Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.286
Jin Kim
Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understanding of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still remains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this review, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are highlighted.
{"title":"Pelvic exenteration: surgical approaches.","authors":"Jin Kim","doi":"10.3393/jksc.2012.28.6.286","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.286","url":null,"abstract":"<p><p>Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understanding of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still remains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this review, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are highlighted.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/68/jksc-28-286.PMC3548142.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.280
Byung-Kwon Ahn
See Article on Page 299-303 Incisional hernias, with an incidence of 9 to 38%, remain one of the most common complications after an incision of the abdominal wall [1-3]. An incisional hernia is defined as a protrusion of intraperitoneal structures through a defect in the anterior abdominal wall fascia [4]. This means that wound healing often fails to occur when multiple predisposing factors, including surgical site infection, malnutrition, diabetes, immunosuppression, and morbid obesity, are present [5]. Incisional hernias are almost universally regarded as technical failures. Technical factors are related to suture material selection, type of fascial closure, ratio of suture to incision length [5]. In spite of many advances, such as new procedures for closing the abdominal wall and new suture materials, the incidence of incisional hernias has not been reduced in recent decades because the developments of incisional hernias is also related to many factors affecting the patients. Surgical site infection is one of the important risk factors for the development of an incisional hernia. Recently, Murray et al. [6] analyzed the incidence of incisional hernias related with surgical site infection in colorectal surgery. They reported that patients with a surgical site infection were 1.9 times more likely to have an incisional hernia than those without a surgical site infection (36.3% vs. 18.8%, P ≤ 0.01). In clean-contaminated and contaminated surgery, such as colorectal surgery, the incidence of surgical site infection has been reported as 3 to 30% [7, 8]. Thus, in colorectal surgery, more effort to prevent surgical site infection is needed. Morbid obesity is another important risk factor for the development of an incisional hernia and a parastomal hernia [9, 10]. Schreinemacher et al. [9] reported that hernias were more prevalent in patients with morbid obesity (body mass index of 30 and higher) and in patients with a temporary stoma wound (25.8% vs. 59.1%). De Raet et al. [10] reported that a waist circumference in excess of 100 cm increased the risk of developing a parastomal hernia (odds ratio, 1.009; 95% confidence interval, 1.002 to 1.016). Other factors, such as anemia, hypoproteinemia, malnutrition, diabetes, immunosuppression, male gender, and old age, are related to surgical wound dehiscence and incisional hernias [11]. Conditions that increase abdominal pressure, such as coughing, vomiting, distention, and ascites, also increase the incidence of incisional hernias. Surgeons have to be aware of poor wound healing conditions to prevent incisional hernias. Perioperative efforts to reduce risk factors and to select proper technical methods of wound closure are essential if the incidence of incisional hernias is to be reduced.
{"title":"Risk factors for incisional hernia and parastomal hernia after colorectal surgery.","authors":"Byung-Kwon Ahn","doi":"10.3393/jksc.2012.28.6.280","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.280","url":null,"abstract":"See Article on Page 299-303 \u0000 \u0000Incisional hernias, with an incidence of 9 to 38%, remain one of the most common complications after an incision of the abdominal wall [1-3]. An incisional hernia is defined as a protrusion of intraperitoneal structures through a defect in the anterior abdominal wall fascia [4]. This means that wound healing often fails to occur when multiple predisposing factors, including surgical site infection, malnutrition, diabetes, immunosuppression, and morbid obesity, are present [5]. \u0000 \u0000Incisional hernias are almost universally regarded as technical failures. Technical factors are related to suture material selection, type of fascial closure, ratio of suture to incision length [5]. In spite of many advances, such as new procedures for closing the abdominal wall and new suture materials, the incidence of incisional hernias has not been reduced in recent decades because the developments of incisional hernias is also related to many factors affecting the patients. \u0000 \u0000Surgical site infection is one of the important risk factors for the development of an incisional hernia. Recently, Murray et al. [6] analyzed the incidence of incisional hernias related with surgical site infection in colorectal surgery. They reported that patients with a surgical site infection were 1.9 times more likely to have an incisional hernia than those without a surgical site infection (36.3% vs. 18.8%, P ≤ 0.01). In clean-contaminated and contaminated surgery, such as colorectal surgery, the incidence of surgical site infection has been reported as 3 to 30% [7, 8]. Thus, in colorectal surgery, more effort to prevent surgical site infection is needed. \u0000 \u0000Morbid obesity is another important risk factor for the development of an incisional hernia and a parastomal hernia [9, 10]. Schreinemacher et al. [9] reported that hernias were more prevalent in patients with morbid obesity (body mass index of 30 and higher) and in patients with a temporary stoma wound (25.8% vs. 59.1%). De Raet et al. [10] reported that a waist circumference in excess of 100 cm increased the risk of developing a parastomal hernia (odds ratio, 1.009; 95% confidence interval, 1.002 to 1.016). \u0000 \u0000Other factors, such as anemia, hypoproteinemia, malnutrition, diabetes, immunosuppression, male gender, and old age, are related to surgical wound dehiscence and incisional hernias [11]. Conditions that increase abdominal pressure, such as coughing, vomiting, distention, and ascites, also increase the incidence of incisional hernias. Surgeons have to be aware of poor wound healing conditions to prevent incisional hernias. Perioperative efforts to reduce risk factors and to select proper technical methods of wound closure are essential if the incidence of incisional hernias is to be reduced.","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3393/jksc.2012.28.6.280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.299
In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park
Purpose: The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.
