82 results on '"Yong Son"'
Search Results
2. Reply to: Letter to the Editor: Comment on 'Prediction of Survival Outcomes Based on Preoperative Clinical Parameters in Gastric Cancer' by Bektaş, Mustafa et al
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Ho-Jung Shin, Chul-kyu Roh, Sang-Yong Son, Hoon Hur, Sang-Uk Han, and Yong-Ok Choi
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Oncology ,Surgery - Published
- 2022
3. Long-term Comparison of Robotic and Laparoscopic Gastrectomy for Gastric Cancer
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Ho-Jung Shin, Chul Kyu Roh, Sang-Yong Son, Hoon Hur, Bo Wang, and Sang-Uk Han
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Population ,Blood Loss, Surgical ,Urology ,Kaplan-Meier Estimate ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Propensity Score ,education ,Lymph node ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,education.field_of_study ,business.industry ,Hazard ratio ,Laparoscopic gastrectomy ,Cancer ,Middle Aged ,medicine.disease ,Confidence interval ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Propensity score matching ,Lymph Node Excision ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Surgery ,business ,Follow-Up Studies - Abstract
OBJECTIVE To compare long-term outcomes between robotic and LG approaches using propensity score weighting based on a generalized boosted method to control for selection bias. SUMMARY OF BACKGROUND DATA Minimally invasive surgical approaches for GC are increasing, yet limited evidence exists for long-term outcomes of robotic gastrectomy (RG). METHODS Patients (n = 2084) with GC stages I-III who underwent LG or RG between 2009 and 2017 were analyzed. Generalized boosted method was used to estimate a propensity score derived from all available preoperative characteristics. Long-term outcomes were compared using the adjusted Kaplan-Meier method and the weighted Cox proportional hazards regression model. RESULTS After propensity score weighting, the population was balanced. Patients who underwent RG showed reduced blood loss (16 mL less, P = 0.025), sufficient lymph node harvest from the initial period, and no changes in surgical outcomes over time. With 52-month median follow-up, no difference was noted in 5-year overall survival in unweighted [91.5% in LG vs 94% in RG; hazard ratio (HR), 0.71; 95% confidence interval (CI), 0.46-1.1; P = 0.126] and weighted populations (94.2% in LG vs 93.2% in RG; HR, 0.88; 95% CI, 0.52-1.48; P = 0.636). There were no differences in 5-year recurrence-free survival (RFS), with unweighted 5-year RFS of 95.4% for LG and 95.2% for RG (HR, 0.95; 95% CI, 0.55-1.64; P = 0.845) and weighted 5-year RFS of 96.3% for LG and 95.3% for RG (HR, 1.24; 95% CI, 0.66-2.33; P = 0.498). CONCLUSIONS After balancing covariates, RG demonstrated reliable surgical outcomes from the beginning. Long-term survival after RG and LG for GC was similar.
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- 2020
4. A Simple Approach for Splenic Hilar Lymphadenectomy During Laparoscopic Total Gastrectomy for Advanced Gastric Cancer: the SHINY (Splenic HIlar Node dissection after total gastrectomY) Maneuver
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Bo Wang, Sang-Uk Han, and Sang-Yong Son
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medicine.medical_specialty ,Dissection ,business.industry ,medicine.medical_treatment ,Gastroenterology ,medicine ,Surgery ,Lymphadenectomy ,Laparoscopic total gastrectomy ,Gastrectomy ,Radiology ,Advanced gastric cancer ,business - Published
- 2020
5. Clinical pathway for enhanced recovery after surgery for gastric cancer: A prospective single‐center phase II clinical trial for safety and efficacy
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Sook Young Lee, Chul Kyu Roh, Sang-Yong Son, Hoon Hur, and Sang-Uk Han
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Single Center ,03 medical and health sciences ,0302 clinical medicine ,Clinical pathway ,Gastrectomy ,Stomach Neoplasms ,medicine ,Clinical endpoint ,Humans ,Minimally Invasive Surgical Procedures ,Prospective Studies ,business.industry ,Postoperative complication ,Retrospective cohort study ,General Medicine ,Middle Aged ,Surgery ,Clinical trial ,Oncology ,030220 oncology & carcinogenesis ,Critical Pathways ,Female ,030211 gastroenterology & hepatology ,Enhanced Recovery After Surgery ,Complication ,business - Abstract
BACKGROUND We aimed to evaluate the safety and efficacy of a clinical pathway (CP) for enhanced recovery after surgery (ERAS) in gastric cancer patients, including early oral feeding and discharge on postoperative day 4. METHODS We performed a prospective, single-center, phase II clinical trial. Based on proposed indications for an ERAS CP in our retrospective study, we enrolled 133 patients younger than 65 years who were undergoing minimally invasive subtotal gastrectomy. The primary endpoint was the ERAS CP completion rate. Secondary endpoints included complication, mortality, hospital stay, and readmission. RESULTS Among 133 patients, six patients were dropped out from this study. The ERAS CP completion rate (77.2%, 98 of 127) was comparable to the historical control group that completed a conventional CP (85.4%, P = .085). The postoperative complication incidence (13.4%, 15 of 127) was also similar to that of the conventional CP group (9.5%, P = .174). We identified reduced hospital stays (4.7 ± 1.3 vs 7.2±2.3 days; P
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- 2020
6. Textbook outcome and survival of robotic versus laparoscopic total gastrectomy for gastric cancer: A propensity score matched cohort study
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Chul Kyu Roh, Soomin Lee, Sang-Uk Han, Sang-Yong Son, and Hoon Hur
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Male ,medicine.medical_specialty ,Intraoperative Complication ,medicine.medical_treatment ,Science ,Operative Time ,030230 surgery ,Article ,law.invention ,Cohort Studies ,Gastrointestinal cancer ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Gastrectomy ,Stomach Neoplasms ,law ,Humans ,Medicine ,Laparoscopic total gastrectomy ,Propensity Score ,Survival rate ,Aged ,Multidisciplinary ,business.industry ,Gastroenterology ,Cancer ,Length of Stay ,Middle Aged ,medicine.disease ,Intensive care unit ,humanities ,Surgery ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Propensity score matching ,Resection margin ,Female ,Laparoscopy ,Lymph Nodes ,business - Abstract
Introduction Textbook outcome is a composite quality measurement of short-term outcomes for evaluating complex surgical procedures. We compared textbook outcome and survival of robotic total gastrectomy(RTG) with those of laparoscopic total gastrectomy(LTG).Methods We retrospectively reviewed 395patients(RTG,n = 74;LTG,n = 321) who underwent curative total gastrectomy for gastric cancer via minimally invasive approaches from 2009 to 2018. We performed propensity score matched analysis to adjust for potential selection bias. Textbook outcome included a negative resection margin, no intraoperative complication, retrieved lymph nodes > 15, no severe complication, no reintervention, no unplanned intensive care unit admission, hospitalisation ≤ 21days, no readmission after discharge, and no postoperative mortality. Survival outcomes included 5-year overall and relapse-free survival rates.Results After matching, 74patients in each group were selected. Textbook outcome was similar in the RTG and LTG groups(70.3% and 75.7%,respectively), although RTG required a longer operative time. The quality metric least often achieved was the presence of severe complications in both groups(77.0% in both groups). There were no differences in the 5-year overall survival rate(90.7% and 85.9%,respectively;log-rank P = 0.144) and relapse-free survival rate between the RTG and LTG groups(89.5% and 85.2%,respectively;log-rank P = 0.167).Conclusion Textbook outcome and survival outcome of RTG were comparable to those of LTG for gastric cancer.
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- 2021
7. The Learning Curve of Linear-Shaped Gastroduodenostomy Associated with Totally Laparoscopic Distal Gastrectomy
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Sang-Uk Han, Bo Wang, Sang-Yong Son, Ho-Jung Shin, and Hoon Hur
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medicine.medical_specialty ,Operative Time ,Anastomosis ,Gastroduodenostomy ,Bile reflux ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Humans ,Medicine ,Major complication ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Significant difference ,Gastroenterology ,medicine.disease ,Surgery ,Learning curve ,030220 oncology & carcinogenesis ,Laparoscopy ,030211 gastroenterology & hepatology ,Gastroenterostomy ,business ,Laparoscopic distal gastrectomy ,Learning Curve - Abstract
Linear-shaped gastroduodenostomy (LSGD) is a new method of intracorporeal reconstruction that is simpler to perform and associated with a lower rate of bile reflux than delta-shaped anastomosis. Here, we analyzed the learning curve of LSGD in totally laparoscopic distal gastrectomy. The cumulative sum method was used to retrospectively analyze consecutive gastric cancer patients undergoing intracorporeal gastroduodenostomy after distal gastrectomy between January 2009 and May 2016. The duration of surgery, postoperative complications, hospital stay, and endoscopic findings in the postoperative period and the first, third, and fifth year were evaluated according to the two phases of the learning curve (learning period versus mastery period). Data from 222 patients were included in the analysis. The LSGD learning period was 29 cases. The surgical time in mastery period was significantly shorter than the learning period (124.9 ± 34.5 versus 168.2 ± 42.0 min, p
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- 2019
8. ASO Author Reflections: Prediction of Survival Outcomes Based on Preoperative Clinical Parameters in Gastric Cancer
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Chul Kyu Roh, Sang-Uk Han, Sang-Yong Son, Hoon Hur, Ho-Jung Shin, and Yong Ok Choi
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medicine.medical_specialty ,business.industry ,General surgery ,MEDLINE ,Cancer ,medicine.disease ,Text mining ,Oncology ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Surgery ,business - Published
- 2021
9. Prediction of Survival Outcomes Based on Preoperative Clinical Parameters in Gastric Cancer
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Sang-Uk Han, Chul Kyu Roh, Ho-Jung Shin, Yongok Choi, Hoon Hur, and Sang-Yong Son
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Oncology ,medicine.medical_specialty ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Stomach Neoplasms ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Retrospective Studies ,Tumor size ,business.industry ,Cancer ,Nomogram ,medicine.disease ,University hospital ,Nomograms ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Surgery ,Risk assessment ,business ,Body mass index - Abstract
Few current preoperative risk assessment tools provide essential, optimized treatment for gastric cancer. The purpose of this study was to develop and validate a nomogram that uses preoperative data to predict survival and risk assessments. A survival prediction model was constructed using data from a developmental cohort of 1251 patients with stage I to III gastric cancer who underwent curative resection between January 2005 and December 2008 at Ajou University Hospital, Korea. The model was internally validated for discrimination and calibrated using bootstrap resampling. To externally validate the model, data from a validation cohort of 2012 patients with stage I to III gastric cancer who underwent surgery at multiple centers in Korea between January 2001 and June 2006 were analyzed. Analyses included the model’s discrimination index (C-index), calibration plots, and decision curve that predict overall survival. Eight independent predictors, including age, sex, clinical tumor size, macroscopic features, body mass index, histology, clinical stages, and tumor location, were considered for developing the nomogram. The discrimination index was 0.816 (adjusted C-index) in the developmental cohort and 0.781 (adjusted C-index) in the external validation cohort. Additionally, in both the developmental and validation datasets, age and tumor size were significantly correlated with each other and were independent indicators for survival (P < 0.05). We developed a new nomogram by using the most common and significant preoperative parameters that can help to identify high-risk patients before treatment and help clinicians to make appropriate decisions for patients with stage I to III gastric cancer.
