• Title/Summary/Keyword: Curative surgery

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Versatile Two Island Flaps for Head and Neck Reconstruction (두경부 재건에 융용한 두가지 도서형 피판 : 대흉근피판과 외측 승모근피판)

  • Lee Hye-Kyung;Shin Keuk-Sun;Kim Kwang-Moon
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.2
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    • pp.92-98
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    • 1991
  • Numerous mycoutaneous island flaps or free flaps have been used to reconstruct a defect which resulted from the wide resection of tumor mass in head and neck region. Since the curative resection of tumor usually include muscles and bones as well as skin and mucosa, the anatomical and functional restoration of the defect depend on which and what amount of tissues were provided to cover the defect; good aesthetic appearance subsequently follows the result. Furthermore, a simultaneous neck nodes dissection usually results in exposure of major neck vessels., which should be protected with sufficient padding. The ideal method to reconstruct a defect in the head and neck region requires a sufficient coverage by muscle layer with good vascularity, a wide arc of rotation, and minimization of donor site defect. The pectoralis major myocutaneous flap which was first decribed by Ariyan and lateral trapezius myocutaneous flap by Demergasso meet these criteria. We describe the use of these myocutaneous flaps in reconstruction of mandible and oral cavity.

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Survival Analysis of Biliary Tract Cancer Cases in Turkey

  • Akca, Zeki;Mutlu, Hasan;Erden, Abdulsamet;Buyukcelik, Abdullah;Cihan, Yasemin Benderli;Goksu, Sema Sezgin;Aslan, Tuncay;Sezer, Emel Yaman;Inal, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6025-6027
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    • 2014
  • Background: Because of the relative rarity of biliary tract cancers (BTCs), defining long term survival results is difficult. In the present study, we aimed to evaluate the survival of a series of cases in Turkey. Materials and Methods: A totally of 47 patients with billiary tract cancer from Mersin Goverment Hospital, Acibadem Kayseri Hospital and Kayseri Training and Research Hospital were analyzed retrospectively using hospital records between 2006-2012. Results: The median overall survival was $19.3{\pm}3.9$ months for all patients. The median disease free and overall survivals were $24.3{\pm}5.3$ and $44.1{\pm}12.9$ months in patients in which radical surgery was performed, but in those with with inoperable disease they were only $5.3{\pm}1.5$ and $10.7{\pm}3.2$ months, respectively. Conclusions: BTCs have a poor prognosis. Surgery with a microscopic negative margin is still the only curative treatment.

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching

  • Kim, Cho Shin;Kim, Sohyun
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.216-221
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    • 2017
  • Background: This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer. Methods: Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ${\geq}6ng/mL$) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage. Results: The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups. Conclusion: Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Comparison of Functional Voice Outcomes in Patients Treated with Laser Surgery and Radiation Therapy for Early Glottic Cancer (조기 성문암에서 레이저 수술과 방사선 치료 후 음성기능 비교)

  • Lee, Jong-Cheol;Lee, Yoon-Se;Nam, Soon-Yuhl
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.7-10
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    • 2008
  • The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

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Thoracoscopic Radical Esophagectomy in Cervico-Thoracic Esophageal Cancer (경구경계부식도암에서 흉강경을 이용한 근치적 식도암적출술)

  • 박재길;이선희
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.681-688
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    • 1996
  • Most patients with carcinoma of the cervico-thoracic esophagus present with locally advanced disease. For this reason, therapeutic efforts have been largely palliative, focused on eradicating locoregional dis- ease, and have been attended by high morbidity rates. A 61 year old man was diagnosed to advanced cervicothoracic esophageal cancer(Type 1) and reli ved concurrent chromo-radiotherapy for 2 months in St. Mary's Hospital. And then he underwent transhiatal subtotal esophagectomy and radical dissection of cervical and superior mediastinal Iymph nodes with thoracoscopy. The histologic diagnosis was early esophageal cancer(Type 0-llb, SM2) and the curability of operation was calculated to highly curative(Clll). And the postoperative course was unevenful.

