• Title/Summary/Keyword: 내시경적 절제

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The Surgical Outcome for Gastric Submucosal Tumors: Laparoscopy vs. Open Surgery (위 점막하 종양에 대한 개복 및 복강경 위 절제술의 비교)

  • Lim, Chai-Sun;Lee, Sang-Lim;Park, Jong-Min;Jin, Sung-Ho;Jung, In-Ho;Cho, Young-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.225-231
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    • 2008
  • Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

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A Case of Colitis Cystica Profunda Mixed with Juvenile Retention Polyp in a 7-month-old Infant (직장에 발생한 심재성 낭성 대장염(Colitis Cystica Profunda) 및 연소성 정류 용종(Juvenile Retention Polyp)의 혼재형 1례)

  • Lee, Chang-Jin;Kim, Beyong-Chan;Moon, Jin-Soo;Kim, Jeong-Eun;Choi, Kyung-Dan;Ko, Jae-Sung;Kang, Gyeong-Hoon;Kim, Woo-Sun;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.96-100
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    • 2002
  • Colitis cystica profunda is a rare benign condition characterized by the presence of mucus-filled cysts in the submucosa of the colon and the rectum. Although it may diffusely involve the entire colon, this disease primarily affects the pelvic colon and rectum. It has rarely been described in the pediatric literature. The surgical treatment has been widely advocated. We report a 7-month-old case, successfully treated by colonoscopic polypectomy without complication. Histologically, components of juvenile retention polyp were mixed with colitis cytsica profunda.

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A Case of Large Laryngomucocele (거대 후두점액낭종 1예)

  • Mun, Sue Jean;Lee, Ji-Eun;Hong, Seung No;Choi, Hyo Geun;Kim, Kwang Hyun;Jung, Young Ho
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.146-148
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    • 2012
  • 후두낭종은 후두소낭의 비정상적인 팽창으로 발생하는 드문 질환이다. 후두낭종의 크기와 증상에 따라 치료 방법은 단순 경과관찰에서부터 흡인, 경화제 주입, 수술적 치료까지 다양하다. 수술적 치료는 외적 접근법, 내시경적 접근법 또는 두 접근법을 혼용한 접근법을 통해 이루어진다. 최근 저자들은 경부 외적 접근법 및 연골막하 절제를 통한 혼합 후두점액낭종 1예의 치료를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

A Case of Endobronchial Aspergilloma Presented by Solitary Pulmonary Nodule (고립성 폐 결절 형태로 나타난 기관지 내 국균종 1예)

  • Lee Ki-Man;Kim Sung-Jin;Hong Jong-Myeon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.648-651
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    • 2006
  • A 53 year-old woman visited to our hospital due to increased hemoptysis for 4 days. The chest X-ray showed solitary pulmonary nodule on right upper lobe and computed tomography of chest demonstrated mass on posterior segmental bronchus of right upper lobe. Bronchoscopic examination revealed that this segmental bronchus was completely obstructed by a yellow and brownish mud like mass, which was identified as an aspergilloma by pathologic examination. Patient had undergone bilobectomy because of persistent hemoptysis. Tracheobronchial apergillosis in an immunocompetent person is very rare disease. then, we report this case with review of the Korean literature.

A Case of Blue Rubber Bleb Nevus Syndrome (Blue Rubber Bleb Nevus Syndrome 1예)

  • Kang, Ki-Soo;Oh, Hyun-Ju;Ko, Jae-Sung;Seo, Jeong-Kee;Park, Kwi-Won;Kang, Gyeong-Hoon;Kim, Woo-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.198-203
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    • 2008
  • We report a 10-year-old girl with the blue rubber bleb nevus syndrome (BRBNS) who had chronic severe anemia caused by chronic occult bleeding in the gastrointestinal (GI) tract. The patient was admitted to the hospital frequently for recurrent pallor and fatigue since the age of 7 years. Gastroduodenoscopy and capsule endoscopy revealed multiple venous malformations with blood oozing in the stomach, small bowel and colon. The patient was treated by aggressive surgical resection of the 23 vascular malformations in the GI tract. The patient is well without anemia 15 months post surgery.

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Primary Peritoneal Psammocarcinoma Misdiagnosed as an Heterotopic Ossification: A Case Report (이소골화로 오진된 복막의 일차성 모래종암종: 증례 보고)

  • Gayoung Jeon;Seo Young Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.958-963
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    • 2023
  • Primary peritoneal psammocarcinoma is a rare type of serous carcinoma that is characterized by the massive formation of psammoma bodies and the invasion of adjacent organs. A 55-year-old female who previously underwent a hysterectomy presented to the emergency room with severe abdominal pain. Contrast-enhanced CT revealed an intra-abdominal calcific mass. Initially, it was thought to be a heterotopic ossification due to the previous pelvic surgery with intact ovaries. However, this was diagnosed as a primary peritoneal psammocarcinoma. Primary peritoneal psammocarcinoma is a very rare disease entity that should be considered a differential diagnosis in patients with normal ovaries, massive ossification in the pelvic cavity, and calcific peritoneal nodules.