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- 2021
10. Quality of life after laparoscopic sentinel node navigation surgery in early gastric cancer: a single-center cohort study
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Sang Il Youn, Hyung Ho Kim, Sa-Hong Min, Yongjoon Won, Sang Hoon Ahn, Sang-Yong Son, Young Suk Park, and Kanghaeng Lee
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Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Sentinel lymph node ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Gastrectomy ,Stomach Neoplasms ,Surveys and Questionnaires ,Republic of Korea ,medicine ,Humans ,Prospective Studies ,business.industry ,Gastroenterology ,General Medicine ,Sentinel node ,Middle Aged ,Dysphagia ,humanities ,Early Gastric Cancer ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Quality of Life ,Lymph Node Excision ,030211 gastroenterology & hepatology ,Lymphadenectomy ,Female ,Laparoscopy ,medicine.symptom ,Sentinel Lymph Node ,business ,Cohort study ,Abdominal surgery - Abstract
To investigate the quality of life (QOL) of patients after laparoscopic sentinel node navigation surgery (SNNS) compared to conventional laparoscopy-assisted distal gastrectomy (LADG) in early gastric cancer patients. Patients recruited for laparoscopic SNNS surgery between July 2010 and April 2013 were assessed for their QOL. A historical control group was established, consisting of patients who underwent conventional LADG with radical lymphadenectomy from the same institution. QOL questionnaire was taken serially from preoperative week 1 until 12 months postoperatively (1, 3, 6, and 12 months) using the Korean version of the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire-core (QLQ-C30) and gastric cancer-specific questionnaire (STO22). A total of 80 prospectively gathered patients who received SNNS were categorized into the comparison group (SNNS group). The QOL was compared with 78 patients identified to have received LADG from the gastric cancer database of our institution and were sorted into the control group (LADG group). In QLQ-C30, SNNS group showed better functioning scales in all except role functioning and better scores from the symptom scales in fatigue, insomnia, and diarrhea compared to the LADG group. In QLQ-STO22, scores on dysphagia, eating restriction, anxiety, and body image disturbance were better in SNNS group. Postoperative QOL in laparoscopic gastrectomy combined with SNNS is superior compared to conventional laparoscopic distal gastrectomy in patients with stage I gastric cancer.
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- 2020
11. Extensive peritoneal lavage with saline after curative gastrectomy for gastric cancer (EXPEL): a multicentre randomised controlled trial
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Han Kwang Yang, Jiafu Ji, Sang Uk Han, Masanori Terashima, Guoxin Li, Hyung Ho Kim, Simon Law, Asim Shabbir, Kyo Young Song, Woo Jin Hyung, Nik Ritza Kosai, Koji Kono, Kazunari Misawa, Hiroshi Yabusaki, Takahiro Kinoshita, Peng Choong Lau, Young Woo Kim, Jaideep Raj Rao, Enders Ng, Takanobu Yamada, Kazuhiro Yoshida, Do Joong Park, Bee Choo Tai, Jimmy Bok Yan So, Hyuk Joon Lee, Seong Ho Kong, Yun-Suhk Suh, Sang-Uk Han, Hon Hur, Sang Yong Son, Sang-Hoon Ahn, Ian YH Wong, Claudia LY Wong, Fion SY Chan, Desmond KK Chan, Betty TT Law, Guo Wei Kim, Young-Woo Kim, and Jimmy B.Y. So
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Neoplasm Seeding ,Randomized controlled trial ,law ,Gastrectomy ,Stomach Neoplasms ,Clinical endpoint ,medicine ,Humans ,Peritoneal Lavage ,Single-Blind Method ,Adverse effect ,Peritoneal Neoplasms ,Aged ,Aged, 80 and over ,Intention-to-treat analysis ,Intraoperative Care ,Hepatology ,business.industry ,Hazard ratio ,Gastroenterology ,Middle Aged ,Interim analysis ,Survival Analysis ,Surgery ,Intention to Treat Analysis ,Clinical trial ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Saline Solution ,business ,Follow-Up Studies - Abstract
Peritoneal recurrence of gastric cancer after curative surgical resection is common and portends a poor prognosis. Early studies suggest that extensive intraoperative peritoneal lavage (EIPL) might reduce the risk of peritoneal recurrence and improve survival. We aimed to evaluate the survival benefit of EIPL in patients with gastric cancer undergoing curative gastrectomy.In this open-label, phase 3, multicentre randomised trial, patients aged 21-80 years with cT3 or cT4 gastric cancer undergoing curative resection were enrolled at 22 centres from South Korea, China, Japan, Malaysia, Hong Kong, and Singapore. Patients were randomly assigned to receive surgery and EIPL (EIPL group) or surgery alone (standard surgery group) via a web-based programme in random permuted blocks in varying block sizes of four and six, assuming equal allocation between treatment groups. Randomisation was stratified according to study site and the sequence was generated using a computer program and concealed until the interventions were assigned. After surgery in the EIPL group, peritoneal lavage was done with 1 L of warm (42°C) normal 0·9% saline followed by complete aspiration; this procedure was repeated ten times. The primary endpoint was overall survival. All analyses were done assuming intention to treat. This trial is registered with ClinicalTrials.gov, NCT02140034.Between Sept 16, 2012, and Aug 3, 2018, 800 patients were randomly assigned to the EIPL group (n=398) or the standard surgery group (n=402). Two patients in the EIPL group and one in the standard surgery group withdrew from the trial immediately after randomisation and were excluded from the intention-to-treat analysis. At the third interim analysis on Aug 28, 2019, the predictive probability of overall survival being significantly higher in the EIPL group was less than 0·5%; therefore, the trial was terminated on the basis of futility. With a median follow-up of 2·4 years (IQR 1·5-3·0), the two groups were similar in terms of overall survival (hazard ratio 1·09 [95% CI 0·78-1·52; p=0·62). 3-year overall survival was 77·0% (95% CI 71·4-81·6) for the EIPL group and 76·7% (71·0-81·5) for the standard surgery group. 60 adverse events were reported in the EIPL group and 41 were reported in the standard surgery group. The most common adverse events included anastomotic leak (ten [3%] of 346 patients in the EIPL group vs six [2%] of 362 patients in the standard surgery group), bleeding (six [2%] vs six [2%]), intra-abdominal abscess (four [1%] vs five [1%]), superficial wound infection (seven [2%] vs one [1%]), and abnormal liver function (six [2%] vs one [1%]). Ten of the reported adverse events (eight in the EIPL group and two in the standard surgery group) resulted in death.EIPL and surgery did not have a survival benefit compared with surgery alone and is not recommended for patients undergoing curative gastrectomy for gastric cancer.National Medical Research Council, Singapore.
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- 2020
12. Does bisphenol-A affect alteration of gut microbiome after bariatric/metabolic surgery?: a comparative metagenomic analysis in a long-term high-fat diet induced-obesity rat model
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Sang-Yong Son, Bo Wang, Hoon Hur, Hyung-Ho Kim, and Sang-Uk Han
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Surgery - Abstract
Bisphenol A (BPA) is a widely used environmental contaminant that is associated with type 2 diabetes mellitus and a shift of gut microbial community. However, little is known about the influence of BPA on gut microbial changes related to bariatric surgery. We investigated whether long-term exposure to dietary BPA causing alterations of gut microbiome occurred after bariatric surgery.Six-week-old male Wistar rats were fed either a high-fat diet (HFD) or HFD + BPA for 40 weeks. Then sleeve gastrectomy (SG) or Roux-en Y gastric bypass (RYGB) was performed in each diet group and observed for 12 weeks postoperatively. Fecal samples were collected at the 40th weeks and 12th postoperative weeks. Using 16S ribosomal RNA gene sequencing analysis on fecal samples, a comparative metagenomic analysis on gut microbiome composition was performed.Long-term exposure to HFD with BPA showed higher body weight change and higher level of fasting blood sugar after 40 weeks-diet challenge than those of the HFD only group. After bariatric surgeries, mean body weight of the HFD with BPA group was significantly higher than the HFD only group, but there was no difference between the SG and RYGB groups. The metagenomic analyses demonstrated that long-term exposure to dietary BPA did not affect significant alterations of gut microbiome before and after bariatric surgery, compared with the HFD groups.Our results highlighted that BPA was a risk factor for obesity and may contribute to glucose intolerance, but it did not affect alterations of gut microbiome after bariatric/metabolic surgery.