Methods: The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.
Results: The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.
Conclusion: Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
目的:本研究的目的是评估结直肠手术后切口疝和造口旁疝的总体发生率和危险因素。方法:研究队列包括795名在2005年至2007年间由同一名外科医生连续接受开腹结直肠手术的患者。对前瞻性收集的资料进行回顾性分析。结果:切口疝总发生率为2%(14/690)。该研究显示，切口疝的累积发生率在12个月时为1%，在36个月后为3%。86%的切口疝是在结肠切除术后3年内发生的。造口患者造口旁疝的总发生率为6.7%(7/105)。结肠造口组造口旁疝的发生率明显高于回肠造口组(11.9% vs 0%;P = 0.007)。肥胖、腹主动脉瘤、美国麻醉医师学会评分、血清白蛋白水平、急诊手术和术后肠梗阻对切口或造口旁疝的发生率没有影响。然而，多因素分析显示，女性和伤口感染是切口疝发生的重要危险因素(P = 0.009，伤口感染:P = 0.041)。造口旁疝的发生无明显相关因素。结论:我们的研究结果表明，大多数切口疝在结肠切除术后3年内发生。女性和伤口感染是结直肠癌术后切口疝发生的危险因素。相反，没有发现明显的因素与造口旁疝的发生有关。
{"title":"Analysis of risk factors for the development of incisional and parastomal hernias in patients after colorectal surgery.","authors":"In Ho Song, Heon-Kyun Ha, Sang-Gi Choi, Byeong Geon Jeon, Min Jung Kim, Kyu Joo Park","doi":"10.3393/jksc.2012.28.6.299","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.299","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery.</p><p><strong>Methods: </strong>The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed.</p><p><strong>Results: </strong>The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias.</p><p><strong>Conclusion: </strong>Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/72/jksc-28-299.PMC3548144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.279
Seung Chul Heo
See Article on Page 294-298 Condyloma acuminata arising from human papillomavirus (HPV) infection may cause anal squamous cell cancer and can have a recurrence rate of up to 50% of patients after surgical treatment because surgery cannot control latent HPV infection in surrounding tissue [1]. Therefore, trials using interferon, imiquimod, 5-fluorouracil, vaccine and natural products have been performed to reduce the recurrence rate. That the immune function of the host is important to the recurrence of condyloma is supported by the higher recurrences in patients with immune-suppressants and with human immunodeficiency virus (HIV) infection and by condyloma acuminate being a viral infection [2]. The incidence of HPV infection is more than twice in homosexual man than in others, and anal condyloma increases the incidence of anal cancer; hence, anal cancers are increasing in men who have sex with men [3]. With the increases in homosexuality and homosexual marriage, anal condyloma has become a disease deserving attention. Anal condylomas have more dysplasia in homosexual man and a more frequent neoplastic process in HIV-positive patients [4, 5]. Moreover, frequent multiple infections of oncogenic HPV strains such as HPV-type 16 or 18 are seen in HIV-positive patients [6]. Highly active antiretroviral therapy is thought by some researchers to contribute to reduce morbidity and mortality due to HIV infection, resulting in a decreased incidence of HPV infection and anal cancer while other researchers suggest that prolonged survival of HIV-positive patients may increase the prevalence of anal cancers [7]. Few data exist on the incidence of anal condyloma and associated anal squamous cell cancer in Korea. However, the increases in the number of HIV-positive patients and in their survival [8] will eventually make condyloma acuminata and associated anal cancer an important issue. As uterine cervical cancer, a typical cancer caused by HPV infection, diminishes in incidence and mortality because of publicity and education, the time to start surveillance and to increase education to prevent and to reduce the incidence of anal cancer due to HPV infection has arrived.