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Current Status of Clinical Practice for Gastric Cancer Patients in Korea -A Nationwide Survey- (전국 위암 환자 진료 현황에 관한 설문조사 결과)

  • ;Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.4 no.2
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    • pp.95-108
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    • 2004
  • This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were $32.6\%$ (97/298) for individuals and $59.3\%$ (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: $71.6\%$, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+$\alpha$ lymph node dissection in advanced gastric cancer. About $20\%$ of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.

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Laparoscopic Gastrectomy Performed by an Expert in Open Gastrectomy

  • Chi, Kyong-Choun;Park, Joong-Min
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.237-245
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    • 2017
  • Purpose: Senior surgeons prefer open gastrectomy (OG), while young surgeons prefer laparoscopic gastrectomy (LG). The purpose of this study was to evaluate the surgical outcomes of LG performed by a senior surgeon who was an expert in OG during his learning period, by comparing them with LGs performed by a young surgeon. Materials and Methods: A senior surgeon performed 50 curative gastrectomies with laparoscopy (LG-S group) from March 2015 to August 2016. A young surgeon's initial 50 LGs comprised the LG-Y group. Clinicopathological characteristics and surgical outcomes were compared between the LG-S and LG-Y groups. Results: D2 lymphadenectomy was more frequently performed in the LG-S group than in the LG-Y group (P=0.029). The operation time and number of retrieved lymph nodes did not significantly differ between the 2 surgeons (P=0.258 and P=0.410, respectively). Postoperative hospital stay and postoperative complication rate were similar between 2 groups (P=0.234 and P=1.000, respectively). Similarly, significant decreases in operation time with increasing case numbers were observed for both surgeons, whereas the number of retrieved lymph nodes increased significantly in the LG-Y group but not in the LG-S group. Conclusions: The LG outcomes when performed by the senior surgeon were comparable to those when performed by the young surgeon, despite performing more extended lymphadenectomies. Senior surgeons who are experts in OG should not refrain from performing LG.

Clinical Evaluation of the Mediastinal Tumors (종격동 종양의 임상적 고찰)

  • 고영호
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.379-385
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    • 1994
  • Generally early surgical extirpation is considered to be beneficial for the treatment of mediastinal tumors and prevention of its complication. The review of the clinical course, histopathologic characteristics and current diagnostic and treatment modalities will help us to decide when to treat and how to treat mediastinal tumors. For this purpose clinical analysis of the 42 patients who were surgically treated from July 1984 to August 1993 in the Chung Ang University Hospital is done in this report. There were 24 males and 18 females[1.3:1], and their age ranged from 1 year to 75 years. Nonspecific symptoms such as chest pain, cough and dyspnea were the most frequently encountered symptoms. Asymptomatic patients were relatively common[21.4%]. The tumors were found most frequently in the posterior mediastinum[45.2%]. Anterior mediastinum was the next and middle and upper mediastinum showed relatively rare occurrence of the tumor. Neurogenic tumor was the most common histopathologic type . Germ cell tumor, benign cyst and thymoma followed it. Curative resection was possible in 27 patients[64%], partial resection in 6 patients[14.3%]and just open biopsy in 7 patients[16.7%]. There was no early operative mortality. Postoperative complications were occurred in 5 patients[11.9%] and most of them were not serious.

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Factors affecting complications after treatment of epidermal cyst

  • Choi, Man Ki;Chung, Kyu Jin
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.136-140
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    • 2019
  • Background: Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment. Methods: Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively. Results: Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications. Conclusion: Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

Radiologic Evaluation for Resectability of Pancreatic Adenocarcinoma (췌장 선암의 절제 가능성 평가)

  • Shin Hye Hwang;Mi-Suk Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.315-334
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    • 2021
  • Imaging studies play an important role in the detection, diagnosis, assessment of resectability, staging, and determination of patient-tailored treatment options for pancreatic adenocarcinoma. Recently, for patients diagnosed with borderline resectable or locally advanced pancreatic cancers, it is recommended to consider curative-intent surgery following neoadjuvant or palliative therapy, if possible. This review covers how to interpret imaging tests and what to consider when assessing resectability, diagnosing distant metastasis, and re-assessing the resectability of pancreatic cancer after neoadjuvant or palliative therapy.