VATS Resection of Giant Leiomyoma of the Esophagus -1 case- (흉강경을 이용한 식도의 거대 평활근종 절제술 -치험 1예-)

  • 황호영;한국남;김주현;김영태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.715-717
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    • 2004
  • A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day.

The Effects of Educational Video Program Delivered Using Tablet PC on Physical Discomfort, Uncertainty, State Anxiety, and Nursing Education Satisfaction among Early Gastric Cancer Patients Undergoing Endoscopic Submucosal Dissection (태블릿 PC를 활용한 동영상 교육이 내시경적 절제술을 받는 조기 위암 환자의 신체적 불편감, 불확실성, 상태불안 및 간호교육만족도에 미치는 효과)

  • Kim, Mi Kyung;Kim, Jinhee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.2
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    • pp.147-158
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    • 2018
  • Purpose: This study was conducted to identify the effects of educational video program delivered using Tablet PC on physical discomfort, uncertainty, state anxiety, and nursing education satisfaction among early gastric cancer patients undergoing endoscopic submucosal dissection. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 60 patients who were hospitalized to undergo endoscopic submucosal dissection. The experimental group watched educational video using Tablet PC (n=30) and the control group received only the usual education (n=30). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of physical discomfort (t=3.05, p=.003) and nursing education satisfaction (t=-2.20, p=.032) in the experimental group were significantly different from that of the control group. However, the level of uncertainty (t=-0.82, p=.418) and state anxiety (t=-1.69, p=.097) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that the educational video program delivered using Tablet PC as an effective intervention alleviating physical discomfort and improving satisfaction regarding nursing education among early gastric cancer patients undergoing endoscopic submucosal dissection. Based on the findings, we believe that the educational video program can be helpful in decreaseing physical discomfort, and it also can be utilized to improve nursing education satisfaction.

Telomerase Activity in Primary Lung Cancers (원발성 폐암에 있어서 Telomerase 활성도에 대한 연구)

  • Yun, Sang-Myung;Kwak, Kyung-Rok;Hwang, Jee-Yoon;Park, Sam-Seok;Jeon, Doo-Soo;Kim, Cheol-Min;Lee, Min-Ki;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.195-203
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    • 1999
  • Background: Telomerase enzyme activity is not detected in most normal cells, a phonomenon believed to be associated with limitations on cellular proliferation. Since this activity is detected in nearly all human tumor, including lung cancers, it has been suggested that telomerase activation may be coupled to acquisition of malignant phenotype. In this study, we determined whether telomerase activity was associated with tumor pathologic stage. Methods: Primary tumor specimens obtained by bronchoscopic biopsies from 33 patients were analyzed. Telomerase activity was measured by means of a modified Telomeric Repeat Amplication Protocol(TRAP) assay. Results: Telomerase activity was detected in 23 of the 27 non-small-cell lung cancer and 5 of 6 small-cell lung cancer. A few primary tumors did not appear to have detectable telomerase activity. Positive associations were found between the telomerase-positive rate and tumor stage(p<0.05). Conclusion: High telomerase activity is detected frequently in primary lung cancers that exhibit high tumor cell proliferation rates and advanced pathologic stage.

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Clinicopathologic Evaluation of Gastric Polyps Remainding in the Stomach after a Gastrectomy (위 절제술 후 발생한 위 폴립의 임상 병리학적 특징)

  • Yoon, Ki-Young;Cho, Sung-Jin;Kim, Jeong-Hon;Kim, Young-Sik;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.169-173
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    • 2005
  • Background: Gastric polyps encompass a wide variety of lesions that most commonly arise from the gastric epithelium. However, coincidental gastric carcinomas have rarely been reported, being found in $1.5{\sim}2.1%$ of patients with hyperplastic polyps. The sizes and the pathologies of polyps seem to be important in the application of treatment. Therefore, it is necessary to classily gastric polypoid lesions after a gastrectomy. Materials and Methods: During a follow-up endoscopy study, 23 patients were found to have developed gastric polyps after a gastrectomy. Most of those polyps were removed by using an endoscopic polypectomy. We performed clinical and pathologic evaluations of the gastric polyps in the remainding in the stomach after a gastrectomy, Results: The mean age of the patients was 64.5 years old with the incidence of polyps remainding in the stomach after a gastrectomy increasing after the first year following the gastrectomy. The sizes of the polyps ranged from 0.3cm to 3.5cm in diameter and the numbers of polyps below 1.0cm were 19 (82.6%). The anastomotic site was the most prevalent place 10 (43.2%), followed by the cardia 6 (26.0%) and the body 4 (17.3%). Among 23 gastric polypoid lesions Yamada types of gastric polyps in the remainding in the stomach were as follows: 1 case in type I, 12 cases in type II, 9 cases in type III, 1 case in type IV. The pathologic diagnoses of the polyps were hyperplastic polyps in 6 cases, tubular adenomas in 2 cases and inflammatory polyps in 15 cases. Conclusion: Endoscopic polypectomy is believed to be important in assessing the precise diagnosis of gastric polyps remainding in the stomach. In this study, hyperplastic polyps were found to have no malignant potential, despite their sizes. As a result aggressive biopsy with a polypectomy of gastric polyp afier gastrectomy is recommended and frequent follow-up be performed.

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