{"title":"Condyloma acuminate and increase in the number of human immunodeficiency virus-positive patients.","authors":"Seung Chul Heo","doi":"10.3393/jksc.2012.28.6.279","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.279","url":null,"abstract":"See Article on Page 294-298 \u0000 \u0000Condyloma acuminata arising from human papillomavirus (HPV) infection may cause anal squamous cell cancer and can have a recurrence rate of up to 50% of patients after surgical treatment because surgery cannot control latent HPV infection in surrounding tissue [1]. Therefore, trials using interferon, imiquimod, 5-fluorouracil, vaccine and natural products have been performed to reduce the recurrence rate. That the immune function of the host is important to the recurrence of condyloma is supported by the higher recurrences in patients with immune-suppressants and with human immunodeficiency virus (HIV) infection and by condyloma acuminate being a viral infection [2]. \u0000 \u0000The incidence of HPV infection is more than twice in homosexual man than in others, and anal condyloma increases the incidence of anal cancer; hence, anal cancers are increasing in men who have sex with men [3]. With the increases in homosexuality and homosexual marriage, anal condyloma has become a disease deserving attention. Anal condylomas have more dysplasia in homosexual man and a more frequent neoplastic process in HIV-positive patients [4, 5]. Moreover, frequent multiple infections of oncogenic HPV strains such as HPV-type 16 or 18 are seen in HIV-positive patients [6]. Highly active antiretroviral therapy is thought by some researchers to contribute to reduce morbidity and mortality due to HIV infection, resulting in a decreased incidence of HPV infection and anal cancer while other researchers suggest that prolonged survival of HIV-positive patients may increase the prevalence of anal cancers [7]. \u0000 \u0000Few data exist on the incidence of anal condyloma and associated anal squamous cell cancer in Korea. However, the increases in the number of HIV-positive patients and in their survival [8] will eventually make condyloma acuminata and associated anal cancer an important issue. As uterine cervical cancer, a typical cancer caused by HPV infection, diminishes in incidence and mortality because of publicity and education, the time to start surveillance and to increase education to prevent and to reduce the incidence of anal cancer due to HPV infection has arrived.","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/c4/jksc-28-279.PMC3548138.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.304
Jungwoo Kang, Byung Noe Bae, Geumhee Gwak, Inseok Park, Hyunjin Cho, Keunho Yang, Ki Whan Kim, Sehwan Han, Hong-Joo Kim, Young-Duck Kim
Purpose: For the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA.
Methods: We analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications.
Results: The patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 ± 22.74 minutes whereas that in the LA group was 61.70 ± 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups.
Conclusion: Postoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.
