Holstein calves during short‑term heat stress and recovery conditions

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Journal of Animal Science and Biotechnology 2024年第2期15卷 812-825页

作者： A-Rang Son seon-Ho kim Mahfuzul Islam Michelle Miguel Ye Pyae Naing Sang-Suk Lee Ruminant Nutrition and Anaerobe Laboratory Department of Animal Science and TechnologySunchon National UniversitySuncheon 57922Korea Department of Microbiology and Parasitology Sher-e-Bangla Agricultural UniversityDhaka 1207Bangladesh

Background This study investigated the effects of inorganic and organic minerals on physiological responses,oxidative stress reduction,and rumen microbiota in Holstein bull calves(123.81±9.76 kg;5 months old)during short-term heat stress(HS)and recovery *** Holstein calves were randomly assigned to four treatment groups:no mineral supplementation(Con),inorganic minerals(IM),organic minerals(OM),and high-concentration organic minerals(HOM)and two thermal environments(HS and recovery)using 4×2 factorial arrangement in a crossover design of four periods of 35 *** were maintained in a temperature-controlled *** experimental period consisted of 14 d of HS,14 d of recovery condititon,and a 7-d washing *** Body temperature and respiration rate were higher in HS than in the recovery conditions(P0.05).The principal coordinate analysis represented that the overall rumen microbiota was not influenced by mineral supplementation;however,temperature-induced microbial structure shifts were indicated(PERMANOVA:P<0.05).At the phylum level,Firmicutes and Actinobacteria decreased,whereas Fibrobacteres,Spirochaetes,and Tenericutes increased(P<0.05),under HS *** genus Treponema increased under HS conditions,while Christensenella was higher in recovery conditions(P<0.05).Conc

关键词： Antioxidant status Heat stress Holstein bull calves Organic mineral supplementation Oxidative stress

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Body-Shaping Membrane to Regenerate Breast Fat by Elastic Structural Holding

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Research 2024年第1期2023卷 165-180页

作者： Hye-seon kim Jeongeun Park Hyun-Su Ha Sewoom Baek Chan Hee Lee Kyubae Lee Suji Park Jueun kim Se Won Yi Hak-Joon Sung Department of Medical Engineering Graduate School of Medical ScienceBrain Korea 21 ProjectYonsei University College of MedicineSeoul 03722Republic of Korea TMD LAB Co.Ltd. 6th Floor31Gwangnaru-ro 8-gilSeongdong-guSeoul 04799Republic of Korea

Tissue regeneration requires structural holding and movement support using tissue-type-specific aids such as bone casts,skin bandages,and joint ***,an unmet need exists in aiding breast fat regeneration as the breast moves following continuous body motion by exposing the breast fat to dynamic ***,the concept of elastic structural holding is applied to develop a shape-fitting moldable membrane for breast fat regeneration(“adipoconductive”)after surgical defects are *** membrane has the following key characteristics:(a)It contains a panel of honeycomb structures,thereby efficiently handling motion stress through the entire membrane;(b)a strut is added into each honeycomb in a direction perpendicular to gravity,thereby suppressing the deformation and stress concentration upon lying and standing;and(c)thermo-responsive moldable elastomers are used to support structural holding by suppressing large deviations of movement that occur *** elastomer became moldable upon a temperature shift above T_(m).The structure can then be fixed as the temperature *** a result,the membrane promotes adipogenesis by activating mechanotransduction in a fat miniature model with pre-adipocyte spheroids under continuous shaking in vitro and in a subcutaneous implant placed on the motion-prone back areas of rodents in vivo.

关键词： thereby shaking Elastic

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