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- 2022
13. A Novel Auxiliary Device for Preventing Band Slippage After Laparoscopic Adjustable Gastric Banding: Infra-Band Fixation Using S-Loop
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Sang-Yong Son and Yun Chan Park
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Adult ,Male ,medicine.medical_specialty ,Gastroplasty ,business.industry ,Operative Time ,Length of Stay ,Middle Aged ,Obesity, Morbid ,Surgery ,Morbid obesity ,Fixation (surgical) ,Postoperative Complications ,Weight Loss ,medicine ,Humans ,Female ,Laparoscopy ,Slippage ,business ,Laparoscopic adjustable gastric banding ,Follow-Up Studies ,Retrospective Studies - Abstract
Band slippage is known to be a troublesome complication of laparoscopic adjustable gastric banding (LAGB), often requiring surgical intervention. To prevent band slippage, a new auxiliary device "S-loop" was developed.From July 2010 to January 2014, a total of 814 LAGBs were performed by a single surgeon. The patients were divided into two groups based on the application of S-loop: conventional LAGB group (n = 378) and S-loop group (n = 436). The operative outcomes were compared between the two groups.The mean operative time and the length of hospital stay were significantly longer in the conventional LAGB group than in the S-loop group (64.3 minutes versus 57.1 minutes; P .001 and 5.0 hours versus 3.6 hours; P .001, respectively). The complications occurred in 7.1% of the conventional LAGB group and 1.6% in the S-loop group (P .001). Slippage was the most common complication: 13 cases were observed in the conventional LAGB group, whereas no slippage was observed in the S-loop group.Infra-band fixation using S-loop is a simple and effective method for preventing band slippage compared with the conventional LAGB.
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- 2018
14. Laparoscopic Gastrectomy Using Instruments with a Minimal Diameter for Early Gastric Cancer: A Feasible Alternative to Conventional Laparoscopic Gastrectomy for Experienced Surgeons
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Sang-Yong Son, Hyuk-Jae Kwon, Sang-Uk Han, Jongsu Woo, Chul Kyu Roh, and Hoon Hur
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Laparoscopic surgery ,Adult ,Male ,medicine.medical_specialty ,Neutrophils ,medicine.medical_treatment ,Operative Time ,Leukocyte Count ,Postoperative Complications ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Postoperative Period ,Aged ,Retrospective Studies ,business.industry ,Laparoscopic gastrectomy ,Middle Aged ,Surgery ,Early Gastric Cancer ,Feasibility Studies ,Lymph Node Excision ,Female ,Laparoscopy ,business ,Learning Curve - Abstract
Background: The application of laparoscopic surgery using instruments that are 3 mm or less in diameter for patients with early gastric cancer (EGC) has not yet been established. We aimed to evalua...
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- 2019
15. Acute Cholecystitis after Operative Treatment of Compression Fracture in the Thoracolumbar Junction Area: A Report of Two Cases
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Seon Yong Son, Seong-Han Oh, Pyunggoo Cho, and Kwang-Chun Cho
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medicine.medical_specialty ,business.industry ,Cholecystitis ,medicine ,Acute cholecystitis ,Fracture (geology) ,General Medicine ,Compression (physics) ,medicine.disease ,business ,Thoracolumbar junction ,Surgery - Published
- 2018
16. Long-Term Oncologic Outcomes of Laparoscopic Sentinel Node Navigation Surgery in Early Gastric Cancer: A Single-Center, Single-Arm, Phase II Trial
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Sang Hoon Ahn, Soyeon Ahn, Ju Hee Lee, Hyung Ho Kim, Young Soo Park, Kyoung Un Park, Do Joong Park, Kyoung Ho Lee, Won Woo Lee, Young Hoon Kim, Young Suk Park, Hye Seung Lee, and Sang-Yong Son
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Adenocarcinoma ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Gastroscopy ,medicine ,Clinical endpoint ,Humans ,Prospective Studies ,Prospective cohort study ,Survival rate ,Early Detection of Cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Sentinel Lymph Node Biopsy ,business.industry ,Middle Aged ,Sentinel node ,Surgery ,Early Gastric Cancer ,Survival Rate ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Lymphadenectomy ,Neoplasm Recurrence, Local ,Sentinel Lymph Node ,business ,Follow-Up Studies ,Wedge resection (lung) - Abstract
Sentinel node navigation surgery (SNNS) in early gastric cancer (EGC) is technically feasible according to previous literature, however its long-term oncologic safety has not been reported. A single-center, single-arm, phase II trial was conducted to determine the oncologic outcomes of laparoscopic sentinel node (SN) biopsy in clinical stage T1N0M0 gastric cancer patients. Cases with positive SNs on intraoperative pathologic examination underwent conventional gastrectomy with radical lymphadenectomy (SN-positive group), whereas those with negative SNs underwent laparoendoscopic-limited gastric resections without further lymph node dissections (SN-negative group). The primary endpoint was 3-year relapse-free survival. Between July 2010 and April 2013, 113 patients were enrolled, with 100 patients being included in the final analysis. SNs were detected in 99 patients. The mean number of identified SNs was 6.1 ± 3.9. Eleven patients were included in the SN-positive group and 89 in the SN-negative group. After a median follow-up period of 46.4 months, four patients died and three showed cancer recurrence. All recurrences occurred on the remnant stomach after endoscopic submucosal resection or wedge resection in the SN-negative group. The 3-year relapse-free and overall survival rates were 96.0% (95% confidence interval [CI] 92.2–100.0%) and 98.0% (95% CI 95.2–100.0%), respectively. Our results indicate that laparoscopic SNNS may be oncologically safe in EGC. Limited gastric resections should be carefully performed to prevent local recurrence in SN-negative cases. A randomized controlled trial is needed based on the present study.
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- 2018
17. Neural Invasion is a Significant Contributor to Peritoneal Recurrence in Signet Ring Cell Gastric Carcinoma
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Sang-Yong Son, Young Bae Kim, Hoon Hur, Sang-Uk Han, and Dakeun Lee
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Male ,medicine.medical_specialty ,Gastroenterology ,Disease-Free Survival ,03 medical and health sciences ,Peritoneal Neoplasm ,0302 clinical medicine ,Stomach Neoplasms ,Surgical oncology ,Internal medicine ,Signet ring cell carcinoma ,medicine ,Humans ,Neoplasm Invasiveness ,Peripheral Nerves ,Survival rate ,Peritoneal Neoplasms ,Lymphatic Vessels ,Neoplasm Staging ,Retrospective Studies ,Signet ring cell ,business.industry ,Incidence (epidemiology) ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Survival Rate ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Surgery ,business ,Carcinoma, Signet Ring Cell - Abstract
Gastric signet ring cell carcinoma (SRC) has shown a favorable outcome in early stages but has a worse prognosis than non-SRC in advanced stages. However, the cause for this stage-dependent prognostic impact has not been determined. This study aimed to compare clinicopathologic features and recurrence patterns between gastric SRC and non-SRC in a cohort of Eastern patients. This study reviewed the prospectively collected data of 764 patients undergoing curative resection for gastric cancer from 2005 to 2008. The demographics, clinicopathologic characteristics, disease-specific survival (DSS) rate, and recurrence-free survival (RFS) rate of the patients were analyzed. The SRC patients (n = 176) had a worse prognosis than the non-SRC patients (n = 588), especially in stages T3 and T4. Peritoneal recurrence and the incidence of neural invasion (NI) were significantly increased in the SRC patients, albeit only in stages T3 and T4. In the T3 and T4 patients with NI, peritoneal recurrence occurred more frequently in SRC than in non-SRC (28.7% vs. 13.7%; p = 0.001), but not in the T3 and T4 patients without NI. Only in the patients with NI, SRC led to a significantly shorter DSS (67.6 vs. 90.7 months; p = 0.008) and RFS (67.1 vs. 80.3 months; p = 0.036) than non-SRC. This report is the first to present the relationship between NI and peritoneal recurrence as the cause of stage-dependent prognoses for SRC. A better understanding of NI may lend insight into cancer spread and recurrence, especially in gastric SRC.
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- 2018
18. Case Report of an Adult Patient Who Underwent a Serial Transverse Enteroplasty Procedure for Short Bowel Syndrome Following an Esophagectomy and Total Gastrectomy
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Sang-Yong Son, Ho-Jung Shin, Sang-Uk Han, Long-Hai Cui, and Hoon Hur
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medicine.medical_specialty ,Serial transverse enteroplasty ,business.industry ,medicine.medical_treatment ,Short bowel syndrome ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Esophagectomy ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,Gastrectomy ,business - Published
- 2017
19. A Novel Roux-en-Y Reconstruction Involving the Use of Two Circular Staplers after Distal Subtotal Gastrectomy for Gastric Cancer
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Chang Wook Ahn, Ho Jung Shin, Sang-Uk Han, Sang-Yong Son, Hoon Hur, Cheul Su Byun, and Young Bae Kim
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Cancer Research ,medicine.medical_specialty ,Anastomosis ,Circular stapler ,law.invention ,Bile reflux ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Medicine ,business.industry ,Gastroenterology ,Reflux ,Cancer ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Distal subtotal gastrectomy ,Clinical trial ,Oncology ,Distal gastrectomy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Original Article ,business ,Gastric cancer ,Roux en Y reconstruction - Abstract
PURPOSE Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. MATERIALS AND METHODS A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. RESULTS No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P
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- 2017
20. The value of N staging with the positive lymph node ratio, and splenectomy, for remnant gastric cancer: A multicenter retrospective study
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Sang Hoon Ahn, Yun Suhk Suh, Young Suk Park, Han-Kwang Yang, Hyung Ho Kim, Seong Ho Kong, Hye Seong Ahn, Hyuk Joon Lee, Do Joong Park, and Sang-Yong Son
- Subjects
Male ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,030230 surgery ,Stage ii ,Gastroenterology ,Disease-Free Survival ,Malignant disease ,03 medical and health sciences ,0302 clinical medicine ,Stomach Neoplasms ,Internal medicine ,Gastric Stump ,medicine ,Humans ,Positive lymph node ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Cancer ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Surgery ,Lymph Nodes ,Lymph ,business - Abstract
Background Surgery for remnant gastric cancer (RGC) frequently fails to obtain the >15 lymph nodes necessary for tumor-node-metastasis (TNM) staging. We aimed to evaluate the utility of the recently developed tumor-ratio-metastasis (TRM) staging system. We also examined the pattern of lymph node metastasis and the role of prophylactic splenectomy in RGC. Methods Between May 2003 and December 2012, data from 170 patients who underwent surgery for RGC were retrospectively analyzed. Results RGC arising after previous benign disease (n = 46) was associated with retrieval of more lymph nodes (27.3 vs 10.0; P
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- 2017
21. Spleen-preserving lymphadenectomy versus splenectomy in laparoscopic total gastrectomy for advanced gastric cancer
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Young Suk Park, Dong Joon Shin, Hyung Ho Kim, Aung Myint Oo, Sang-Yong Son, Sang Hoon Ahn, Chang Min Lee, Do Joong Park, and Do Hyun Jung
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Humans ,Medicine ,Neoplasm Invasiveness ,Prospective Studies ,Lymph node ,Retrospective Studies ,business.industry ,Middle Aged ,Prognosis ,Surgery ,Survival Rate ,Dissection ,medicine.anatomical_structure ,Splenic Hilum ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,Lymphadenectomy ,Lymph ,Neoplasm Recurrence, Local ,business ,Organ Sparing Treatments ,Spleen ,Splenic lymph nodes ,Follow-Up Studies - Abstract
Background To investigate the optimal approach for laparoscopic splenic hilum lymph node dissection in proximal advanced gastric cancer, we compared the operative outcomes between laparoscopic spleen-preserving total gastrectomy (sp-LTG) and laparoscopic total gastrectomy with splenectomy (sr-LTG). Methods A retrospective case-cohort study was conducted between February 2006 and December 2012. The operative outcomes, the number of retrieved splenic hilum lymph node, complication, and patients' survivals were analyzed. Results 112 patients who underwent laparoscopic total gastrectomy with or without splenectomy for advanced gastric cancer were enrolled (68 sp-LTGs and 44 sr-LTGs). The mean operation time (227 min vs. 224 min, p = 0.762), estimated blood loss (157 ml vs. 164 ml, p = 0.817), and complication rate (17.6% vs . 13.6%, p = 0.572) were not different between two groups. Regarding splenic lymph node dissection, there were significantly differences in the mean number of retrieved lymph nodes between sp-LTG and sr-LTG (LN no.10; 1.78 vs. 3.21, p = 0.033, LN no.11d; 1.41 vs. 2.76, p = 0.004). The 5-year survivals were 77.3% in sp-LTG and 65.9% in sr-LTG ( p = 0.240). The hazard ratio of splenectomy was 1.139 (95% confidence interval 0.514–2.526, p = 0.748). Conclusion In laparoscopic total gastrectomy for proximal advanced gastric cancer, spleen-preserving hilar dissection showed comparable short-term and long-term outcomes.