目的:在急性阑尾炎的治疗中，传统的腹腔镜阑尾切除术(LA)已被广泛应用。近年来，单切口腹腔镜手术(SILS)的使用越来越多，因为它被认为比传统的腹腔镜手术有优势。在这项研究中，我们比较了SILS和传统的LA。方法:对2010年8月至2012年4月仁济大学附属白尚溪医院行腹腔镜阑尾切除术的217例患者进行分析。112例患者行SILS, 105例患者行LA。对于两组，我们比较了手术次数、术后实验室结果、术后疼痛、住院时间和术后并发症。结果:两组患者的人口统计学指标，包括体重指数，差异无统计学意义。SILS组有6例阑尾炎穿孔，LA组有5例。SILS组平均手术时间为65.88±22.74 min, LA组平均手术时间为61.70±22.27 min (P = 0.276)。两组患者的平均住院时间、非甾体类抗炎药的使用和伤口感染均无显著差异。结论:SILS组与LA组术后疼痛、并发症及住院时间差异无统计学意义。然而，我们的SILS方法使用一个套管针和两个乳胶管，因此可以节省成本并减少手术过程中的干扰。
{"title":"Comparative study of a single-incision laparoscopic and a conventional laparoscopic appendectomy for the treatment of acute appendicitis.","authors":"Jungwoo Kang, Byung Noe Bae, Geumhee Gwak, Inseok Park, Hyunjin Cho, Keunho Yang, Ki Whan Kim, Sehwan Han, Hong-Joo Kim, Young-Duck Kim","doi":"10.3393/jksc.2012.28.6.304","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.304","url":null,"abstract":"<p><strong>Purpose: </strong>For the treatment of acute appendicitis, a conventional laparoscopic appendectomy (LA) has been widely performed. Recently, the use of single incision laparoscopic surgery (SILS) is increasing because it is believed to have advantages over conventional laparoscopic surgery. In this study, we compared SILS and a conventional LA.</p><p><strong>Methods: </strong>We analyzed the 217 patients who received laparoscopy-assisted appendectomies between August 2010 and April 2012 at Inje University Sanggye Paik Hospital. One hundred-twelve patients underwent SILS, and 105 patients underwent LA. For the two groups, we compared the operation times, postoperative laboratory results, postoperative pain, hospital stay, and postoperative complications.</p><p><strong>Results: </strong>The patients' demographics, including body mass index, were not significantly different between the two groups. There were 6 perforated appendicitis cases in the SILS group and 5 cases in the LA group. The mean operative time in the SILS group was 65.88 ± 22.74 minutes whereas that in the LA group was 61.70 ± 22.27 minutes (P = 0.276). There were no significant differences in the mean hospital stays, use of nonsteroidal antiinflammatory drugs, and wound infections between the two groups.</p><p><strong>Conclusion: </strong>Postoperative pain, complications and hospital stay showed no statistically significant differences between the SILS and the LA groups. However, our SILS method uses a single trocar and two latex tubes, so cost savings and reduced interference during surgery are expected.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/7d/jksc-28-304.PMC3548145.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.284
Hungdai Kim
See Article on Page 315-320 For detecting new biomarkers in colorectal cancer, whether they are prognostic or predictive, we should understand the mechanism of the metastatic process at the gene expression level. This article presents a new prognostic biomarker, 'placental growth factor (PlGF)' to the clinical field. PlGF, which is a member of the vascular endothelial growth factor (VEGF) family in conjunction with VEGF-A and VEGF-B, is a ligand for VEGF receptor-1, which is expressed on endothelial cells, monocytes/macrophages, and some tumor cells. PlGF was isolated in 1991 from the placenta and was found only in very low levels under physiological conditions, but it was up-regulated in pathological circumstances such as wound healing, ischemia and tumor growth [1]. PlGF up-regulation has been found in human meningiomas, hemangioblastomas, melanomas, and cervical squamous cell carcinomas and is associated with angiogenesis in renal cell carcinomas. On the contrary, PlGF is down-regulated in thyroid carcinomas, germ cell tumors and cervical adenocarcinomas. Chen et al. [2] reported that PlGF was significantly up-regulated in gastric cancer tissue and was significantly correlated with microvessel density-evaluated angiogenesis and tumor stage. In this research, the authors found that the PlGF protein expression level in colorectal cancer tissue was significantly correlated with microvessel density, overall patient survival, and clinicopathological factors such as lymph-node metastasis, tumor stage, and lymphovascular invasion. According to the authors, PlGF seems to be an independent surrogate prognostic factor for colorectal cancer progression. However, for these results to be adopted in the clinical filed, it is very important that a large-sample-size study be brought conducted in a validation setting. The findings of this research finding suggest that PlGF may constitute a novel approach to colorectal cancer treatment. Several agents against PlGF have already developed or are currently under development. Among these agents, two novel agents against PlGF will be briefly discussed. Firstly, aflibercept (ZALTRAP) is a recombinant fusion protein that acts as a soluble receptor that binds to VEGF-A, VEGF-B and PIGF. In April 2011, Van Cutsem et al. [3] reported that aflibercept improved the primary endpoint of overall survival in the Velour phase III clinical trial for second-line treatment for metastatic colorectal cancer. Secondly, the humanized anti-PlGF mAb (TB-403) is directed against PlGF. A trial with TB-403 has only completed its first phase. Antitumor activity has been demonstrated with TB-403 in human tumor xenograft models of renal cell carcinomas and hepatocellular carcinomas. The mechanism of action for TB-403 is currently under investigation; preclinical studies suggest its effects may include blocking tumor angiogenesis and primary tumor growth, as well as inhibition of metastasis. In addition, PIGF inhibition may complement
