• Title/Summary/Keyword: Surgical resection

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Clinicopathologic Analysis of Remnant Gastric Cancer after Distal Partial Gastrectomy: Experience of Single Center during 15 Years

  • Choi, Seung-Hui;Kim, Tae-Gyun;Kim, June-Young;Hur, Hoon;Han, Sang-Uk;Cho, Yong-Kwan;Kim, Myung-Wook
    • Journal of Gastric Cancer
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    • 제10권2호
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    • pp.63-68
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    • 2010
  • Purpose: Remnant gastric cancer (RGC) are generally detected at advanced stages or infiltration of adjacent organs. We retrospectively reviewed the surgical outcomes and clinicopathologic results of remnant gastric cancers that have operated during fourteen years in one institution of Korea. Materials and Methods: 34 patients who were diagnosed with RGC at Ajou University Hospital from April 1995 to October 2009 were enrolled. We analyzed the features of previous operation, and according to these results, surgical outcomes and clinicopathologic results for RGC were analyzed. Results: Of 34 patients, 20 patients had previously undergone distal gastrectomy for malignant disease, and 14 patients for benign disease. The period between previous operation and surgery for RGC in the patients underwent operation for malignant disease was shorter than that in benign patients (P<0.001). In surgical field, 31 patients (91.0%) were resected and curative resection was possible in 23 patients (67.6%). When 31 patients who underwent resection for RGC were divided into previous malignant and benign disease, there was no significantly different in terms of surgical outcomes and pathologic findings between two groups. Meanwhile, the patients who recently (after 2005) underwent surgery for RGC showed less advanced stage compared with the patients who underwent surgery before 2004. Conclusions: Resection was possible in the higher proportion (91.0%) of patients diagnosed with RGC compared with previous reports. The cause of previous operation did not effect on the surgical outcomes for surgery of RGC. Recent trend of RGC is to increase the proportion of early stage gastric cancer. Therefore, surgeons should consider curatively surgical resection for RGC the regardless of pattern of previous operation.

Outcomes of Completion Lobectomy for Locoregional Recurrence after Sublobar Resection in Patients with Non-small Cell Lung Cancer

  • Cho Eun Lee;Jeonghee Yun;Yeong Jeong Jeon;Junghee Lee;Seong Yong Park;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Jhingook Kim;Young Mog Shim
    • Journal of Chest Surgery
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    • 제57권2호
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    • pp.128-135
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    • 2024
  • Background: This retrospective study aimed to determine the treatment patterns and the surgical and oncologic outcomes after completion lobectomy (CL) in patients with locoregionally recurrent stage I non-small cell lung cancer (NSCLC) who previously underwent sublobar resection. Methods: Data from 36 patients who initially underwent sublobar resection for clinical, pathological stage IA NSCLC and experienced locoregional recurrence between 2008 and 2016 were analyzed. Results: Thirty-six (3.6%) of 1,003 patients who underwent sublobar resection for NSCLC experienced locoregional recurrence. The patients' median age was 66.5 (range, 44-77) years at the initial operation, and 28 (77.8%) patients were men. Six (16.7%) patients underwent segmentectomy and 30 (83.3%) underwent wedge resection as the initial operation. The median follow-up from the initial operation was 56 (range, 9-150) months. Ten (27.8%) patients underwent CL, 22 (61.1%) underwent non-surgical treatments (chemotherapy, radiation, concurrent chemoradiation therapy), and 4 (11.1%) did not receive treatment or were lost to follow-up after recurrence. Patients who underwent CL experienced no significant complications or deaths. The median follow-up time after CL was 64.5 (range, 19-93) months. The 5-year overall survival (OS) and post-recurrence survival (PRS) were higher in the surgical group than in the non-surgical (p<0.001) and no-treatment groups (p<0.001). Conclusion: CL is a technically demanding but safe procedure for locoregionally recurrent stage I NSCLC after sublobar resection. Patients who underwent CL had better OS and PRS than patients who underwent non-surgical treatments or no treatments; however, a larger cohort study and long-term surveillance are necessary.

Aggressive clinical course of extramammary Paget disease after radiotherapy

  • Choi, Yunseon;Park, Won;Lee, Jeeyun;Cho, Eun Yoon;Moon, Goo-Hyun
    • Radiation Oncology Journal
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    • 제32권2호
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    • pp.95-98
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    • 2014
  • Extramammary Paget disease (EMPD) is a rare disease, especially in Asian populations. Surgical resection is considered the primary treatment option. Recently, radiotherapy has been suggested as an EMPD treatment, either as an alternative to surgical resection or in combination with surgical resection. This report reviewed a patient with EMPD who was treated with wide excision of the EMPD site followed by radiotherapy for remaining gross lymph node metastases. The aim of this report was to determine the optimal treatment for advanced EMPD.

