폐경 전후 여성의 신체활동 및 생활습관과 골 밀도 수치와의 관련성

배성욱,남철현,홍성철,최연희,이정옥,양숙희 대한보건협회 2002 대한보건연구 Vol.28 No.3

To evaluate the degree of bone mineral density according to physical activity, lifestyle in pre- and postmenopausal women. The subjects were 951 premenopausal and 1,167 postmenopausal women who have examined in health promotion center of Yeungnam University Hospital in Daegu city from January, 1999 to Januaty, 2001. The test for bone mineral density. The physical activity and life style were evaluated by questionaire through interview. The results were summarized as follow. 1) The prevalence rates of reduced bone mineral density and osteoporosis in premenopausal women were 23.8% and 1.6%, respectively. However, these values were increased to 46.1% and 28.1% in postmenopausal women. 2) The regular exercise was revealed to have preventive effect for osteoporosis in pre- and postmenopausal women. Among the types of exercise, the most effective exercise was bowling and moderately effective exercise was swimming on prevention of osteoporosis, however, bare hand physical exercise was not significant effect on bone mineral density. 3) The risk for reducing bone mineral density was decreased in women who have higher educational background and income in pre- and postmenopausal. The bone mineral density was highest in white color worker and lowest in blue color worker. 4) The premenopausal women who favor meat were revealed higher bone mineral density than the women who favor vegetable. The women who have drunk none or small amount of alcohol were revealed increased bone mineral density and smoking was a risk factor for osteoporosis. These results suggested that to prevent osteoporosis, the systemized program for promoting anti-osteoporotic factor have to be developed and apply from the thirties whom have maximal bone mineral density.

Single-Port Laparoscopic Total Extraperitoneal Inguinal Hernia Repair without Fixation of the Mesh

배성욱,민병소,백승혁,김남규,허혁 대한내시경복강경외과학회 2016 Journal of Minimally Invasive Surgery Vol.19 No.1

Purpose: Single-port laparoscopic surgery has been used increasingly to treat a variety of conditions, and one recently introduced technique is single-port laparoscopic total extraperitoneal (SPLTEP) hernia repair. The aim of this study was to evaluate the safety and technical feasibility of SPLTEP hernia repair without fixation of the mesh. Method: From June 2010 to October 2012, 112 consecutive patients underwent SPLTEP hernia repair. Results: We performed 129 inguinal hernia repairs in 112 patients, 17 of which were bilateral and 95 unilateral. Indirect hernias occurred in 90 patients, direct hernias in 20 patients, and both direct and indirect hernias in 2 patients. Successful SPLTEP hernia repair was performed in 110 patients, with two conversions to an open surgical approach. Median operative times for unilateral and bilateral hernias were 70 minutes (40-145 minutes) and 90 minutes (67-135 minutes), respectively, and the hospital stay was 1 day (1-5 days). Postoperative complications included 10 patients with wound seromas or hematomas, 2 with urinary retention, 4 with groin pain, and 1 with bleeding from the incision site. There was no recurrence during a median follow-up period of 18 months (6-31 months). Conclusions: SPLTEP inguinal hernia repair without fixation of the mesh is both safe and technically feasible, and provides acceptable operative outcomes. A prospective randomized study with long-term follow-up is needed to confirm the benefit of this technique in patients with inguinal hernia.

Which Patients with Isolated Para-aortic Lymph Node Metastasis Will Truly Benefit from Extended Lymph Node Dissection for Colon Cancer?