{"title":"Finding a new prognostic biomarker for metastatic colorectal cancer.","authors":"Hungdai Kim","doi":"10.3393/jksc.2012.28.6.284","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.284","url":null,"abstract":"See Article on Page 315-320 \u0000 \u0000For detecting new biomarkers in colorectal cancer, whether they are prognostic or predictive, we should understand the mechanism of the metastatic process at the gene expression level. This article presents a new prognostic biomarker, 'placental growth factor (PlGF)' to the clinical field. PlGF, which is a member of the vascular endothelial growth factor (VEGF) family in conjunction with VEGF-A and VEGF-B, is a ligand for VEGF receptor-1, which is expressed on endothelial cells, monocytes/macrophages, and some tumor cells. PlGF was isolated in 1991 from the placenta and was found only in very low levels under physiological conditions, but it was up-regulated in pathological circumstances such as wound healing, ischemia and tumor growth [1]. \u0000 \u0000PlGF up-regulation has been found in human meningiomas, hemangioblastomas, melanomas, and cervical squamous cell carcinomas and is associated with angiogenesis in renal cell carcinomas. On the contrary, PlGF is down-regulated in thyroid carcinomas, germ cell tumors and cervical adenocarcinomas. Chen et al. [2] reported that PlGF was significantly up-regulated in gastric cancer tissue and was significantly correlated with microvessel density-evaluated angiogenesis and tumor stage. In this research, the authors found that the PlGF protein expression level in colorectal cancer tissue was significantly correlated with microvessel density, overall patient survival, and clinicopathological factors such as lymph-node metastasis, tumor stage, and lymphovascular invasion. According to the authors, PlGF seems to be an independent surrogate prognostic factor for colorectal cancer progression. However, for these results to be adopted in the clinical filed, it is very important that a large-sample-size study be brought conducted in a validation setting. \u0000 \u0000The findings of this research finding suggest that PlGF may constitute a novel approach to colorectal cancer treatment. Several agents against PlGF have already developed or are currently under development. Among these agents, two novel agents against PlGF will be briefly discussed. Firstly, aflibercept (ZALTRAP) is a recombinant fusion protein that acts as a soluble receptor that binds to VEGF-A, VEGF-B and PIGF. In April 2011, Van Cutsem et al. [3] reported that aflibercept improved the primary endpoint of overall survival in the Velour phase III clinical trial for second-line treatment for metastatic colorectal cancer. Secondly, the humanized anti-PlGF mAb (TB-403) is directed against PlGF. A trial with TB-403 has only completed its first phase. Antitumor activity has been demonstrated with TB-403 in human tumor xenograft models of renal cell carcinomas and hepatocellular carcinomas. The mechanism of action for TB-403 is currently under investigation; preclinical studies suggest its effects may include blocking tumor angiogenesis and primary tumor growth, as well as inhibition of metastasis. In addition, PIGF inhibition may complement","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/8c/jksc-28-284.PMC3548141.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.309
Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Chan Ho Park, Sa Min Hong, Seung Kyu Jeong, June Young Kim, Hyung Kyu Yang
Purpose: The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.
Methods: According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.
Results: The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.
Conclusion: In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.
{"title":"The use of a staged drainage seton for the treatment of anal fistulae or fistulous abscesses.","authors":"Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Chan Ho Park, Sa Min Hong, Seung Kyu Jeong, June Young Kim, Hyung Kyu Yang","doi":"10.3393/jksc.2012.28.6.309","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.309","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.</p><p><strong>Methods: </strong>According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.</p><p><strong>Results: </strong>The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.</p><p><strong>Conclusion: </strong>In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3393/jksc.2012.28.6.309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.321
Pyong Wha Choi
Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula.
