• Title/Summary/Keyword: Limited resection

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Postoperative Adjuvant Radiotherapy for Patients with Gastric Adenocarcinoma

  • Lim, Do Hoon
    • Journal of Gastric Cancer
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    • v.12 no.4
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    • pp.205-209
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    • 2012
  • In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.

Single-Port Thoracic Surgery: A New Direction

  • Ng, Calvin S.H.
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.327-332
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    • 2014
  • Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique's popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures.

Extraordinary radiation super-sensitivity accompanying with sorafenib combination therapy: what lies beneath?

  • Lee, Jayoung;Lee, Ju Hye;Yoon, Hanbin;Lee, Ho Jeong;Jeon, Hosang;Nam, Jiho
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.185-188
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    • 2017
  • Primary liver tumor, especially hepatocellular carcinoma (HCC), is a common cause of cancer death worldwide. The incidence is generally higher in Asian countries than in western countries. Carcinogenesis of HCC is often associated with hepatitis viral infections. Current standard treatment of HCC is surgical resection or transplantation in patients with early stage disease. However, the patient with advanced stage disease, surgical resection is often limited. Sorafenib or other treatment modalities are not so effective as well. We report a case of unusual radiation super-sensitivity in advanced stage HCC, and review the literature.

A Periosteal Fibrosarcoma in a Puppy Dog (강아지에서의 골막섬유육종 증례)

  • 김순신;김휘율;장화석;송영성;김성미;김혜진;서정향
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.52-57
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    • 2004
  • A 4 months old Golden retriever male dog was referred. By the history taking, it was kwon that the mass has been formed at the parietal region of the patient after fourth prevention inoculation. The appetite, urination and excretion were normal. The mass confirmation which was limited in the parietal region, did not seem to be enlargement of lymph node from physical examination palpation. Complete blood count and serum biochemical profiles were consistent with mild lymphocytosis, mild monocytosis, anisocytosis, regenerative anemia and elevated ALP, CPK. Survey radiographs indicated a mixed density in parietal region. We performed surgical resection and chemotherapy for cure and biopsy. Histological finding was periosteal fibrosarcoma. The application of cisplatin was topically used in operation site. Up to now the indication of recurrence is not visible.

Endoscopic Resection of Undifferentiated-type Early Gastric Cancer

  • Lee, Ayoung;Chung, Hyunsoo
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.345-354
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    • 2020
  • Early detection of gastric cancer is crucial because the survival rate can be improved through curative treatment. Although surgery and gastrectomy with lymph node dissection remain as the gold standard for curative treatment, early gastric cancer (EGC) with negligible risk of lymph node metastasis can be treated with endoscopic resection (ER), such as endoscopic submucosal dissection. Among gastric cancers, undifferentiated-type cancer is distinguished from differentiated-type cancer in various aspects in terms of clinical features and pathophysiology. The undifferentiated-type cancer is also known to be associated with an aggressive behavior and a poor prognosis. Therefore, the indication of ER for undifferentiated EGC is limited compared with differentiated-type. Recent studies have reported that ER for undifferentiated EGC is safe and shows favorable short- and long-term outcomes. However, it is necessary to understand the details of the research results and to selectively accept them. In this review, we aimed to evaluate the current practice guidelines and the short-term and long-term outcomes of ER for undifferentiated type EGC.

A Case Report of Resection of a Mediastinal Paraganglioma: Why All the Fuss?

  • Staunton, Laura Mary;Casey, Laura;Young, Vincent K.;Fitzmaurice, Gerard J.
    • Journal of Chest Surgery
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    • v.55 no.2
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    • pp.174-176
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    • 2022
  • Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

Surgical Treatment of Recurrent Lung Cancer (재발성 비소세포암의 수술적 치료)

