• Title/Summary/Keyword: Resection range

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Bronchoplastic Procedures (기관지 성형술)

  • 조건현
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.772-777
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    • 1995
  • Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

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Characterization and predictive value of volume changes of extremity and pelvis soft tissue sarcomas during radiation therapy prior to definitive wide excision

  • Gui, Chengcheng;Morris, Carol D.;Meyer, Christian F.;Levin, Adam S.;Frassica, Deborah A.;Deville, Curtiland;Terezakis, Stephanie A.
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.117-126
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    • 2019
  • Purpose: The purpose of this study was to characterize and evaluate the clinical significance of volume changes of soft tissue sarcomas during radiation therapy (RT), prior to definitive surgical resection. Materials and Methods: Patients with extremity or pelvis soft tissue sarcomas treated at our institution from 2013 to 2016 with RT prior to resection were identified retrospectively. Tumor volumes were measured using cone-beam computed tomography obtained daily during RT. Linear regression evaluated the linearity of volume changes. Kruskal-Wallis tests, Mann-Whitney U tests, and linear regression evaluated predictors of volume change. Logistic and Cox regression evaluated volume change as a predictor of resection margin status, histologic treatment response, and tumor recurrence. Results: Thirty-three patients were evaluated. Twenty-nine tumors were high grade. Prior to RT, median tumor volume was 189 mL (range, 7.2 to 4,885 mL). Sixteen tumors demonstrated significant linear volume changes during RT. Of these, 5 tumors increased and 11 decreased in volume. Myxoid liposarcoma (n = 5, 15%) predicted decreasing tumor volume (p = 0.0002). Sequential chemoradiation (n = 4, 12%) predicted increasing tumor volume (p = 0.008) and corresponded to longer times from diagnosis to RT (p = 0.01). Resection margins were positive in three cases. Five patients experienced local recurrence, and 7 experienced distant recurrence, at median 8.9 and 6.9 months post-resection, respectively. Volume changes did not predict resection margin status, local recurrence, or distant recurrence. Conclusion: Volume changes of pelvis and extremity soft tissue sarcomas followed linear trends during RT. Volume changes reflected histologic subtype and treatment characteristics but did not predict margin status or recurrence after resection.

Endoscopic Submucosal Dissection for Superficial Barrett's Neoplasia in Korea: a Single-Center Experience

  • Joo, Dong Chan;Kim, Gwang Ha;Lee, Bong Eun;Lee, Moon Won;Baek, Dong Hoon;Song, Geun Am;Lee, Sojeong;Park, Do Youn
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.426-438
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    • 2021
  • Purpose: While the incidence of Barrett's neoplasia has been increasing in Western countries, the disease remains rare in Asian countries. Therefore, very few studies have investigated the endoscopic treatment for Barrett's neoplasia in Korea. Endoscopic submucosal dissection (ESD) enables en bloc and complete resection of gastrointestinal neoplastic lesions. This study aimed to evaluate the therapeutic outcomes of ESD for Barrett's neoplasia in a single center in Korea and to examine the predictive factors for incomplete resection. Materials and Methods: We conducted a retrospective observational study of 18 patients who underwent ESD for superficial Barrett's neoplasia (dysplasia and early cancer) between January 2010 and December 2019 at Pusan National University Hospital. The therapeutic outcomes of ESD and procedure-related complications were analyzed. Results: En bloc resection, complete resection, and curative resection were performed in 94%, 72%, and 61% of patients, respectively. Histopathology (submucosal or deeper invasion of the tumor) was a significant predictive factor for incomplete resection (P=0.047). Procedure-related bleeding and stenosis were not observed, whereas perforation occurred in one case. During the median follow-up period of 12 months (range, 6-74 months), local recurrence occurred in 2 patients with incomplete resection, one patient underwent repeat ESD, and the other patient received concurrent chemoradiotherapy. The 3-year overall and disease-specific survival rates were 73% and 93%, respectively. Conclusions: ESD seems to be an effective and safe treatment for superficial Barrett's neoplasia in Korea. Nevertheless, the suitability of ESD for Barrett's cancer cases should be determined considering the high risk of deep submucosal invasion.