{"title":"Colouterine fistula caused by diverticulitis of the sigmoid colon.","authors":"Pyong Wha Choi","doi":"10.3393/jksc.2012.28.6.321","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.321","url":null,"abstract":"<p><p>Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/0d/jksc-28-321.PMC3548148.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.282
Seung-Yong Jeong
See Article on Page 304-308 The open appendectomy, which was described first by McBurney [1] in 1894, has been accepted as the gold standard of an appendectomy for around 100 years. Furthermore, since its introduction by Semm [2] in 1983, the laparoscopic appendectomy has been conducted more frequently than the open appendectomy due to its advantages of being minimally invasive and having a shorter length of stay, a faster return of bowel function, decreased use of narcotics and lower rates of wound complications. In addition, much attention has been paid to recent remarkable innovative developments and improvements in laparoscopic equipment, instruments and techniques. As emphasis has focused more on minimizing the surgical technique utilized to access the pathology and on the exponential development of therapeutic endoscopy, surgical procedures that enter the peritoneum through hollow visceras that can be accessed via natural body openings, precluding skin incision, have been developed. The new approaches, named natural orifice transluminal endoscopic surgery (NOTES), aim to further limit treatment morbidity, but studies addressing these approaches have yet to be initiated because the clinical techniques for these approaches are still being developed. One of the most critical issues in NOTES when it is applied to humans is whether to securely close the extraction site of an organ such as the stomach, vagina, or rectum. If the closure fails, serious morbidities such as intraperitoneal infection or fistula may arise. NOTES can be performed as a pure procedure involving one portal of entry or as a combined procedure involving use of multiple body openings. However, based predominantly on experimental results, pure NOTES should be actively pursued as a research topic until its safety has been proven. NOTES can also be performed as a hybrid procedure in conjunction with conventional transabdominal ports. Closely related to NOTES is the development of procedures performed through a solitary small transabdominal incision. These procedures have been referred to as single-port access surgery, single-port laparoscopy surgery, single-incision laparoscopy surgery (SILS), or laparoendoscopic single-site surgery; consensus on the most appropriate name for the approach has not been achieved. Since the first report of single-incision laparoscopic surgery for acute appendicitis by Rispoli et al. [3] in 2002, it has been proposed as the next evolution in minimally invasive surgery. However, evidence supporting the safety and efficacy of this innovative approach is limited. Nevertheless, the increased interest in single-incision laparoscopic appendectomy (SILA) has seemed to be primarily focused on better cosmesis (scarless abdominal surgery performed through an umbilical incision), less incisional pain, and conversion to standard multiport laparoscopic surgery if needed. SILA also has several disadvantages and limitations, such as the restricted degrees
{"title":"Single-incision laparoscopic appendectomy.","authors":"Seung-Yong Jeong","doi":"10.3393/jksc.2012.28.6.282","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.282","url":null,"abstract":"See Article on Page 304-308 \u0000 \u0000The open appendectomy, which was described first by McBurney [1] in 1894, has been accepted as the gold standard of an appendectomy for around 100 years. Furthermore, since its introduction by Semm [2] in 1983, the laparoscopic appendectomy has been conducted more frequently than the open appendectomy due to its advantages of being minimally invasive and having a shorter length of stay, a faster return of bowel function, decreased use of narcotics and lower rates of wound complications. In addition, much attention has been paid to recent remarkable innovative developments and improvements in laparoscopic equipment, instruments and techniques. \u0000 \u0000As emphasis has focused more on minimizing the surgical technique utilized to access the pathology and on the exponential development of therapeutic endoscopy, surgical procedures that enter the peritoneum through hollow visceras that can be accessed via natural body openings, precluding skin incision, have been developed. The new approaches, named natural orifice transluminal endoscopic surgery (NOTES), aim to further limit treatment morbidity, but studies addressing these approaches have yet to be initiated because the clinical techniques for these approaches are still being developed. One of the most critical issues in NOTES when it is applied to humans is whether to securely close the extraction site of an organ such as the stomach, vagina, or rectum. If the closure fails, serious morbidities such as intraperitoneal infection or fistula may arise. NOTES can be performed as a pure procedure involving one portal of entry or as a combined procedure involving use of multiple body openings. However, based predominantly on experimental results, pure NOTES should be actively pursued as a research topic until its safety has been proven. NOTES can also be performed as a hybrid procedure in conjunction with conventional transabdominal ports. Closely related to NOTES is the development of procedures performed through a solitary small transabdominal incision. These procedures have been referred to as single-port access surgery, single-port laparoscopy surgery, single-incision laparoscopy surgery (SILS), or laparoendoscopic single-site surgery; consensus on the most appropriate name for the approach has not been achieved. \u0000 \u0000Since the first report of single-incision laparoscopic surgery for acute appendicitis by Rispoli et al. [3] in 2002, it has been proposed as the next evolution in minimally invasive surgery. However, evidence supporting the safety and efficacy of this innovative approach is limited. Nevertheless, the increased interest in single-incision laparoscopic appendectomy (SILA) has seemed to be primarily focused on better cosmesis (scarless abdominal surgery performed through an umbilical incision), less incisional pain, and conversion to standard multiport laparoscopic surgery if needed. SILA also has several disadvantages and limitations, such as the restricted degrees","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/26/jksc-28-282.PMC3548140.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01Epub Date: 2012-12-31DOI: 10.3393/jksc.2012.28.6.315
Chan Yong Sung, Myoung Won Son, Tae Sung Ahn, Dong Jun Jung, Moon Soo Lee, Moo Jun Baek
Purpose: Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. PlGF is implicated in several pathologic processes, including the growth and spread of cancer and tumor angiogenesis. The aim of this study was to evaluate the expression and the clinical implications of PlGF in colorectal cancer.