기관지확장증의 외과적 치료 (Surgical Observation of Bronchiectasis)

  • 이동준;김찬용
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.260-264
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    • 1978
  • Sixty-one bronchiectatic patients were reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 14 years from January of 1965 to August of 1978. 1. Various pulmonary resection was performed; lobectomy was 55.5%, lobectomy and segmental resection 20.6%, bilobectomy 13.1%, lobectomy, segmental resection and thoracoplasty 4.9% and pneumonectomy was 3. 2%. 2. The most common associated disease was pulmonary Tbc, its frequency was 47.5% and next was chronic bronchitis [31%]. 3. The postoperative complication was observed in 19.6% [12 cases] and the most common was wound infection. 4. The possibility of recurrence was relatively high in the cases of residual lesion and it needs more intensive medical care. 5. The surgical result was satisfactory in 86.9% (53 cases), slight improvement in 4.9% (3 cases) and the mortality rate was 1.6% (1 case).

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전이성 폐암의 외과적 치료 (Surgical Treatment of Metastatic Lung Cancer)

  • 주홍돈;조재일;심영목
    • Journal of Chest Surgery
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    • 제25권10호
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    • pp.1030-1034
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    • 1992
  • There are follow-up data according to thirteen patients recieved the surgical resection for metastatic lung cancer arising from different primary tumor. The patients were received the surgical resection at Korean Cancer Center Hospital from July 1987 to Setember 1991 and followed-up to August 1992. There were 9 men and 4 women, ranging in age from 16 to 70 years[mean age, 42.8 years]. The primary tumors were 2 synovial sarcoma, 2 sarcoma, 2 osteosarcoma, 3 laryngeal ca, 1 melanoma, 1 ovarian ca and 1 bladder ca. The operative procedures were 5 wedge resections, 1 segmental resection, 5 lobectomies, 1 bil-obectomy and 1 pneumonectomy. There was no operative and hospital death. There were 3 deaths[each survival period: 2, 9 and 20 months, average 10.3 months]and 5 tumor recurrence during follow-up. At now, the average survival period of aliving patients is 29.1 months.

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종격동에 발생한 고립성 섬유종의 외과적 치험 1례 (Surgical Resection of Solitary Fibrous Tumor in the Anterior Mediastinum -Report of a Case-)

  • 조수신
    • Journal of Chest Surgery
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    • 제27권1호
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    • pp.76-80
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    • 1994
  • A solitary fibrous tumor in the pleura has been reported occasionally, but extremely rare in themediastinum. The histogenesis of this tumor has been still in controverse, but recent studies paid attention to it a mesenchymal origin by the immunohistochemical and ultrastructural bases. A few cases, reported in the literature, suggest that the mediastinal solitary fibrous tumor occurs more commonly in adult and shows slightly higher incidence in women. Its aggressive behavior such as recurrence rate and distant metastasis, is more prominant than reported in solitary fibrous tumor of the pleura. No single histologic feature allows an assumption definite prognosis. Surgical resection of this tumor is usually curative although the recurrence or distant metastasis are reported in about half of the patients. This report is a case of solitary fibrous tumor in the mediastinum in a 16-year-old female patient.She underwent surgical resection and her postoperative result was satisfactory.

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Squamous cell carcinoma of the buccal mucosa involving the masticator space: a case report

  • Kim, Il-hyung;Myoung, Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권3호
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    • pp.191-196
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    • 2017
  • Squamous cell carcinoma of the buccal mucosa has an aggressive nature, as it grows rapidly and penetrates well with a high recurrence rate. If cancers originating from the buccal mucosa invade adjacent anatomical structures, surgical tumor resection becomes more challenging, thus raising specific considerations for reconstruction relative to the extent of resection. The present case describes the surgical management of a 58-year-old man who presented with persistent ulceration of the mucosal membrane and a mouth-opening limitation of 11 mm. Diagnostic imaging revealed a buccal mucosa tumor that had invaded the retroantral space upward with involvement of the anterior border of the masseter muscle by the lateral part of the tumor. In this report, we present the surgical approach we used to access the masticator space behind the maxillary sinus and discuss how to manage possible damage to Stensen's duct during resection of buccal mucosa tumors.