  • 유원희;김문수;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.68-72
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    • 2000
  • Background: The resection of recurrent non-small cell lung cancer can be performed very rarely. There has been many arguments for longterm result and therapeutic role in surgical management of recurrent non-small cell lung cancer(NSCLC). We analyze our result of surgical re-resection of recurrent NSCLC for 10 years retrospectively. Material and Method: In the period from 1987 to 1997, 702 patients who had been confirmed for NSCLC had undergone complete resection in Seoul National University Hospital. As December 1997, 22 of these patients have been operated on the diagnosis of recurrent lung cancer. In these patients one has revealed for benign nodule at postoperative pathologic pathologic was unresectable. and two had revealed other cell type on postoperative pathologic examination. Analysis about postoperative survival rate and the factors that influence postoperative survival rate - sex, age, pathologic stage, cell type, operation adjuvant therapy after first and second operation location of recurrence disease free survival-was 59.1$\pm$10.9 year. There were 14 men and 3 women. Four patients was received radiation therpy after first opration and two patients was received postoperative chemotherapy. At first operation 2 patients was stage Ia, 8 was stage Ib, 1 was stage IIa 6 was stage IIb. Eleven patients had squamous. cell carcinoma at postoperatrive pathologic examination five had adenocarcinoma and one had bronchioalveolar carcinoma. In second operation 8 patients were received limited resection. 9 were received lobectomy or pneumonectomy. One-year survival rate was 82.4% and five-year survival rate was 58.2% Non-adjuvant therapy group after initial operation was more survived than adjuvant therapy group statistically. Conclusion: operation was more survived than adjuvant therapy group statistically. Conclusion : Operation was feasible treatment modality for re-resectable non-small cell lung cancer. But we cannot rule out possibility of double primary lung cancer for them. Postoperative prognostic factor was adjuvant therapy or nor after first oepration but further study of large scale is needed for stastically more valuable result.

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Partial Resection of Maxillary Ossifying Fibroma in a Thoroughbred Stallion

  • Lee, Sang-Kyu;Kim, Byung Hyun;Luong, Richard;Jung, Bok-Sun;Im, Hyung-Ho;Lee, Jeonghun;Im, Eo-Jin;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.107-110
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    • 2018
  • A 5-year-old Thoroughbred race horse was presented to Busan Korea Racing Authority equine hospital with a 3-year history of a slow-growing left rostral maxillary mass. The location and progressive growth of the mass eventually resulted in poor food prehension, quidding and mouth bit placement. The mass was solitary and hard, and covered by normal smooth oral mucosa. Radiographic examination of the maxillae showed a flocculated and mixed radiolucent lesion protruding outward and displacing the 202 and 203 teeth caudally. The 202 tooth was in normal size and the 203 tooth was hypoplastic on radiography. Under general anesthesia, a partial surgical resection of the mass was performed to minimize functional loss and facilitate prompt return to track. After surgery, there was improvement in food intake, mouth bit placement, and cosmetic appearance. Histopathological examination determined the resected maxillay mass to be an ossifying fibroma. However, there was continued growth of remnant mass in the maxilla. Equine ossifying fibroma is a rare condition and primarily affects the rostral mandible, and less commonly, the maxillae. In this case, the lesion was slow-growing, and caused cosmetic and functional impairments, including poor food intake and reduced trainability. Surgical resection was performed, but the effect of treatment was limited due to advanced size / stage of the tumor. Early dental care is suggested for horse owners to prevent belated identification and improve successful treatment of oral disorders like ossifying fibroma.

Clinical evaluation of root-resected teeth clinical outcome over 2 years (치아절제술이 시행된 증례의 임상적 평가 : 2년 이상 경과한 증례의 평가)

  • Lee, Chung-Ho;Park, Jin-Woo;Seo, Jo-Yeong;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.36 no.4
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    • pp.809-816
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    • 2006
  • Periodontal disease accompany the inflammation around periodontal tissue and generally periodontal destruction is followed, This destruction often makes the molar teeth have furcation defect. And to treat molar furcation involvement, resective surgery such as root resection and ostectomy and regenerative procedure such as guided tissue regeneration were introduced. Also implant can be considered as one of the good treatment methods, Among these treatment alternatives, root resection can be considered as a good procedure in the point of saving one's natural teeth or amount of cost. Therefore the purpose of this article is to evaluate root-resected teeth which were done at least 2 years ago. 70 root-resected teeth in 58 patient who visited Kyungpook National University Hospital were included in this study. They were evaluated by two clinical method. One is subjective evaluation and another is objective evaluation. To evaluate subjective outcome, 58 patients answered to the questionnaire if they experienced tooth extraction, bleeding, swelling, pain, mobility and chewing problem. To evaluate objective outcome, 28 teeth was evaluated according to Langer's criteria. The subjective result showed 82% of success rate and 18% of failure rate. 13 of 70 teeth showed discomfort and were considered as failure, which include chewing problem (39%) and pain (23%). The objective outcome showed that 4 failure (14% failure rate) which were 2 cases of bone loss by periodontal problem, one endodontic problem and one untreatable caries. By these limited results, some of clinical consideration in root resective procedure can be suggested. Periodontal support and less occlusal loading on resected tooth should be evaluated before the procedure, moreover, good oral hygiene is essential. When these factors are considered carefully, the root resection may produce predictive outcomes in the treatment of furcational involvement.

Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

  • Kim, Sin Rak;Lee, Jung Woo;Han, Yea Sik;Kim, Han Kyu
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.17-23
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    • 2015
  • Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.