Methods: In order to ascertain the clinical significance of PlGF expression in colorectal cancer, the researcher analyzed the expression pattern of PlGF by using an immunohistochemical method and attempted to establish if a relationship existed between PlGF expression and microvessel density (MVD), and subsequently between PlGF expression and the predicted prognosis. A total of 83 patients with colorectal cancer were included for immunohistochemical staining. Clinicopathological characteristics were defined according to the tumor-node-metastasis (TNM) criteria of the Union for International Cancer Control. Clinicopathologic factors, such as age, sex, histological types of tumors, tumor cell grade, TNM stage, lymphovascular invasion, and lymph-node metastasis, were reviewed.
Results: In this study, the PlGF protein expression level was significantly correlated with MVD, patient survival, and clinicopathological factors such as lymph-node metastasis, TNM staging, lymphatic invasion and vascular invasion.
Conclusion: PlGF may be an important angiogenic factor in human colorectal cancer, and in this study, PlGF expression level was significantly correlated with positive lymph-node metastases, tumor stage, and patient survival. These findings suggest that PlGF expression correlates with disease progression and may be used as a prognostic marker for colorectal cancer.
{"title":"Expression of placenta growth factor in colorectal carcinomas.","authors":"Chan Yong Sung, Myoung Won Son, Tae Sung Ahn, Dong Jun Jung, Moon Soo Lee, Moo Jun Baek","doi":"10.3393/jksc.2012.28.6.315","DOIUrl":"https://doi.org/10.3393/jksc.2012.28.6.315","url":null,"abstract":"<p><strong>Purpose: </strong>Placenta growth factor (PlGF) is a member of the vascular endothelial growth factor (VEGF) family. PlGF is implicated in several pathologic processes, including the growth and spread of cancer and tumor angiogenesis. The aim of this study was to evaluate the expression and the clinical implications of PlGF in colorectal cancer.</p><p><strong>Methods: </strong>In order to ascertain the clinical significance of PlGF expression in colorectal cancer, the researcher analyzed the expression pattern of PlGF by using an immunohistochemical method and attempted to establish if a relationship existed between PlGF expression and microvessel density (MVD), and subsequently between PlGF expression and the predicted prognosis. A total of 83 patients with colorectal cancer were included for immunohistochemical staining. Clinicopathological characteristics were defined according to the tumor-node-metastasis (TNM) criteria of the Union for International Cancer Control. Clinicopathologic factors, such as age, sex, histological types of tumors, tumor cell grade, TNM stage, lymphovascular invasion, and lymph-node metastasis, were reviewed.</p><p><strong>Results: </strong>In this study, the PlGF protein expression level was significantly correlated with MVD, patient survival, and clinicopathological factors such as lymph-node metastasis, TNM staging, lymphatic invasion and vascular invasion.</p><p><strong>Conclusion: </strong>PlGF may be an important angiogenic factor in human colorectal cancer, and in this study, PlGF expression level was significantly correlated with positive lymph-node metastases, tumor stage, and patient survival. These findings suggest that PlGF expression correlates with disease progression and may be used as a prognostic marker for colorectal cancer.</p>","PeriodicalId":17346,"journal":{"name":"Journal of the Korean Society of Coloproctology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/ad/jksc-28-315.PMC3548147.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31185147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号