배성욱,허혁,민병소,백승혁,이강영,김남규 대한암학회 2018 Cancer Research and Treatment Vol.50 No.3

Purpose The prognosis of patients with colon cancer and para-aortic lymph node metastasis (PALNM) is poor. We analyzed the prognostic factors of extramesenteric lymphadenectomy for colon cancer patients with isolated PALNM. Materials and Methods We retrospectively reviewed 49 patients with PALNM who underwent curative resection between October 1988 and December 2009. Results In univariate analyses, the 5-year overall survival (OS) and disease-free survival (DFS) rates were higher in patients with  7 positive para-aortic lymph node (PALN) (36.5% and 27.5%) than in those with > 7 PALN (14.3% and 14.3%; p=0.010 and p=0.027, respectively), and preoperative carcinoembryonic antigen (CEA) level > 5 was also correlated with a lower 5-year OS and DFS rate of 21.5% and 11.7% compared with those with CEA  5 (46.3% and 41.4%; p=0.122 and 0.039, respectively). Multivariate analysis found that the number of positive PALN (hazard ratio [HR], 3.291; 95% confidence interval [CI], 1.309 to 8.275; p=0.011) was an independent prognostic factor for OS and the number of positive PALN (HR, 2.484; 95% CI, 0.993 to 6.211; p=0.052) and preoperative CEA level (HR, 1.953; 95% CI, 0.940 to 4.057; p=0.073) were marginally independent prognostic factors for DFS. According to our prognostic model, the 5-year OS and DFS rate increased to 59.3% and 53.3%, respectively, in patients with  7 positive PALN and CEA level  5. Conclusion PALN dissection might be beneficial in carefully selected patients with a low CEA level and less extensive PALNM.

절제 불가능한 4기 대장암 환자에서의 고식적 수술

배성욱,허혁,민병소,백승혁,김남규 대한종양외과학회 2012 대한임상종양학회 학술대회지 Vol.2012 No.3

Single-Port Laparoscopic Interval Appendectomy for Perforated Appendicitis With a Periappendiceal Abscess

배성욱,정운경,백성규 대한대장항문학회 2016 Annals of Coloproctolgy Vol.32 No.3

Purpose: Nonoperative management followed by an interval appendectomy is a commonly used approach for treating patients with perforated appendicitis with abscess formation. As minimally-invasive surgery has developed, single-port laparoscopic surgery (SPLS) is increasingly being used to treat many conditions. We report our initial experience with this procedure using a multichannel single-port. Methods: The study included 25 adults who underwent a single-port laparoscopic interval appendectomy for perforated appendicitis with periappendiceal abscess by using a single-port with or without needlescopic grasper between June 2014 and January 2016. Results: Of the 25 patients, 9 (36%) required percutaneous drainage for a median of 7 days (5–14 days) after insertion, and 3 (12%) required conversion to reduced-port laparoscopic surgery with a 5-mm port insertion because of severe adhesions to adjacent organs. Of 22 patients undergoing SPLS, 13 underwent pure SPLS (52.0%) whereas 9 patients underwent SPLS with a 2-mm needle instrument (36.0%). Median operation time was 70 minutes (30–155 minutes), and a drainage tube was placed in 9 patients (36.0%). Median total length of incision was 2.5 cm (2.0–3.0 cm), and median time to soft diet initiation and length of stay in the hospital were 2 days (0–5 days) and 3 days (1–7 days), respectively. Two patients (8.0%) developed postoperative complications: 1 wound site bleeding and 1 surgical site infection. Conclusion: Conservative management followed by a single-port laparoscopic interval appendectomy using a multichannel single-port appears feasible and safe for treating patients with acute perforated appendicitis with periappendiceal abscess.

The Role of Hand-Assisted Laparoscopic Surgery in a Right Hemicolectomy for Right-Sided Colon Cancer

배성욱,박진석,최영진,이민구,조병선,강윤중,박주승,김창남 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.1

Purpose: The purpose of this study is to evaluate the perioperative and long-term oncologic outcomes of hand-assisted laparoscopic surgery (HALS) and standard laparoscopic surgery (SLS) and assess the role of HALS in the management of right-sided colon cancer. Methods: The study group included 53 patients who underwent HALS and 45 patients who underwent SLS for right-sided colon cancer between April 2002 and December 2008. Results: The patients in each group were similar in age, American Society of Anesthesiologist (ASA) score, body mass index, and history of previous abdominal surgeries. Eight patients in the HALS group and no patient in the SLS group exhibited signs of tumor invasion into adjacent structures. No differences were noted in the time to return of normal bowel function, time to toleration of diet, lengths of hospital stay and narcotic usage, and rate of postoperative complications. The median incision length was longer in the HALS group (HALS: 7.0 cm vs. SLS: 4.8 cm, P < 0.001). The HALS group had a significantly higher pathologic TNM stage and significantly larger tumor size (HALS: 6.0 cm vs. SLS: 3.3 cm, P < 0.001). The 5-year overall, disease-free, and cancer-specific survival rates of the HALS and the SLS groups were 87.3%, 75.2%, and 93.9% and 86.4%, 78.0%, and 90.7%, respectively (P = 0.826, P = 0.574, and P = 0.826). Conclusion: Although patients in the HALS group had more advanced disease and underwent more complex procedures than those in the SLS group, the short-term benefits and the oncologic outcomes between the two groups were comparable. HALS can, therefore, be considered an alternative to SLS for bulky and fixed right-sided colon cancer.