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- 2017
22. How could we make clinical evidence for early recovery after surgery (ERAS) in minimally invasive surgery for gastric cancer?
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Chul Kyu Roh, Hoon Hur, Sang-Uk Han, and Sang-Yong Son
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medicine.medical_specialty ,Oncology ,business.industry ,Clinical evidence ,Invasive surgery ,Early recovery ,medicine ,Cancer ,Surgery ,General Medicine ,business ,medicine.disease - Published
- 2020
23. Feasibility of Linear-Shaped Gastroduodenostomy during the Performance of Totally Robotic Distal Gastrectomy
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Hoon Hur, Chul Kyu Roh, Sang-Yong Son, Sang-Uk Han, Bo Wang, and Ho-Jung Shin
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Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Anastomosis ,Robotic surgical procedure ,Gastroduodenostomy ,Bile reflux ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,medicine ,Robotic surgery ,Billroth I ,Risk factor ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,medicine.disease ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Propensity score matching ,030211 gastroenterology & hepatology ,Original Article ,business ,Gastric cancer ,Gastroenterostomy - Abstract
Purpose Although linear-shaped gastroduodenostomy (LSGD) was reported to be a feasible and reliable method of Billroth I anastomosis in patients undergoing totally laparoscopic distal gastrectomy (TLDG), the feasibility of LSGD for patients undergoing totally robotic distal gastrectomy (TRDG) has not been determined. This study compared the feasibility of LSGD in patients undergoing TRDG and TLDG. Materials and Methods: All c onsecutive patients who underwent LSGD after distal gastrectomy for gastric cancer between January 2009 and December 2017 were analyzed retrospectively. Propensity score matching (PSM) analysis was performed to reduce the selection bias between TRDG and TLDG. Short-term outcomes, functional outcomes, learning curve, and risk factors for postoperative complications were analyzed. Results This analysis included 414 patients, of whom 275 underwent laparoscopy and 139 underwent robotic surgery. PSM analysis showed that operation time was significantly longer (163.5 vs. 132.1 minutes, P
- Published
- 2019
24. The role of surgical resection before palliative chemotherapy in advanced gastric cancer
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Mi Sun Ahn, Seong Hyun Jeong, Jin-Hyuk Choi, Hoon Hur, Seung Soo Sheen, Yong Won Choi, Sang-Uk Han, Seok Yun Kang, Joon Seong Park, Geum Sook Jeong, Sang-Yong Son, and Hyun Woo Lee
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,lcsh:Medicine ,Antineoplastic Agents ,Article ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Neoplasm Metastasis ,lcsh:Science ,Survival analysis ,Aged ,Chemotherapy ,Multidisciplinary ,business.industry ,Palliative Care ,lcsh:R ,Cancer ,Palliative chemotherapy ,medicine.disease ,Survival Analysis ,Surgery ,030104 developmental biology ,Propensity score matching ,Female ,lcsh:Q ,Metastasectomy ,business ,030217 neurology & neurosurgery - Abstract
The role of palliative surgical resection in recurrent or metastatic gastric cancer is still controversial. A retrospective review was conducted on 689 patients who received palliative chemotherapy for recurrent (n = 307) or primary metastatic (n = 382) gastric cancer. Among 131 patients (89 primary metastatic and 42 recurrent) with surgical resection before chemotherpay, 75 underwent gastrectomy, 42 metastasectomy, and 14 gastrectomy with metastasectomy. The median overall survival (OS) of patients who underwent surgical resection was significantly longer than that of patients who received chemotherapy alone (18 vs. 9 months, p p p p pensity score matching. In addition, the median OS of patients who underwent gross complete resection (n = 54) was significantly longer than that of patients who underwent incomplete resection (n = 77) (30 vs. 15 months, p = 0.002). The present study suggests that judicious use of surgical resection before chemotherapy in recurrent or metastatic gastric cancer patients may result in a favorable outcome, especially when complete resection is achievable.
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- 2019
25. Reconstruction Methods After Robotic Distal or Total Gastrectomy
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Sang-Uk Han and Sang-Yong Son
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Laparoscopic surgery ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,technology, industry, and agriculture ,Laparoscopic gastrectomy ,Wrist ,Reconstruction method ,Surgery ,body regions ,medicine.anatomical_structure ,Medicine ,Lymphadenectomy ,Gastrectomy ,business ,human activities ,Cancer surgery - Abstract
Robotic technology has been introduced to gastric cancer surgery more recently than laparoscopic methods. Therefore, most robotic procedures, including radical lymphadenectomy and reconstructions, are based on those of laparoscopic surgery. Currently, various reconstruction techniques are used in laparoscopic gastrectomy, and these are currently reproduced by the robotic surgical systems, utilizing the improved dexterity resulting from the internal articulated endoscopic wrist [1–6].
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- 2019
26. Eleven-year experience with 3000 cases of laparoscopic gastric cancer surgery in a single institution: analysis of postoperative morbidities and long-term oncologic outcomes
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Hyung Ho Kim, Aung Myint Oo, Sang Hoon Ahn, Do Joong Park, Do Hyun Jung, Dong Joon Shin, Young Suk Park, and Sang-Yong Son
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Adult ,Male ,Laparoscopic surgery ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Adenocarcinoma ,030230 surgery ,Body Mass Index ,Hospitals, University ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,Sex Factors ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,Republic of Korea ,Humans ,Medicine ,Young adult ,Laparoscopy ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Anastomosis, Surgical ,Cancer ,Retrospective cohort study ,Middle Aged ,Hepatology ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Female ,business ,Abdominal surgery - Abstract
The present study summarizes the 11-year laparoscopic gastric cancer surgery experience of a single institution in South Korea and evaluates the current trends of laparoscopic gastric cancer surgery through our experience. A total of 3000 minimally invasive gastric cancer surgeries were performed at Seoul National University Bundang Hospital between May 2003 and January 2014. The types of laparoscopic gastrectomy used, surgical techniques, postoperative morbidities, and long-term oncologic outcomes were analyzed. The proportion of challenging procedures such as laparoscopic total gastrectomy and laparoscopic gastrectomy for patients with advanced gastric cancer increased during the study period. The frequency of laparoscopic function-preserving gastrectomy for patients with early-stage cancer also increased. The overall rate of complications was 16.7 %; surgical and systemic complication rates were 11.8 and 6.2 %, respectively. There was one case of postoperative mortality due to delayed bleeding after discharge. Male gender, high BMI, long operating times, combined resection of other organs, and total and proximal gastrectomies were independent predictors of surgical morbidities; however, pathologic T-stage was not a predictable factor. Accumulated experience in laparoscopic surgery decreased the surgical complication rates of total and proximal gastrectomies more than it did in distal gastrectomy over time. The 5-year overall survival rates of patients in advanced stages and those who underwent laparoscopic total gastrectomy were comparable to those reported previously. Our results indicate the trends toward the expansion of laparoscopic approaches to technically demanding procedures and an increased use of laparoscopic function-preserving surgeries for patients with EGC with acceptable outcomes.
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- 2015
27. Laparoscopic Distal Gastrectomy for Gastric Cancer
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Sang-Uk Han and Sang-Yong Son
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medicine.medical_specialty ,Phase iii trials ,D2 lymphadenectomy ,business.industry ,General surgery ,Cancer ,Postoperative recovery ,medicine.disease ,Surgery ,Clinical trial ,Blood loss ,Medicine ,business ,Hospital stay ,Laparoscopic distal gastrectomy - Abstract
Laparoscopic distal gastrectomy for gastric cancer has rapidly gained popularity because of its short-term benefits, including less blood loss, less postoperative pain, earlier postoperative recovery, and shorter hospital stay, compared to the conventional open method. Although the long-term results of phase III trials have yet to be published, laparoscopic distal gastrectomy is now considered to be accepted for early-stage gastric cancer. As advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic distal gastrectomy is being used for advanced gastric cancer. However, due to the technical difficulty of performing D2 lymphadenectomy, this application remains controversial. Well-designed clinical trials will clarify the surgical feasibility and oncological safety of laparoscopic distal gastrectomy for advanced gastric cancer in the near future.