Intracranial Meningiomas, WHO Grade II : Prognostic Implications of Clinicopathologic Features

  • Moon, Hyung-Sik;Jung, Shin;Jang, Woo-Youl;Jung, Tae-Young;Moon, Kyung-Sub;Kim, In-Young
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.14-20
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    • 2012
  • Objective : Intracranial meningiomas are primarily benign tumors with a good prognosis. Although WHO grade II meningiomas are rare (2-10%), WHO grade II meningiomas have higher recurrence and mortality rates than benign. We evaluated the patient recurrence rate and investigated the prognostic factors of WHO grade II meningiomas. Methods : Between 1993 and 2005, 55 patients were diagnosed with WHO grade II meningiomas in our hospital. WHO grade II meningiomas (n=55) were compared with other WHO grades meningiomas (I, n=373; and III, n=20). The patients had a median age of 48.4 years (range, 14-17 years), a male-to-female ratio of 26 : 29, and a mean follow-up time of 45 months (range, 3-175 months). Results : In WHO grade II meningiomas, only the extent of resection was a significant prognostic factor. Post-operative radiotherapy had no significant influence on tumor recurrence (p=0.053). The relative risk of recurrence was significantly higher in WHO grade II meningiomas with incomplete resection (10/27, RR=37%) than in WHO grade II meningiomas with complete resection (4/28, RR=14%) regardless of post-operative radiotherapy. In the incomplete resection group, Simpson grade III or IV had a significantly high risk of recurrence regardless of post-operative RT (n=3, RR=100%) However, if the degree of resection was Simpson grade II, the recurrence rate was similar to the complete resection group even though post-operative RT was not performed. Conclusion : Complete resection was the most powerful independent predictive factor of the recurrence rate in WHO grade II meningiomas. Post-operative adjuvant RT was not a significant factor in this study.

Metachronous Ovarian Metastases Following Resection of the Primary Gastric Cancer

  • Jun, Si-Youl;Park, Jong-Kwon
    • Journal of Gastric Cancer
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    • v.11 no.1
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    • pp.31-37
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    • 2011
  • Purpose: We performed this study to evaluate the clinical presentation as well as the proper surgical intervention for ovarian metastasis from gastric cancers and these tumors were identified during postoperative follow-up. This will help establish the optimal strategy for improving the survival of patients with this entity. Materials and Methods: 22 patients (3.2%) with ovarian metastasis were noted when performing a retrospective chart review of (693) females patients who had undergone a resection for gastric cancer between 1981 and 2008. The covariates used for the survival analysis were the patient age at the time of ovarian relapse, the size of the tumor, the initial TNM stage of the gastric cancer, the interval to metastasis and the presence of gross residual disease after treatment for Krukenberg tumor. The cumulative survival curves for the patient groups were calculated with the Kaplan-Meier method and they were compared by means of the Log-Rank test. Results: The average age of the patients was 48.6 years (range: 24 to 78 years) and the average survival time of the 22 patients was 18.8 months (the estimated 3-year survival rate was 15.8%) with a range of 2 to 59 months after the diagnosis of Krukenberg tumor. The survival rate for patients without gross residual disease was longer than that of the patients with gross residual disease (P=0.0003). In contrast, patient age, the size of ovarian tumor, the initial stage of gastric adenocarcinoma, the interval to metastasis and adjuvant chemotherapy were not prognostic indicators for survival after the development of ovarian metastasis. Conclusions: Early diagnosis and complete resection are the only possible hope to improve survival. As the 3-year survival rate after resection of Krukenberg tumor is 15.8%, it seems worthwhile to consider performing tumorectomy as the second cytoreduction.

Comparisons of Single Photo Resection Algorithms for the Determination of Exterior Orientation Parameters (단사진의 외부표정요소 결정을 위한 후방교회법 알고리즘의 비교)

  • Kim, Eui Myoung;Seo, Hong Deok
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.4
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    • pp.305-315
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    • 2020
  • The purpose of this study is to compare algorithms of single photo resection, which determines the exterior orientation parameters used in fields such as photogrammetry, computer vision, robotics, etc. To this end, the algorithms were compared by generating experimental data by simulating terrain based on a camera used in aerial and close-range photogrammetry. Through experiments on aerial photographic camera that was taken almost vertically, it was possible to determine the exterior orientation parameters using three ground control points, but the Procrustes algorithm was sensitive to the configuration of the ground control points. Even in experiments with a close-range amateur camera where the attitude angles of the camera change significantly, the algorithm was sensitive to the configuration of the ground control points, and the other algorithms required at least six ground control points. Through experiments with two types of cameras, it was found that cosine lawbased spatial resection shows performance similar to that of a traditional photogrammetry algorithm because the number of iterations is short and no explicit initial values are required.