Reduced-Port Laparoscopic Surgery for a Tumor-Specific Mesorectal Excision in Patients With Colorectal Cancer: Initial Experience With 20 Consecutive Cases

배성욱,백세진,민병소,백승혁,김남규,허혁 대한대장항문학회 2015 Annals of Coloproctolgy Vol.31 No.1

Purpose: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Methods: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. Results: The median operation time was 231 minutes (range, 160−347 minutes), and the estimated blood loss was 100 mL (range, 50−500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3−6 days), and the length of hospital stay was 7 days (range, 5−45 days). The median total number of lymph nodes harvested was 16 (range, 7−36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12−40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. Conclusion: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.

건설공사의 해지비용 산정 방법 ( Calculating Termination of a Contract in Construction Project )

배성욱,이영민,이상욱,진유나,이상범,김정길 대한건축학회 2002 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.22 No.1

Robotic Total Mesorectal Excision using a Wristed Suctionirrigation Device for Efficient Traction and Visualization

배성욱,정운경,백성규 대한내시경복강경외과학회 2017 Journal of Minimally Invasive Surgery Vol.20 No.3

In rectal cancer surgery, gentle opening of the plane by continuous traction and optimized visualization is essential. Recently, a wristed robotic suction-irrigation device was developed for efficient traction of the rectum and good surgical visualization. This video shows a technique of robotic total mesorectal excision using a wristed robotic suction-irrigation device. A 74-year-old woman with rectal cancer had a biopsy-proven adenocarcinoma within 9 cm of the anal verge. She underwent totally robotic total mesorectal excision using a dual-docking technique. Total procedure time was 445 minutes. The patient was discharged on postoperative day 8 without any complications. Total number of lymph nodes harvested was 12, and proximal and distal resection margins were 11.2 and 4.7 cm, respectively. Totally robotic total mesorectal excision using a wristed robotic suctionirrigation device was an efficient and useful procedure for rectal cancer.

Robotic Low Ligation of the Inferior Mesenteric Artery for Rectal Cancer Using the Firefly Technique

배성욱,김남규,민병소 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.4

Purpose: By integrating intraoperative near infrared fluorescence imaging into a robotic system, surgeons can identify the vascular anatomy in real-time with the technical advantages of robotics that is useful for meticulous lymphovascular dissection. Herein, we report our initial experience of robotic low ligation of the inferiormesenteric artery (IMA) with real-time identification of the vascular system for rectal cancer using the Firefly technique. Materials and Methods: The study group included 11 patients who underwent a robotic total mesorectal excision with preservation of the left colic artery for rectal cancer using the Firefly technique betweenJuly 2013 and December 2013. Results: The procedures included five low anterior resections and six ultra-low anterior resections with loop ileostomy. The median total operation time was 327 min (226‒490). The low ligation time was 10 min (6‒20), and the time interval between indocyanine green injection and division of the sigmoid artery was 5 min (2‒8). The estimated blood loss was 200 mL (100‒500). The median time to soft diet was 4 days (4‒5), and the median length of stay was 7 days (5‒9). Three patients developed postoperative complications; one patients developed anal stricture, one developed ileus, and one developed non-complicatedintraabdominal fluid collection. The median total number of lymph nodes harvested was 17 (9‒29). Conclusion: Robotic low ligation of the IMA with real-time identification of the vascular system for rectal cancer using the Firefly techniqueis safe and feasible. This technique can allow for precise lymph node dissectionalong the IMA and facilitate the identification of the left colic branch of the IMA.