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- 2015
28. The learning curve associated with laparoscopic total gastrectomy
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Hye Seong Ahn, Hyung Ho Kim, Do Joong Park, Do Hyun Jung, Sang Hoon Ahn, Dong Joon Shin, Sang-Yong Son, and Young Suk Park
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Operative Time ,Blood Loss, Surgical ,030230 surgery ,Resection ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,Gastrectomy ,medicine ,Humans ,Laparoscopic total gastrectomy ,Aged ,Aged, 80 and over ,business.industry ,Gastroenterology ,General Medicine ,Length of Stay ,Middle Aged ,Surgery ,Oncology ,Learning curve ,030220 oncology & carcinogenesis ,Operative time ,Female ,Laparoscopy ,Clinical Competence ,Lymph Nodes ,business ,Complication ,Hospital stay ,Learning Curve ,Spleen ,Abdominal surgery - Abstract
Although the frequency of laparoscopic total gastrectomy (LTG) has been increasing, the procedure requires considerable experience because of its technical difficulty and the concern for oncological safety. This study intended to define the learning curve associated with the procedure. All 256 cases of LTG performed from June 2003 to December 2012 were enrolled. The cases were divided into ten groups of 25 cases based on when they occurred. The learning curve was defined using the moving average method. LTG, performed in the absence of other procedures (pure-LTG, 132 cases), was extracted from the ten groups, and the mean operative time and estimated blood loss (EBL) were compared to define the learning curve. Retrieved lymph nodes, hospital stay, and complications were compared across the phases of the learning curve. LTG with spleen resection, performed in the absence of other procedures (pure-srLTG, 53 cases), was also analyzed by the same method. A three-phase learning curve of LTG was defined: the first two groups, the following two groups, and the final six groups (mean operative time: 223.0, 244.8, and 207.8 min, respectively, p = 0.003; mean EBL: 94.6, 237.0, and 116.5 ml, respectively, p
- Published
- 2014
29. Laparoscopic gastrectomy versus open gastrectomy for gastric cancer in patients with body mass index of 30 kg/m2 or more
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Hye Seong Ahn, Chang Min Lee, Do Joong Park, Hyung Ho Kim, Sang-Yong Son, Do Hyun Jung, and Sang Hoon Ahn
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Gastroenterology ,Body Mass Index ,Gastrectomy ,Risk Factors ,Stomach Neoplasms ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Obesity ,Retrospective Studies ,business.industry ,Case-control study ,Cancer ,Retrospective cohort study ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Case-Control Studies ,Defecation ,Female ,Laparoscopy ,Lymph ,business ,Body mass index ,Abdominal surgery - Abstract
High body mass index (BMI) and high visceral fat area (VFA) are known to be a preoperative risk factor for laparoscopic gastrectomy (LG) for gastric cancer. However, the impact of obesity on LG still remains controversial. In the present study, we compared the operative outcomes of LG with those of OG in patients with BMI of 30 kg/m2 or more. Seventy-seven patients who underwent distal or total gastrectomy for gastric cancer were enrolled. The patients were divided into two groups by approach method; an OG group (n = 19) and a LG group (n = 62). Aquarius iNtuition® program was used to measure VFA. The operation time, estimated blood loss, complication rate, the number of retrieved lymph nodes, and patient survival were compared between two groups. The mean BMI and VFA were 31.6 kg/m2 and 195.3 cm2. The complication rate was 42.1 % in OG group and 14.5 % in LG group, respectively (P = 0.010). LG group showed less estimated blood loss (P = 0.030) and fast recovery of bowel movement (P
- Published
- 2014
30. Pure Single-Port Laparoscopic Distal Gastrectomy for Early Gastric Cancer: Comparative Study with Multi-Port Laparoscopic Distal Gastrectomy
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Hyung Ho Kim, Sang-Yong Son, Do Hyun Jung, Sang Hoon Ahn, and Do Joong Park
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Adult ,Male ,medicine.medical_specialty ,Port (medical) ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Lymph node ,Multi port ,Aged ,Aged, 80 and over ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Surgery ,Early Gastric Cancer ,Treatment Outcome ,medicine.anatomical_structure ,Feasibility Studies ,Female ,Laparoscopy ,Lymph ,business ,Laparoscopic distal gastrectomy - Abstract
The purpose of this study was to show the feasibility and safety of pure single-port laparoscopic distal gastrectomy (SDG) by comparing its short-term outcomes with those of conventional multiport totally laparoscopic distal gastrectomy (TLDG).Prospectively collected data of 50 gastric cancer patients who underwent pure SDG from November 2011 through October 2013 were compared with the matched data of 50 TLDG patients.Mean operation time (144.5 vs 140.3 minutes; p = 0.561) and number of harvested lymph nodes (51.7 ± 16.3 vs 52.4 ± 17.9; p = 0.836) were comparable. Estimated blood loss was lower in the SDG patients (50.5 ± 31.5 mL vs 87.5 ± 79.6 mL; p = 0.007). Postoperative recovery was faster in the SDG patients in terms of lower maximum pain score on the operative day (6.1 ± 1.4 vs 6.9 ± 1.5; p = 0.015) and postoperative day 1 (4.6 ± 1.0 vs 5.5 ± 1.4; p0.001), less use of parenteral analgesics (0.8 ± 1.0 vs 1.4 ± 1.0; p = 0.020), and less increase in C-reactive protein level on postoperative day 5 (4.57 ± 6.26 mg/L vs 8.51 ± 5.25 mg/L; p = 0.008). Postoperative morbidity occurred in 6 (12%) and 5 (10%) patients in the SDG and TLDG group, respectively.This study showed that pure SDG is both safe and feasible for early gastric cancer, with similar operation time and better short-term outcomes than TLDG in terms of postoperative pain, estimated blood loss, inflammatory reaction, and cosmetic result.
- Published
- 2014
31. Billroth II with Braun Enteroenterostomy Is a Good Alternative Reconstruction to Roux-en-Y Gastrojejunostomy in Laparoscopic Distal Gastrectomy
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Cheulsu Byun, Long-Hai Cui, Sang-Yong Son, Hoon Hur, Sang-Uk Han, Yong Kwan Cho, and Ho-Jung Shin
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Billroth II ,medicine.medical_specialty ,Hepatology ,Ileus ,Article Subject ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Retrospective cohort study ,Anastomosis ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Bile reflux ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Clinical Study ,030211 gastroenterology & hepatology ,Billroth I ,lcsh:Diseases of the digestive system. Gastroenterology ,lcsh:RC799-869 ,business ,Laparoscopic distal gastrectomy - Abstract
Background. Although Billroth II (BII) reconstruction is simpler and faster than Billroth I or Roux-en-Y (RY) reconstruction in patients undergoing totally laparoscopic distal gastrectomy (TLDG), BII reconstruction is associated with several complications, including more severe bile reflux. BII Braun anastomosis may be a better alternative to RY reconstruction. Methods. This retrospective study included 56 consecutive patients who underwent TLDG for gastric cancer, followed by BII Braun or RY reconstruction, between January 2013 and December 2015. Surgical outcomes, including length of operation, quantity of blood lost, and postoperative complications, were compared in the two groups. Results. Clinicopathological characteristics did not differ between the BII Braun and RY groups. Mean length of operation was significantly longer in the RY than the BII Braun group (157.3 min versus 134.6 min, p < 0.010), but length of hospital stay, blood loss, and complication rate did not differ between the two groups. Ileus occurred in three patients (10.0%) in the RY group. Endoscopic findings 6 months after surgery showed bile reflux in seven (28%) patients in the BII Braun group and five (17.2%) in the RY group (p = 0.343), but no significant differences in rate of gastric residue or degree of gastritis in the remnant stomach in the two groups. Conclusions. B-II Braun anastomosis is a good alternative to RY reconstruction, reducing length of operation and ileus after TLDG.
- Published
- 2017
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32. Sentinel node navigation surgery in gastric cancer
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Sang-Yong Son, Hyung Ho Kim, and Dong Joon Shin
- Subjects
medicine.medical_specialty ,business.industry ,Melanoma ,Stomach ,Cancer ,Sentinel node ,medicine.disease ,Lymphatic flow ,Surgery ,chemistry.chemical_compound ,medicine.anatomical_structure ,Breast cancer ,chemistry ,medicine ,Near infrared imaging ,business ,Indocyanine green - Abstract
The sentinel node (SN) concept has revolutionized surgery for both melanoma and breast cancer over the past two decades. The clinical utility of the SN concept has been confirmed, and individualized treatment based on the status of SNs is well accepted in breast cancer. However, the clinical application of SN navigation surgery (SNNS) for gastric cancer has remained highly controversial during last decade due to the complexity of lymphatic flow in the stomach. A recent meta-analysis and prospective multicenter studies have shown an acceptable rate of detection of SNs and a high accuracy in determining SN status. At present, a dual tracer method using radioactive colloid and vital dye is considered the best means to detect SNs in gastric cancer. Nonetheless, new technologies such as near infrared imaging and fluorescence imaging using indocyanine green have potential to improve the quality of SNNS and change the treatment strategy for gastric cancer. Additionally, rapid intraoperative immunohistochemical staining and intraoperative real-time reverse transcription polymerase chain reaction assay can be used to supplement traditional hematoxylin-eosin staining. In the near future, minimally invasive, function-preserving procedures based on SN mapping of the stomach will likely become increasingly utilized. Herein, the current status of SNNS and individualized treatments for gastric cancer are reviewed.
