Background: Recently, many surgeons have chosen sublobar resection for the curative treatment of lung tumors with ground-glass opacity, which is a hallmark of lepidic lung cancer. The purpose of this study was to evaluate the oncological results of sublobar resection for non-lepidic lung cancer in comparison with lobectomy. Methods: We conducted a retrospective chart review of 328 patients with clinical N0 non-small cell lung cancer sized ${\leq}2cm$ who underwent curative surgical resection from January 2009 to December 2014. The patients were classified on the basis of their lesions into non-lepidic and lepidic groups. The survival rates following lobectomy and sublobar resection were compared within each of these 2 groups. Results: The non-lepidic group contained a total of 191 patients. The 5-year recurrence-free survival rate was not significantly different between patients who received sublobar resection or lobectomy in the non-lepidic group (80.1% vs. 79.2%, p=0.822) or in the lepidic group (100% vs. 97.4%, p=0.283). Multivariate analysis indicated that only lymphatic invasion was a significant risk factor for recurrence in the non-lepidic group. Sublobar resection was not a risk factor for recurrence in the non-lepidic group. Conclusion: The oncological outcomes of sublobar resection and lobectomy in small-sized non-small cell lung cancer did not significantly differ according to histological type.
Purpose: To evaluate the clinical results of resection of os subfibulare and lateral ligament reattachment or modified Brostrom procedure in patients with symptomatic os subfibulare. Materials and Methods: This is a retrospective study on fourteen patients (14 ankles) who have symptoms associated with os subfibulare. Between August 1999 and July 2004, they underwent 4 resection of os subfibulare and lateral ligament reattachment for ankle pain due to os subfibulare or 10 resection of os subfibulare and modified Brostrom procedure available for ankle instability due to os subfibulare. Follow-up period is averaged for 17.6 months (12-24 months). Clinical results were graded according to the AOFAS clinical rating system. Results: Clinical results were rated as good in 4 ankles after resection of os subfibulare and lateral ligament reattachment, excellent in 5, good in 4, and fair in 1 ankle after the resection of os subfibulare and modified Brostrom procedure. In the last follow up period, 1 case of anterolateral ankle instability, 1 case of ankle pain and 1 case of inversion limitation were present postoperatively, but all symptoms were improved progressively. Conclusion: Resection of os subfibulare and modified Brostrom procedure is a good surgical technique for chronic ankle instability due to os subfibulare. But if just the ankle pain is present, resection of os subfibulare and lateral ligament reattachment is a sufficient procedure.
Endoscopic submucosal dissection (ESD) was originally developed for en bloc resection of large, flat gastrointestinal lesions. Compared with endoscopic mucosal resection (EMR), ESD is considered to be more time consuming and have more complications for treatment of early esophageal carcinoma, such as bleeding, stenosis and perforation. The objective of this study was to compare the efficacy and safety of ESD and EMR for such lesions. We searched databases, such as PubMed, EMBASE, Cochrane Library and Science Citation Index updated to 2013 for related trials. In the meta-analysis, the main outcome measurements were the en bloc resection rate, the histologically resection rate and the local recurrence rate. We also compared the operation time and the incidences of procedure-related complications. Five trials were identified, and a total of 710 patients and 795 lesions were included. The en bloc and histologically complete resection rates were higher in the ESD group compared with the EMR group (odds ratio (OR) 27.3; 95% CI, 11.5-64.8; OR 18.4; 95% CI, 8.82-38.59). The local recurrence rate was lower in the ESD group (OR 0.13, 95 % CI 0.04-0.43). The meta-analysis also showed ESD was more time consuming, but did not increase the complication rate (P=0.76). The results implied that compared with EMR, ESD showed better en bloc and histologically resection rates, and lower local recurrence, without increasing the incidence of procedure-related complications in the treatment of early esophageal carcinoma.