Sleeve Resection of Lung Cancer - A report of 5 cases- (폐암 환자에서의 기관지 성형술 -5례 보고-)

  • 두홍서
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.408-413
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    • 1988
  • Sleeve resection is safe, effective, and appropriate treatment for a wide range of endo-bronchial lesions including neoplasms of low grade malignant potential and selected cases of bronchogenic carcinoma. Five cases of bronchoplastic procedures were performed for primary bronchogenic carcinoma patients at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital from Aug. 1983 to Oct. 1987. Of the 5 patients, four were male and one patient was female and ages ranged from 51 years to 66 years old. Histopathologically, 4 cases were squamous cell carcinoma and one case small cell carcinoma. Operative procedures of the 5 patients were as follows: Right upper sleeve lobectomy, 1 case; Left upper sleeve lobectomy, 1 case; left lower sleeve lobectomy, 1 case; Left lower lobe and lingular segment sleeve resection, 2 cases. The early and late postoperative complications of the above operations were pneumonia, atelectasis, bronchopleural fistula, empyema, brain metastasis, and local recurrence of primary tumor.

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Clinical Evaluation of Chest Wall Tumors -Review of 33 Cases- (흉벽종양 33례에 대한 임상적 고찰)

  • Lee, Mun-Geum;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.778-783
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    • 1995
  • The incidence of chest wall tumor is rare than those of other portions of the body. The chest wall tumors need special attention about their diagnosis and management than other tumors. From March, 1985 to September, 1994, 33 patients with chest wall tumor underwent surgical treatment, and those were consisted of 28 benign tumors and 5 malignant tumors arising from soft tissue, rib and sternum.Benign tumors were included 11 lipoma, 4 cysticercosis, 2 chondroma and 1 each of fibroma, dermatofibroma, osteochondroma, fibrous dysplasia and hemangioma,and 6 other cases. Malignant chest wall tumors were included 2 metastatic carcinoma,1 each of giant cell tumor, chondrosarcoma and epithelioid sarcoma.Sex ratio of male to female was 1.5:1, and the range of age was 16 to 72 years,and the mean age was about 40 years. Clinical manifestations of chest wall tumor were palpable mass[55% , pain[21% ,tender mass[9% , growing mass[9% and asymptomatic[9% .The all cases were treated surgically, the results were as follows:Local excision 16 cases, wide resection 12 cases, wide resection with chemotherapy 3 cases, each one case of wide resection with radiotherapy and wide resection with chest wall reconstruction.

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Clinical Grading System, Surgical Outcomes and Prognostic Analysis of Cranial Base Chordomas

  • Wang, Benlin;Tian, Fengxuan;Tong, Xiaoguang
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.469-478
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    • 2022
  • Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

Undifferentiated (Embryonal) Sarcoma of the Liver in Children (소아의 미분화(태생) 간육종)

  • Kim, Dae-Yeon;Kim, Ki-Hong;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.33-38
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    • 1999
  • Undifferentiated (embryonal) sarcoma is a rare malignancy of the liver in children and young adults. Seven cases of undifferentiated (embryonal) sarcoma of the liver pathologically verified at Seoul National University Children's Hospital between 1986 and 1999 were retrospectively analyzed. There were three girls and four boys, and their mean age at diagnosis was 12.1 years (range 7-13 years). Six patients presented with an abdominal mass or pain, and one with weight loss. Tumor size ranged from $8.0{\times}8.0$ cm to $15.0{\times}15.0$ cm. Four tumors were located in the right lobe, two in the left lobe and one in both. One patient died during chemotherapy. Initial complete resection was accomplished in three patients. Two patients underwent complete resection after chemotherapy. Five patients with complete resection survived without evidence of disease for 8, 11, 13, 28, and 84 months. A patient with partial resection and chemotherapy died of sepsis during chemotherapy 19 months after complete surgical resection. Adjuvant chemotherapy and radiotherapy were performed in all patients after complete surgical resection. In conclusion, though undifferntiated (embryonal) sarcoma of the liver is highly malignant, the combination therapy of surgery, chemotherapy and radiotherapy appears to result in a favorable prognosis.

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