- Published
- 2014
33. Laparoscopic versus open gastrectomy for gastric cancer: Long-term oncologic results
- Author
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Do Joong Park, Hyung Ho Kim, Chang Min Lee, Ju Hee Lee, Sang-Yong Son, and Sang Hoon Ahn
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Subgroup analysis ,Adenocarcinoma ,Gastroenterology ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,Republic of Korea ,medicine ,Humans ,Laparoscopy ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Tumor progression ,Female ,Lymphadenectomy ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Background Data are lacking regarding the oncologic safety of laparoscopic gastrectomy (LG) for the treatment of gastric cancer. The aim of this study was to compare the long-term outcomes of LG with open gastrectomy (OG) for the treatment of gastric cancer. Methods A total of 1,874 patients underwent curative distal or total gastrectomy for gastric adenocarcinoma between May 2003 and December 2009 and were included in this retrospective study. Recurrence-free survival and recurrence pattern were compared according to each tumor stage, and a subgroup analysis was performed in advanced gastric cancer patients who underwent D2 lymphadenectomy. Results Of 1,874 patients, 816 were treated with OG and 1,058 with LG. No differences were observed in recurrence-free survival rates between the LG and the OG groups for any tumor stage. The number of harvested lymph nodes was similar between the two groups when analyzed according to tumor progression, operative procedure, and extent of lymphadenectomy. There were no differences between the 2 groups when we compared recurrence patterns after stratifying for tumor stage. The subgroup analysis in advanced gastric cancer patients who underwent D2 lymphadenectomy showed that there was no difference in the recurrence-free survival rates for any tumor stage between the 2 groups. Multivariate analysis indicated that the type of operative approach did not influence recurrence in either early or advanced gastric cancer patients. Conclusion LG for gastric cancer is an oncologically safe procedure with comparable long-term outcomes with OG.
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- 2014
34. Single-incision laparoscopic total gastrectomy with D1+beta lymph node dissection for proximal early gastric cancer
- Author
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Sang-Yong Son, Sang Hoon Ahn, Hyung-Ho Kim, Chang Min Lee, and Do Joong Park
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Dissection (medical) ,Adenocarcinoma ,Gastrectomy ,Stomach Neoplasms ,Surgical oncology ,medicine ,Humans ,Laparoscopy ,Lymph node ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Early Gastric Cancer ,Surgery ,medicine.anatomical_structure ,Oncology ,Lymph Node Excision ,business ,Abdominal surgery - Abstract
Single-incision laparoscopic distal gastrectomy for early gastric cancer has recently been reported by a few centers in Korea and Japan. In this technical report, we describe the world's first pure single-incision laparoscopic total gastrectomy with D1+beta lymph node dissection for proximal early gastric cancer.
- Published
- 2013
35. Can Robotic Gastrectomy Surpass Laparoscopic Gastrectomy by Acquiring Long-Term Experience? A Propensity Score Analysis of a 7-Year Experience at a Single Institution
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Sang-Yong Son, Long-Hai Cui, Hoon Hur, Ho-Jung Shin, Sang-Uk Han, and Sung-Soo Hong
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Stomach neoplasms ,Postoperative recovery ,03 medical and health sciences ,0302 clinical medicine ,Blood loss ,Gastrectomy ,medicine ,Single institution ,Learning curve ,business.industry ,Gastroenterology ,Laparoscopic gastrectomy ,Robotics ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Propensity score matching ,Operative time ,030211 gastroenterology & hepatology ,Original Article ,Laparoscopy ,business ,Laparoscopic distal gastrectomy - Abstract
PURPOSE It is hypothesized that robotic gastrectomy may surpass laparoscopic gastrectomy after the operators acquire long-term experience and skills in the manipulation of robotic arms. This study aimed to evaluate the long-term learning curve of robotic distal gastrectomy (RDG) for gastric cancer compared with laparoscopic distal gastrectomy (LDG). MATERIALS AND METHODS From October 2008 to December 2015, patients who underwent LDG (n=809) were matched to patients who underwent RDG (n=232) at a 1:1 ratio, by using a propensity score matching method after stratification for the operative year. The surgical outcomes, such as trends of operative time, blood loss, and complication rate, were compared between the two groups. RESULTS The RDG group showed a longer operative time (171.3 minutes vs. 147.6 minutes, P
- Published
- 2016
36. Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma
- Author
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Sang-Yong Son, Hoon Hur, Yong Kwan Cho, and Sang-Uk Han
- Subjects
Adult ,Male ,Laparoscopic surgery ,medicine.medical_specialty ,General Chemical Engineering ,medicine.medical_treatment ,Adenocarcinoma ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Monitoring, Intraoperative ,Internal medicine ,Gastroscopy ,medicine ,Humans ,Laparoscopy ,Aged ,General Immunology and Microbiology ,medicine.diagnostic_test ,business.industry ,General Neuroscience ,Stomach ,digestive, oral, and skin physiology ,Middle Aged ,medicine.disease ,Early Gastric Cancer ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Resection margin ,Duodenum ,Medicine ,Female ,030211 gastroenterology & hepatology ,business - Abstract
Determining resection margins for gastric cancer, which are not exposed to the serosal surface of the stomach, is the most important procedure during totally laparoscopic gastrectomy (TLG). The aim of this protocol is to introduce a procedure for intraoperative gastroscopy, in order to directly mark tumors during TLG for gastric cancer in the middle third of the stomach. Patients who were diagnosed with adenocarcinoma in the middle third of the stomach were enrolled in this case series. Before surgery, additional gastroscopy for tumor localization is not performed. Under general anesthesia, laparoscopic mobilization of the stomach is performed first. After the first portion of the duodenum is mobilized from the pancreas and clamped, the surgeon moves to the other side for the gastroscopic procedure. On the insertion of a gastroscope through the oral cavity into the stomach, 2 - 3 cc of indigo carmine is administered via an endoscopic injector into the gastric muscle layer at the proximal margin of the stomach. The location of stained serosa in the laparoscopic view is used to guide distal subtotal gastrectomy, however, total gastrectomy is performed if the tumor is too close to the esophagogastric junction. A specimen is sampled after distal gastrectomy to confirm sufficient length from resection margin to tumor before reconstruction. In our case series, all patients had tumor-free margins and required no additional resection. There was no morbidity related to the gastroscopic procedure, and the time required for the procedure has gradually decreased to about five minutes. Intraoperative gastroscopy for tumor localization is an accurate and tolerated method for gastric cancer patients undergoing totally laparoscopic distal gastrectomy.
- Published
- 2016
37. Modified overlap method using knotless barbed sutures (MOBS) for intracorporeal esophagojejunostomy after totally laparoscopic gastrectomy
- Author
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Cheulsu Byun, Long-Hai Cui, Ho-Jung Shin, Hoon Hur, Yong Kwan Cho, Sang-Uk Han, and Sang-Yong Son
- Subjects
Male ,medicine.medical_specialty ,Jejunostomy ,030230 surgery ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Esophagus ,Robotic Surgical Procedures ,Gastrectomy ,Stomach Neoplasms ,Surgical Stapling ,medicine ,Humans ,Major complication ,Laparoscopy ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,Sutures ,business.industry ,General surgery ,Anastomosis, Surgical ,Suture Techniques ,Laparoscopic gastrectomy ,Length of Stay ,Middle Aged ,Surgery ,Intestines ,surgical procedures, operative ,Jejunum ,030220 oncology & carcinogenesis ,Esophagoplasty ,Female ,business ,Hospital stay - Abstract
Compared to end-to-side anastomosis with a circular stapler, the overlap method is favored for intracorporeal esophagojejunostomy because it facilitates handling of the stapler, even in narrow spaces, and wider anastomosis. However, it associates with technical difficulties during anastomosis, including difficult traction on the esophageal stump that necessitates stay sutures. Here, we introduce a new modified overlap method that employs knotless barbed sutures (MOBS) and report the outcomes of our case series. All consecutive patients who underwent intracorporeal esophagojejunostomy in 2015–2016 were included. All patients underwent surgery as follows: After esophageal transection with a linear stapler, two V-loc 90 sutures (Covidien, Mansfield, MA, USA) were sutured in the center of the stapled line. The opening was made between the two threads, and the intraluminal space was identified. The jejunum was ascended toward the esophageal stump by inserting a 45-mm-long linear staple. The anastomosis was made at the space between the right and left crura. After firing the linear stapler, the entry hole was closed bidirectionally using the pre-sutured threads. Forty patients underwent MOBS (27 by laparoscopy; 13 by robot). Mean total operative and MOBS procedural times were 180.6 and 22.4 min, respectively. Mean hospital stay was 6.9 days. Two patients had major complications (5.0 %). There were no anastomosis-related complications. Laparoscopy and robot subgroups did not differ in mean MOBS procedural times (22.2 vs. 22.7 min, p = 0.787). MOBS is a safe and feasible method that is a good option for intracorporeal esophagojejunostomy after laparoscopic gastrectomy.
- Published
- 2016
38. Surgeon's Experience Overrides the Effect of Hospital Volume for Postoperative Outcomes of Laparoscopic Surgery in Gastric Cancer: Multi-institutional Study
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Han Hong Lee, Hoon Hur, Ju Hee Lee, Min Gyu Kim, Do Joong Park, and Sang-Yong Son
- Subjects
Laparoscopic surgery ,Adult ,Male ,medicine.medical_specialty ,Hospitals, Low-Volume ,medicine.medical_treatment ,Operative Time ,Blood Loss, Surgical ,Extent of resection ,03 medical and health sciences ,0302 clinical medicine ,Hospital volume ,Postoperative Complications ,Older patients ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,Medicine ,Humans ,Aged ,Aged, 80 and over ,business.industry ,Significant difference ,Cancer ,Perioperative ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Oncology ,030220 oncology & carcinogenesis ,Lymph Node Excision ,030211 gastroenterology & hepatology ,Female ,Laparoscopy ,Clinical Competence ,business ,Hospitals, High-Volume - Abstract
Hospital volume is known to be a crucial factor in reducing postoperative morbidity and mortality in laparoscopic gastrectomy for gastric cancer. However, it is unclear whether surgeon’s individual experience can overcome the effect of hospital volume. Clinicopathologic data of initial 50 laparoscopic gastrectomy cases were collected from six gastric cancer surgeons. Half of the six surgeons worked in high-volume centers, and the other half worked in low-volume hospitals. Perioperative outcomes were compared between the high-volume centers and the low-volume hospitals. Three low-volume hospitals in this study contained significantly more male and older patients with a higher American Society of Anesthesiologists score than high-volume centers. Although high- and low-volume hospitals mainly used laparoscopy-assisted and totally laparoscopic approach, respectively, there were no differences between the two groups in the extent of resection, operating time, estimated blood loss, and number of collected lymph nodes. Postoperative recovery such as duration to soft diet and hospital stay did not differ between the high- and the low-volume hospitals. No significant difference was found in postoperative morbidities by Clavien–Dindo classification. There was no mortality reported in both groups of the enrolled hospitals. Hospital volume is not a decisive factor in affecting postoperative morbidity and mortality for well-trained beginners in laparoscopic surgery for gastric cancer.