Background: A systematic review and meta-analysis were performed to compare the post-recurrence survival with hepatic re-resection versus transarterial chemoembolization (TACE) for recurrent hepatocellular carcinoma (HCC) after initial resection. Materials and Methods: All relevant papers were searched via PubMed, EMBASE, and Cochrane Library databases. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup analysis was performed according to country. Sensitivity analysis was performed in studies which clearly reported the recurrent regions, in moderate/high-quality studies, in studies published in full-text form, and in studies published after 2005. Results: In total, twelve papers were included in our study. Five and seven of them were of moderate- and poor-quality, respectively. The overall meta-analysis demonstrated a statistically significantly higher post-recurrence survival in the hepatic re-resection group than in those undergoing TACE (HR=0.64, 95%CI=0.52-0.79, P<0.0001). Heterogeneity was statistically significant and statistical significance remained in the subgroup analysis. Sensitivity analyses were also consistent with the overall analysis. Conclusions: Hepatic re-resection might provide a better post-recurrence survival than TACE for recurrent HCC after initial resection. However, considering the low quality of published studies and the potential bias of treatment selection, further randomized trials should be warranted to confirm these findings.
Purpose: Despite apparently complete resection of cancer of the rectum, local recurrence rate was high. Radiation therapy has been used either alone or in combination with chemotherapy as an adjunct to surgery to reduce the risk of recurrence. This study was designed to evaluate the prognostic factors, survival rate and local recurrence rate of the rectal cancer who had received postoperative radiation therapy by retrospective analysis. Method: From 1982 to 1990, 63 patients with cancer of the rectum surgically staged as B2 or C disease received postoperative adjuvant radiation therapy after curative resection of tumor for cure. Postoperative radiation therapy was given to the whole pelvis(mean dose: 5040 cGy in 5-6weets) and perineum was included in irradiated field in case of abdominoperineal resection. Results: Three-year actuarial survival rate was 73.2$ \% $ overall, 87.7$ \% $ in stage B2+3 and 62.9$ \% $ in stage C2+3. Three-year disease-free survival rate was 69.5$ \% $ overall, 87.7$ \% $ in stage B2+3 and 56.8$ \% $ in stage C2+3, Three-year disease-free survival rate in anterior resection was 77.8$ \% $ and 44.4$ \% $ in abdominoperineal resection. The local recurrence rate was 15.9$ \% $ and distant failure rate was 20.6$ \% $. Severe late complication was small bowel obstruction in 6 patients and surgery was required in 4 patients(6.3$ \% $). The prognostic factors were stage(p=0.0221) and method of surgery(p= 0.0414) (anterior resection vs abdominoperineal resection). Conclusion: This study provides evidence supporting the use of postoperative radiation therapy for reducing the local recurrence rate in patients who have had curative resection of rectal cancer with involvement of perirectal fat or regional nodes or both(stage B2 and C).
Background: The prognosis of melanoma metastasized to other organs is very poor. There have been many studies on metastatic melanoma in Western society, but there have been few studies done in Korea because of the small number of cases. Materials and Methods: A retrospective review of 7 patients who underwent complete resection of pulmonary metastases from melanoma from January 2005 to December 2009 was performed. When the primary lesion was controlled or simultaneously controllable and no other metastatic lesion was found, pulmonary resections were performed. We analyzed the clinical prognoses after the initial melanoma diagnosis. Results: Of the seven patients, one was male and six were female. The mean age was 58.2 years (range 45~71). Six patients had a single pulmonary lesion and one patient had three lesions confined to the same lobe. The mean disease-free interval was 43.5 months (0~146 months). Before pulmonary resection, 4 patients had received systemic therapy. After pulmonary resection, 6 patients received systemic therapy. Complete resection was confirmed histologically. The metastasectomy was performed by wedge resection (6 patients) or lobectomy (1 patient). There were no mortalities or complications. After pulmonary resection, 1 patient had recurrent multiple lesions in the lung and 4 patients had metastases to other organs. The organs were the liver, brain, pleura, and lymph nodes. The mean observation time was 31.6 months and 3 patients died during observation. The mean survival was 27.7 months (14~60 months) and the 1-year and 3-year survival rates were 100% and 42%, respectively. Conclusion: When patients were selected carefully, the complete resection of pulmonary metastatic lesions was considered a major therapeutic tool.
Kim, Cheol-Woo;Park, Jin-Woo;Suh, Jo-Young;Lee, Jae-Mok
Journal of Periodontal and Implant Science
/
v.39
no.1
/
pp.53-58
/
2009
Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.
