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재발성 직장암의 간전이 환자에서 시행된 전간 혈류 차단과 정맥 혈류 우회술 그리고 장기 보존액 주입 하의 ante situm 간절제술
주종우(Chong Woo Chu),김형철(Hyung Chul Kim),신응진(Eung Jin Shin),임철환(Cheol Wan Lim),조규석(Gyu Seok Cho),정준철(Jun Cheol Chung),정귀애(Gui Ae Jeong),송옥평(Ok Pyung Song),진수지(Soo Ji Jin),김희경(Hee Kyung Kim),박성진(Seong Ji 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.2
We present here a case of recurrent rectal cancer liver metastasis that was managed with ante situm liver resection under total vascular exclusion (TVE) and venovenous bypass with hypothermic perfusion. A 58-year-old man who suffered with rectal cancer liver metastasis was transferred to our hospital in January 2006. A left lateral sectionectomy had been previously performed. Recurrent lesion developed in segments I, IV and VIII one year after the first hepatectomy. The tumor was 5 cm in diameter and it involved the confluence of the hepatic veins and the retrohepatic vena cava. An incomplete tumor-free margin and massive bleeding were expected with performing a conventional liver resection, together with vena cava reconstruction. Therefore, we planned an ante situm liver resection under TVE and venovenous bypass with hypothermic perfusion. After adhesiolysis, hilar dissection was carried out. The inflow to the medial segment was interrupted, and then the liver and inferior vena cava (IVC) were mobilized fully. During controlling the bleeding of a short hepatic vein, we found adhesion of the hepatocaval portion. Therefore, TVE and venovenous bypass were performed along with suprahepatic IVC transection. The long conduit of V5 was preserved during hepatic parenchymal dissection, and the paracaval portion of the caudate lobe was readily detached from the IVC. The suprahepatic IVC was reconstructed after V5 reconstruction with using the saphenous vein. Portal vein anastomosis was then conducted. After reperfusion, an end-to-side anastomosis was performed between the saphenous vein graft and the IVC. Finally, a Roux-en- Y hepaticojejunostomy was carried out. The patient remains well without recurrence 12 months after the last operation.
담낭암 환자에서 Gemcitabine을 기본으로 한 보조 항암화학요법의 경험
이승원(Seung Won Lee),김형철(Hyung Chul Kim),주종우(Chong Woo Chu),정준철(Jun Chul Chung),정귀애(Gui Ae Chung) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.4
Purpose: Patients with gallbladder cancer tend to have advanced, unresectable tumor at the time of presentation and they face a dismal prognosis in the absence of a standard chemotherapy regimen. This study was performed to evaluate the outcomes of patients with gallbladder cancer and who underwent postoperative gemcitabine-based chemotherapy. Methods: From March of 2001 to February of 2008, a total of 27 patients underwent operation for gallbladder cancer. They underwent two types of gemcitabine-based chemotherapy. One type of regimen was the combined administration of gemcitabine 1,000 mg/㎡ and 5-fluorouracil 200 mg/㎡. The other one was combined administration of gemcitabine 1,000 mg/㎡ and cisplatin 70 mg/㎡. Results: Among the 27 patients, 15 patients were treated with gemcitabine-based chemotherapy and 12 patients were treated with many kinds of the best supportive care without chemotherapy. The median survival was 29.1±2.7 months and 15.7±2.8 months, respectively. The median survival and disease free survival for the gemcitabine based chemotherapy group who received curative resection was 31.6±2.5 and 15.7±3.2 months, respectively. The median survival and disease free survival for the patients without chemotherapy after curative resection was 16.3±2.9 and 15.7±3.2 months, respectively. Conclusion: Patients with gallbladder cancer and who received adjuvant gemcitabine-based chemotherapy had a relatively favorable prognosis. Especially, gemcitabine-based combination chemotherapy could be effective and acceptable for the treatment of gallbladder cancer patients who have undergone curative resection.
Dukes’ B 병기의 대장암 환자에서 Cytokeratin-19 항체를 이용한 림프절 미세전이의 발견
신응진(Eung Jin Shin),김형철(Hyung Chul Kim),임철완(Chul Wan Lim),조규석(Gyu Seok Cho),주종우(Chong Woo Chu),백무준(Moo Joon Baek),박내경(Nae Gyung Park),장용석(Yong Seok Jang),김재준(Jae Joon Kim),송옥평(Ok Pyung Song),이민혁(Min Hy 대한외과학회 2004 Annals of Surgical Treatment and Research(ASRT) Vol.66 No.5
위암에서 복강경 위절제술과 개복 위절제술의 비무작위 전향적 비교 연구
조규석(Gyu-Seok Cho),김형철(Hyung-Chul Kim),이문수(Moon-Su Lee),임철완(Cheol-Wan Lim),신응진(Eung-Jin Shin),주종우(Chong-Woo Chu),강길호(Kil-Ho Kang),김용진(Young-Jin Kim),유기원(Ki-Won Yu),이효원(Hyo-Won Lee),송옥평(Ok-Pyung Song) 대한외과학회 2006 Annals of Surgical Treatment and Research(ASRT) Vol.70 No.3