- Published
- 2016
39. Three-dimensional vision laparoscopy: hype or hope for gastric cancer surgery?
- Author
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Sang-Yong Son, Hoon Hur, and Sang-Uk Han
- Subjects
Surgery - Published
- 2017
40. Feasibility of hyperthermic pressurized intraperitoneal aerosol chemotherapy in a porcine model
- Author
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Hyung Ho Kim, Aung Myint Oo, Sang Hoon Ahn, Do Hyun Jung, Dong Joon Shin, Do Joong Park, Young Suk Park, and Sang-Yong Son
- Subjects
Hyperthermia ,Laparoscopic surgery ,medicine.medical_specialty ,Swine ,medicine.medical_treatment ,Antineoplastic Agents ,Jejunum ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pneumoperitoneum ,Gastrectomy ,medicine ,Animals ,Peritoneal Neoplasms ,Aerosols ,Chemotherapy ,business.industry ,Stomach ,Hyperthermia, Induced ,medicine.disease ,Surgery ,medicine.anatomical_structure ,chemistry ,030220 oncology & carcinogenesis ,Models, Animal ,030211 gastroenterology & hepatology ,Hyperthermic intraperitoneal chemotherapy ,Laparoscopy ,Cisplatin ,business ,Indocyanine green - Abstract
Peritoneal carcinomatosis is an unmet therapeutic need. Several types of intraperitoneal chemotherapy have been introduced. However, hyperthermic intraperitoneal chemotherapy has limited drug distribution and poor peritoneal penetration. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) does not have the benefits of hyperthermia. We developed a device to apply hyperthermic PIPAC (H-PAC) and evaluated its feasibility in a porcine model. The device for H-PAC consisted of a laparoscopic aerosol spray and a heater to create hyperthermic capnoperitoneum. We operated on five pigs for the development of the new device and on another five pigs as a survival model. After a pilot experiment of the survival model (Pig A), a hyperthermic pressurized intraperitoneal aerosol of indocyanine green was administered after insertion of three trocars (Pig B) and laparoscopy-assisted distal gastrectomy (LADG) (Pig C) without chemotherapeutic agents. After that, H-PAC with cisplatin was administered after insertion of three trocars (Pig D) and LADG (Pig E). Autopsies were performed on postoperative day 7. Median operation time was 85 min (80–110 min). Intraperitoneal temperature was constant for 1 h of H-PAC (38.8–40.2 °C). All five pigs were healthy and survived for 7 days. Median weight loss was 0.2 kg. Autopsy tissues of stomach, peritoneum, and jejunum were intact in all five pigs. H-PAC was feasible and safe in a porcine model.
- Published
- 2015
41. Linear-shaped gastroduodenostomy (LSGD): safe and feasible technique of intracorporeal Billroth I anastomosis
- Author
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Young Kwan Cho, Hoon Hur, Sang-Uk Han, Long Hai Cui, Sang-Yong Son, and Cheulsu Byun
- Subjects
Adult ,Male ,medicine.medical_specialty ,Duodenum ,medicine.medical_treatment ,Operative Time ,Constriction, Pathologic ,Anastomosis ,Gastroduodenostomy ,Bile reflux ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,Gastrectomy ,Stomach Neoplasms ,medicine ,Duodenostomy ,Humans ,Billroth I ,Duodenal Diseases ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Stomach ,Bile Reflux ,Carcinoma ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Endoscopy ,Stenosis ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Gastritis ,Feasibility Studies ,Lymph Node Excision ,030211 gastroenterology & hepatology ,Female ,Laparoscopy ,business ,Gastroenterostomy ,Abdominal surgery - Abstract
Although delta-shaped gastroduodenostomy (DSGD) is used increasingly as an intracorporeal Billroth I anastomosis after distal gastrectomy, worries about anatomical distortion always exist in twisting stomach and making an oblique incision on duodenum. We developed a new method of intracorporeal gastroduodenostomy, the linear-shaped gastroduodenostomy (LSGD), in which anastomosis is done using endoscopic linear staplers only without any complicated rotation. In this report, we introduced LSGD and compared its short-term and long-term outcomes with DSGD. We analyzed 261 consecutive gastric cancer patients who underwent the intracorporeal gastroduodenostomy between January 2009 and May 2014 (LSGD: 190, DSGD: 71), retrospectively. All of them underwent a laparoscopic or robotic distal gastrectomy with regional lymph node dissection. Early surgical outcomes such as operation time, postoperative complications, days until soft diet began, length of hospital stay, and endoscopic findings in postoperative 6 and 12 months were evaluated. Although the proportion of robotic approach and D2 lymphadenectomy were significantly higher in LSGD group, the rates for overall complications (13.2 % [LSGD] vs. 9.9 % [DSGD], p = 0.470) and major complications (5.8 vs. 5.6 %, p = 1.0) were similar between two groups. There were no differences in anastomotic bleeding (1.1 vs. 1.4 %, p = 1.0), stenosis (3.2 vs. 2.8 %, p = 1.0), and leakage (0.5 vs. 0.0 %, p = 1.0). Endoscopy performed 6 months postoperatively showed that residual food (p = 0.022), gastritis (p = 0.018), and bile reflux (42.0 vs. 63.2 %, p = 0.003) were significantly decreased in LSGD and there were no significant differences in postoperative 12 months. LSGD is an innovative reconstruction technique with comparable short-term outcomes to DSGD. In addition, reduced residual food, gastritis, and bile reflux were seen in LSGD.
- Published
- 2015
42. Is There any Role of Visceral Fat Area for Predicting Difficulty of Laparoscopic Gastrectomy for Gastric Cancer?
- Author
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Long-Hai Cui, Hoon Hur, Young Chul Kim, Ho-Jung Shin, Jei Hee Lee, Sang-Uk Han, Sang-Yong Son, Cheulsu Byun, and Yong Kwan Cho
- Subjects
Cancer Research ,medicine.medical_specialty ,Predictive marker ,Intra-Abdominal Fat ,business.industry ,medicine.medical_treatment ,Stomach neoplasms ,Gastroenterology ,Laparoscopic gastrectomy ,Cancer ,Intra-abdominal fat ,Subgroup analysis ,medicine.disease ,Obesity ,Surgery ,Laparoscopic ,Oncology ,Gastrectomy ,medicine ,Original Article ,business ,Body mass index - Abstract
PURPOSE: Obesity is associated with morbidity following gastric cancer surgery, but whether obesity influences morbidity after laparoscopic gastrectomy (LG) remains controversial. The present study evaluated whether body mass index (BMI) and visceral fat area (VFA) predict postoperative complications. MATERIALS AND METHODS: A total of 217 consecutive patients who had undergone LG for gastric cancer between May 2003 and December 2005 were included in the present study. We divided the patients into two groups ('before learning curve' and 'after learning curve') based on the learning curve effect of the surgeon. Each of these groups was sub-classified according to BMI (
- Published
- 2015
43. Is a robotic system really better than the three-dimensional laparoscopic system in terms of suturing performance?: comparison among operators with different levels of experience
- Author
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Dong Joon Shin, Sang-Yong Son, Do Joong Park, Do Hyun Jung, Young Suk Park, Hyung Ho Kim, Aung Myint Oo, and Sang Hoon Ahn
- Subjects
Laparoscopic surgery ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Operative Time ,Video Recording ,030230 surgery ,Task (project management) ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,medicine ,Humans ,Robotic surgery ,Laparoscopy ,Surgeons ,medicine.diagnostic_test ,Sutures ,business.industry ,General surgery ,Suture Techniques ,Reproducibility of Results ,Equipment Design ,Robotics ,Surgery ,Robotic systems ,030220 oncology & carcinogenesis ,Performance comparison ,Female ,Clinical Competence ,Completion time ,business ,Abdominal surgery - Abstract
High-quality three-dimensional (3D) vision systems are now available for laparoscopic surgery and may improve surgical performance relative to two-dimensional (2D) laparoscopy. It is unclear whether 3D laparoscopy is superior to 3D robotic systems. The effect of surgeon experience on surgical performance with different instruments also remains unclear. This study compared the ability of experienced and inexperienced surgeons to perform a suturing task with 2D laparoscopy, 3D laparoscopy, and a 3D robot. The 20 recruited surgeons consisted of experts (≥100 laparoscopic cases, n = 9), surgeons with intermediate experience (20–99 cases, n = 7), and novices (
- Published
- 2015
44. Solo Intracorporeal Esophagojejunostomy Reconstruction Using a Laparoscopic Scope Holder in Single-Port Laparoscopic Total Gastrectomy for Early Gastric Cancer
- Author
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Young Suk Park, Hyung Ho Kim, Do Joong Park, Dong Joon Shin, Do Hyun Jung, Sang Hoon Ahn, and Sang-Yong Son
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,General surgery ,medicine.medical_treatment ,Stomach neoplasms ,Gastroenterology ,Early Gastric Cancer ,Surgery ,Dissection ,Solo surgery ,Port (medical) ,Oncology ,Gastrectomy ,medicine ,How I Do It ,Laparoscopic total gastrectomy ,Laparoscopy ,business ,Single port - Abstract
Single-incision laparoscopic total gastrectomy for gastric cancer has recently been reported by Seoul National University Bundang Hospital. However, this is not a popular procedure primarily because of the technical difficulties involved in achieving consistent intracorporeal esophagojejunostomy. At Seoul National University Bundang Hospital, we recently introduced a simple, easy-to-use, low-profile laparoscopic manual scope holder that enables the maintenance of a stable field of view, the most demanding condition in single-port gastrectomy. In this technical report, we describe in detail the world's first solo single-incision laparoscopic total gastrectomy with D1+ lymph node dissection and intracorporeal esophagojejunostomy for proximal early gastric cancer.