Purpose: To compare the success rates of performing only silicone tube intubation versus carrying out both conjunctival resection and silicone tube intubation. Methods: The subjects of this study involved 62 patients (96 eyes) between October 2015 and May 2017 who were diagnosed as having punctal stricture or nasolacrimal duct stenosis. Out of 96 eyes, 47 underwent only silicone tube intubation, and 49 underwent both silicone tube intubation and conjunctival resection. Three parameters were measured at 1, 3, and 6 months after the surgery: the area of the tear meniscus using RTVue-100 anterior segment optical coherence tomography, the height of the tear meniscus using a slit lamp microscope, and the subjective satisfaction of patients as a result of improved sympotms like epiphora. The surgery was considered successful when the patients' experienced the resolution of symptoms and reduction of the area and height of the tear meniscus. Results: The area of the tear meniscus, height of the tear meniscus, and subjective satisfaction of patients was superior in the group that underwent both silicone tube intubation and conjunctival resection compared silicone tube intubation only. Based on these results, the success rate of the surgery was 68.9% in the group that underwent only silicone tube intubation and 78.7% in the group that underwent both silicone tube intubation and conjunctival resection. Conclusions: The resection of relaxed plica semilunares seems to increase the success rate of silicone tube intubation through the reduction of the area and height of the tear meniscus. Therefore, after determining the degree of conjunctivochalasis, if it was found to be severe, a combination with conjunctival resection was expected to increase the success rate of the surgery.
Woo-Jin Kim;Kyung-Min Kim;Won-Jong Lee;Chang-Hwan Moon;Hae-Beom Lee;Seong-Mok Jeong;Dae-Hyun Kim
Journal of Veterinary Clinics
/
v.41
no.1
/
pp.37-42
/
2024
This case report discusses the successful surgical resection of cardiac hemangiosarcoma in a dog using an articulated surgical stapler. Cardiac tumors, particularly hemangiosarcomas, have a poor prognosis. Recommended treatment involves surgical removal of the primary tumor, along with chemotherapy. However, the use of staples for cardiac tumor resection has not yet been extensively documented in the veterinary literature. A 10-year-old dachshund with pericardial effusion underwent surgery to remove a right atrial mass. An articulated linear cutting stapler was used for tumor resection. The patient experienced chylothorax as a complication but recovered well. However, the patient later developed respiratory symptoms and died, most likely due to aspiration pneumonia. The surgical stapler provided stability, convenience, and a shorter surgical time during tumor resection. Surgical resection combined with chemotherapy improves the survival of dogs with cardiac hemangiosarcoma. The stability and adjustability of the stapling device make it advantageous for cardiac tumor resection. Although complications, such as chylothorax, can arise, appropriate management can lead to positive outcomes. This case report demonstrates the feasibility and safety of using an articulated surgical stapler for cardiac tumor resection in dogs. Insights from this case can guide future research and clinical practice.
Jiyoung Yoon;Eun-Kyung Kim;Min Jung Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Y. Park
Korean Journal of Radiology
/
v.21
no.8
/
pp.946-954
/
2020
Objective: To investigate preoperative magnetic resonance imaging (MRI) findings associated with resection margin status in patients with invasive lobular carcinoma (ILC) who underwent breast-conserving surgery. Materials and Methods: One hundred and one patients with ILC who underwent preoperative MRI were included. MRI (tumor size, multifocality, type of enhancing lesion, distribution of non-mass enhancement [NME], and degree of background parenchymal enhancement) and clinicopathological features (age, pathologic tumor size, presence of ductal carcinoma in situ [DCIS] or lobular carcinoma in situ, presence of lymph node metastases, and estrogen receptor/progesterone receptor/human epidermal growth factor receptor type 2 status) were analyzed. A positive resection margin was defined as the presence of invasive cancer or DCIS at the inked surface. Logistic regression analysis was performed to determine pre- and postoperative variables associated with positive resection margins. Results: Among the 101 patients, 21 (20.8%) showed positive resection margins. In the univariable analysis, NME, multifocality, axillary lymph node metastasis, and pathologic tumor size were associated with positive resection margins. With respect to preoperative MRI findings, multifocality (odds ratio [OR] = 3.977, p = 0.009) and NME (OR = 2.741, p = 0.063) were associated with positive resection margins in the multivariable analysis, although NME showed borderline significance. Conclusion: In patients with ILC, multifocality and the presence of NME on preoperative breast MRI were associated with positive resection margins.
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