From Resection to Disconnection for Seizure Control in Pediatric Epilepsy Children

  • Hwang, Jun Kyu;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • 제62권3호
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    • pp.336-343
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    • 2019
  • Epilepsy surgery revealed dramatically improved seizure outcomes over medical therapy in drug-resistant epilepsy patients. Children with epilepsy, however, have multiple epileptic focuses which require multilobar resection for better seizure outcome. Multilobar resection has not only the several severe surgical complications, such as hydrocephalus and shunt-related craniosynostosis, due to intracranial volume reduction. Isolation method (disconnection surgery) was progressively studied over epileptic focus removal (resective surgery) for seizure control. This concept was first introduced for functional hemispherotomy, and its primary principle is to preserve the vital vascularized brain that is functionally disconnected from the contralateral healthy brain. Currently in most epilepsy centers, the predominant disconnection surgical methods, including functional hemispherotomy, are continually being refined and are showing excellent results. They allow the functional isolation of the hemisphere or multi-lobe, affected by severe epilepsy. This review describes recent findings concerning the indication, surgical technique, seizure outcome and complications in several disconnection surgeries including the functional hemispherotomy for refractory pediatric epilepsy.

성인에서 천막상부, 두개엽에 위치한 원발성 교모세포종의 치료에서 종양 절제의 역할 (The Role of Surgical Resection in the Treatment of Newly-Diagnosed Supratentorial Lobar Glioblastoma in Adults)

  • 이종주;안재성;전상룡;김정훈;나영신;김창진;이정교;권병덕
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.221-227
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    • 2001
  • Objective : The therapeutic impact of tumor resection in glioblastomas is poorly defined and still questionable. Therefore, we conducted the current study to verify the role of tumor resection in the treatment of these highly malignant tumors. Methods : A retrospective study was performed(1990-1999) to compare the treatment results of surgical resection plus radiotherapy(130 patients) with those of stereotactic biopsy plus radiotherapy(19 patients) in glioblastomas. Only adult patients with supratentorial, de novo glioblastoma located in one lobe were included. Survival time/rate was analysed with Kaplan-Meier method, and prognostic variables were obtained from the univariate log-rank test and the multivariate Cox's proportional hazards model. Results : The resection group and the biopsy group did not differ in terms of age, gender, duration of symptoms, presenting symptoms, tumor location, tumor side, tumor size, and the frequency of midline shift. Patients in the biopsy group more often were found to have worse preoperative Karnofsky performance status(KPS)(p=0.001). On univariate analysis, age, KPS, and tumor side were associated with survival(p=0.0053, 0.0001, and 0.0331 respectively). Median survival time and 1-year survival rate were also statistically improved by tumor resection ; resection group - 13 months and 61.2%, and biopsy group - 8 months and 19.7%, respectively(p=0.0001). In patients with midline shift of the tumor, resection was highly effective comparing to biopsy(p=0.0001), but in patients without midline shift, external beam radiation alone was as effective as tumor resection(p=0.0605). Other prognostic variables did not affect survival. On multivariate analysis after variable selection, survival was independently associated with KPS(p=0.001), but not the surgical resection(p=0.2837). Even in biopsy group with midline shift of the tumor, survival rate was not different from that seen after tumor resection(p=0.3505). Conclusions : Radiotherapy alone was as effective as tumor resection plus radiotherapy in patients without midline shift of the tumor. Although there was not statistically significant, tumor resection looked like effective in patients with midline shift. For supratentorial, lobar glioblastoma patients without mass effect of the tumor, biopsy with radiotherapy is one of rational treatment strategies. We consider that tumor resection should be performed in patients with pretreatment midline shift.

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Surgery for Pulmonary Sclerosing Hemangioma: Lobectomy versus Limited Resection

  • Park, Joon-Seok;Kim, Kwhan-Mien;Shin, Su-Min;Shim, Hun-Bo;Kim, Hong-Kwan
    • Journal of Chest Surgery
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    • 제44권1호
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    • pp.39-43
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    • 2011
  • Background: Pulmonary sclerosing hemangioma is a rare thoracic tumor, and pathophysiology or clinical course of this tumor is not yet fully described. Furthermore, there is no consensus on the standard operative procedure for this tumor. Material and Methods: Medical records of thirty-two patients, who underwent surgical resection of pulmonary sclerosing hemangioma from 1996 to 2007, were retrospectively reviewed. Results: Nineteen patients underwent lobectomy and thirteen patients underwent limited resection. Video-assisted thoracoscopic surgery was performed in 9 patients in the latter group. Lymph node dissection was done in 21 patients, and one patient was found to have lymph node metastasis of the tumor. There was no postoperative complication, no early death and no tumor-related late mortality. The mean follow-up duration was 39.3 months (2 months~129 months), and all patients were free of local recurrence and distant metastasis during this period. There was no significant difference in patient's characteristics between the two groups, except that the mean hospital stay was shorter in limited resection group than in lobectomy group (p=0.0031). Conclusion: Pulmonary sclerosing hemangioma usually requires surgical resection for both diagnosis and treatment. Limited resection can decrease hospital stay with a surgical outcome comparable to lobectomy, and may be preferred to lobectomy if sufficient resection margin can be achieved.