- Published
- 2015
45. Laparoscopic gastrojejunostomy versus duodenal stenting in unresectable gastric cancer with gastric outlet obstruction
- Author
-
Do Hyun Jung, Chang Min Lee, Do Joong Park, Sang Hoon Ahn, Hyung Ho Kim, Sang-Yong Son, and Sa Hong Min
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Stomach neoplasms ,030230 surgery ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Laparoscopy ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,General surgery ,Medical record ,Cancer ,Gastric outlet obstruction ,medicine.disease ,Chemotherapy regimen ,Propensity score matching ,Original Article ,Stents ,030211 gastroenterology & hepatology ,Surgery ,Gastrojejunostomy ,business - Abstract
Purpose To compare the outcome between laparoscopic gastrojejunostomy (LapGJ) and duodenal stenting (DS) in terms of oral intake, nutritional status, patency duration, effect on chemotherapy and survival. Methods Medical records of 115 patients, who had LapGJ or duodenal stent placement between July 2005 and September 2015 in Seoul National University Bundang Hospital, have been reviewed retrospectively. Oral intake was measured with Gastric Outlet Obstruction Scoring System. Serum albumin and body weight was measured as indicators of nutritional status. The duration of patency was measured until the date of reintervention. Chemotherapy effect was calculated after the procedures. Survival period and oral intake was analyzed by propensity score matching age, sex, T-stage, comorbidities, and chemotherapy status. Results Forty-three LapGJ patients and 58 DS patients were enrolled. Improvement in oral intake was shown in LapGJ group versus DS group (88% vs. 59%, P = 0.011). Serum albumin showed slight but significant increase after LapGJ (+0.75 mg/dL vs. −0.15 mg/dL, P = 0.002); however, there was no difference in their body weight (+5.1 kg vs. −1.0 kg, P = 0.670). Patients tolerated chemotherapy longer without dosage reduction after LapGJ (243 days vs. 74 days, P = 0.006) and maintained the entire chemotherapy regimen after the procedure longer in LapGJ group (247 days vs. 137 days, P = 0.042). LapGJ showed significantly longer survival than DS (220 vs. 114 days, P = 0.004). Conclusion DS can provide faster symptom relief but LapGJ can provide improved oral intake, better compliance to chemotherapy, and longer survival. Therefore, LapGJ should be the first choice in gastric outlet obstruction patients for long-term and better quality of life.
- Published
- 2017
46. Real-time Vessel Navigation Using Indocyanine Green Fluorescence during Robotic or Laparoscopic Gastrectomy for Gastric Cancer
- Author
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Long-Hai Cui, Hoon Hur, Sang-Yong Son, Sang-Uk Han, Ho-Jung Shin, and Mina Kim
- Subjects
Cancer Research ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Stomach neoplasms ,Fluorescence ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Laparoscopic gastrectomy ,Cancer ,medicine.disease ,Indocyanine green ,Surgery ,Dissection ,medicine.anatomical_structure ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Original Article ,030211 gastroenterology & hepatology ,Gastrectomy ,Nuclear medicine ,business ,Artery ,Indocyanine green fluorescence - Abstract
Purpose Identification of the infrapyloric artery (IPA) type is a key component of pylorus-preserving gastrectomy. As the indocyanine green (ICG) fluorescence technique is known to help visualize blood vessels and flow during reconstruction, we speculated that this emerging technique would be helpful in identifying the IPA type. Materials and Methods From August 2015 to February 2016, 20 patients who underwent robotic or laparoscopic gastrectomy were prospectively enrolled. After intravenous injection of approximately 3 mL of ICG (2.5 mg/mL), a near-infrared fluorescence apparatus was applied. The identified shape of the IPA was confirmed by examining the actual anatomy following infrapyloric dissection. Results The mean interval time between ICG injection and visualization of the artery was 22.2 seconds (range, 14–30 seconds), and the mean duration of the arterial phase was 16.1 seconds (range, 9–30 seconds). The overall positive predictive value (PPV) of ICG fluorescence in identifying the IPA type was 80% (16/20). The IPA type was incorrectly predicted in four patients, all of whom were obese with a body mass index (BMI) of more than 25 kg/m2. Conclusions Our preliminary results indicate that intraoperative vascular imaging using the ICG fluorescence technique may be helpful for robotic or laparoscopic pylorus-preserving gastrectomy.
- Published
- 2017
47. Length of negative resection margin does not affect local recurrence and survival in the patients with gastric cancer
- Author
-
Hyung Ho Kim, Sang-Yong Son, Chang Min Lee, Sang Hoon Ahn, Ju Hee Lee, Ye Seob Jee, and Do Joong Park
- Subjects
Male ,medicine.medical_specialty ,Neoplasm, Residual ,Time Factors ,Databases, Factual ,Kaplan-Meier Estimate ,Affect (psychology) ,Disease-Free Survival ,Resection ,Hospitals, University ,Margin (machine learning) ,Gastrectomy ,Risk Factors ,Stomach Neoplasms ,Retrospective Study ,Republic of Korea ,Medicine ,Humans ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,digestive, oral, and skin physiology ,Gastroenterology ,Cancer ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Surgery ,Treatment Outcome ,Multivariate Analysis ,Resection margin ,Female ,Neoplasm Recurrence, Local ,business - Abstract
To investigate the influence of the resection margin on local recurrence and survival in gastric cancer patients.We reviewed the medical records of 1788 patients who had undergone gastrectomy for gastric cancer at the Seoul National University Bundang Hospital, South Korea, between May 2003 and July 2009. The patients were divided into early and advanced gastric cancer groups. In each group, we analyzed the relationship between clinicopathologic factors and survival outcomes, and compared the hazard rates of event occurrence between patients with resection margins above and below the cut-off value, using a Cox proportional hazard model.The early and advanced gastric cancer groups included 1001 and 787 patients, respectively. The hazard rates of event occurrence did not significantly differ between the patients with resection margins above the cut-off value and those with resection margins below the cut-off value (P0.05, in all comparisons). Based on the multivariable analyses, the proximal and distal resection margins were not significantly associated with survival outcomes and local recurrence (P0.05, in all analyses).The proximal or distal resection margins did not affect the prognosis of patients with gastric cancer if the margins were pathologically negative.
- Published
- 2014
48. Comparison of incidence of gastroesophageal reflux and regurgitation associated with timing of removal of the laryngeal mask airway: on appearance of signs of rejection versus after recovery of consciousness
- Author
-
Yong Son, Tai-Yo Kim, Kang-Chang Lee, Yong-Kang Song, Young-Pyo Cheong, Jae Seung Yoon, and Soo-Kyung Park
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Ph monitoring ,Laryngeal Masks ,law.invention ,Swallowing ,Randomized controlled trial ,Laryngeal mask airway ,law ,medicine ,Humans ,business.industry ,Incidence ,Pharynx ,Reflux ,Middle Aged ,Surgery ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Anesthesia ,Anesthetic ,Orthopedic surgery ,Gastroesophageal Reflux ,Female ,business ,medicine.drug - Abstract
To compare the incidence of gastroesophageal reflux and regurgitation associated with laryngeal mask airway (LMA) removal when signs of rejecting the LMA, such as swallowing, struggling, and restlessness, were observed and when the patient could open his or her mouth on command.Randomized clinical trial.Operating room and recovery room of a tertiary care referral hospital.63 ASA physical status I and II adult patients scheduled for elective orthopedic surgery.Using a standardized general anesthetic technique, patients were allocated randomly to Group A (n = 34; LMA removed when signs of rejection, such as swallowing, struggling, and restlessness, were observed) or Group B (n = 29; LMA removed when the patient could open his or her mouth on command).To detect gastroesophageal reflux throughout anesthesia, a pH monitoring probe was positioned in the lower esophagus on the day before surgery. To assess regurgitation during emergence, a gelatin capsule of methylene blue (50 mg) was swallowed prior to induction. At the end of anesthesia, episodes of reflux and regurgitation of gastric contents were analyzed/determined by pH below 4 and bluish staining of the pharynx and/or LMA, respectively. Physical events such as bucking, straining, and coughing during the arousal phase were recorded in both groups by an independent observer. The incidence of reflux (pH4) from the time of the appearance of rejection signs to LMA removal and the total incidence of reflux in Group B were significantly higher than in Group A (p0.05). Staining of the LMA and the pharynx by methylene blue was not observed in patients from either experimental group. The number of physical events in Group B during the arousal phase was significantly increased compared to Group A (p0.05). Considering all patients in Group A and Group B, physical events were associated with the occurrence of reflux (p0.05). Desaturation (SpO295%) and clinical evidence of aspiration of gastric contents did not occur in either group.Maintenance of the LMA until the patient can open his or her mouth on command increases the incidence of gastroesophageal reflux.
- Published
- 1999
49. 37. Risk factors of postoperative pancreatic fistula in curative gastric cancer surgery
- Author
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Hyun-Jib Kim, Sang-Yong Son, Soon-Hyun Ahn, Do Hyun Jung, Hyeong Won Yu, Yujun Park, and Donghwi Park
- Subjects
medicine.medical_specialty ,Oncology ,Pancreatic fistula ,business.industry ,General surgery ,medicine ,Surgery ,General Medicine ,medicine.disease ,business ,Cancer surgery - Published
- 2014
50. Laparoscopic completion total gastrectomy for remnant gastric cancer: a single-institution experience
- Author
-
Ju Hee Lee, Hyung Ho Kim, Sang Hoon Ahn, Do Hyun Jung, Sang-Yong Son, Do Joong Park, and Chang Min Lee
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Malignancy ,Blood loss ,Surgical oncology ,Gastrectomy ,Stomach Neoplasms ,Medicine ,Humans ,Single institution ,Aged ,Pain, Postoperative ,business.industry ,General surgery ,Gastroenterology ,Cancer ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Surgery ,Survival Rate ,Treatment Outcome ,Oncology ,Female ,Laparoscopy ,Lymph Nodes ,Neoplasm Recurrence, Local ,business ,Complication ,Abdominal surgery - Abstract
The aim of the present study was to evaluate the feasibility of laparoscopic completion total gastrectomy (LCTG) in patients with remnant gastric cancer. Patients who underwent completion total gastrectomy for remnant gastric cancer between May 2003 and December 2012 were divided into two groups: an open completion total gastrectomy (OCTG) group and an LCTG group. Clinicopathological data, operative data, and patient survival rates were analyzed. Thirty-four remnant gastrectomies (17 OCTG and 17 LCTG) were performed. The mean time interval between the prior gastrectomy and the remnant gastrectomy was 17.2 years, and benign disease showed a longer time interval than malignancy (30.9 vs. 8.1 years; p
- Published
- 2013
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