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김나래 ( Na Rae Kim ),정동해 ( Dong Hae Chung ),백정흠 ( Jeong Heum Baek ),박연호 ( Yeon Ho Park ),경희은 ( Hee Eun Kyung ),노미숙 ( Mi Sook Roh ),하승연 ( Seung Yeon Ha ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Squamous cell carcinoma of the rectum is extremely rare. Herein we report two cases of rectal squamous cell carcinoma. Case 1 was a 44-year-old Korean female presenting with abdominal pain and rectal bleeding for 3 months before her hospital visit. A colonoscopic examination revealed an ulcerated rectal mass 8 cm proximal to the anal verge. Chemoradiotherapy was administered following Hartmann``s procedure in case 1. The patient remained alive during 19 months of follow up. Case 2 was a 43-year-old Korean female who had severe constipation for 2 months. A barium enema and computed tomography of the pelvis showed a rectal mass adherent to the sacrum. Based on the results of a colonoscopic biopsy, a diverting colostomy was performed in case 2, with no further treatment. The pathologic findings showed that both tumors were composed of oval-shaped cells with abundant eosinophilic cytoplasm and intercellular bridges with keratin pearls, and thus were diagnosed as well-differentiated squamous cell carcinoma. Neither of the cases showed evidence of HPV infection. The pathogenesis of rectal squamous cell carcinoma has not been clarified. Herein we report two cases of rectal squamous cell carcinoma and briefly discuss the possible histogenesis. (Intest Res 2010;8:172-176)
대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm(R) 과 Adept(R) 가 수술 후 장운동 회복에 미치는 영향에 대한 임상적인 비교
홍윤화 ( Yoon Hwa Hong ),이원석 ( Won Suk Lee ),백정흠 ( Jeong Heum Baek ),이정남 ( Jung Nam Lee ),이운기 ( Woon Ki Lee ),최상태 ( Sang Tae Choi ) 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2
목적: 대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm(R) 과 Adept(R) 의 임상 결과를 대조군과 비교하여 장유착으로 인한 술후 합병증을 줄이고 예방하고자 본 연구를 시행하였다. 방법: 2008년 2월부터 2010년 1월까지 가천의과대학교 길병원 외과에서 대장암 수술을 받은 454 명의 환자중 114명은 Seprafilm(R) 그룹으로, 180명은 Adept(R) 그룹으로, 160명의 환자는 아무 것도 사용하지 않은 대조군으로 분류되었다. 각 그룹간의 나이, 성별, 수술 시간은 유사하였다. 결과: 소장 폐쇄은 Adept(R) 그룹에서는 16명(8.9%), Seprafilm(R) 그룹에서는 5명(4.4%), 대조군에서 11명(6.9%)이 발생하였다. 특히, Adept(R) 그룹에서는 Seprafilm(R) 그룹과 대조군에 비해 통계적으로 상당히 높은 결과로 보고 되었다. (Adept(R) vs Seprafilm(R); P = 0.043 Adept(R) vs Control group, P = 0.002) 결론: 대장암 환자에서 Seprafilm(R) 의 사용이 대조군과 비교했을 때 술후 소장 폐쇄의 전체적인발생율은 감소시키지 못하고 Adept(R) 의 사용은 소장 폐쇄의 발생율을 현저히 증가시키므로 수술중 사용함에 있어서 신중히 고려되어야 할 것이다. Purpose: The purpose of this study was to compare the clinical outcomes between Seprafilm(R), Adept(R) groups and control group in colorectal surgery for colorectal cancer. Methods: we retrospectively reviewed the medical records of patients who had undergone a colorectal surgery between February 2008 and January 2010.The patient`s demographic and operative outcomes were also evaluated. Of the 454 patients, 114 patients received Seprafilm, 180 patients received Adept(R) and 160 patients in the no additive control group. The age, gender and operative times among three groups were similar. Results: Small bowel obstruction developed in 16 patients in the Adept(R) group (8.9%), in Seprafilm(R) group 5 patients (4.4%), in the control group 11 patients (6.9%) had small intestinal obstruction. The overall incidence was significantly higher in Adept(R) group than in the Seprafilm(R) group and the control group with statistical significance (Adept(R) vs Seprafilm(R); P = 0.043 Adept(R) vs Control group, P = 0.002) Conclusion: The application of Seprafilm(R) did not reduce the rate of small bowel obstruction in patients undergoing colorectal surgery for colorectal cancer as compared with no additive group and the application of Adept(R) increased the rate of small bowel obstruction. Thus, it should be considered when using of Adept(R) in colorectal cancer operation as an adhesion reduction agents.
Gastrointestinal autonomic nerve tumor in the lower rectum
Sung Won Park(박성원),Jung Nam Lee(이정남),Dong Hae Jung(정동해),Jeong-Heum Baek(백정흠) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.1
Gastrointestinal autonomic nerve tumor (GANT) in the rectum is a subset of gastrointestinal stromal tumor (GIST). It’s a very rare mesenchymal tumor with neuronal differentiation of gastrointestinal tract. We experienced a 34-year-old female patient with GANT in the lower rectum. She was referred to our hospital owing to rectal bleeding, but didn’t have other symptoms such as abdominal pain and constipation. On digital rectal examination, a round and smooth submucosal tumor at posterior wall of the rectum was palpated approximately 5 cm above the anal verge. The mass measured approximately 5 cm in diameter and was not fixed to the underlying structures. Colonoscopy, abdomino- pelvic computed tomography scan, and core needle biopsy were performed. Given the impression of GIST, it was assumed that the patient underwent low anterior resection with double stapling technique. The tumor, a yellow-grayish colored mass, was homogenous and didn’t have hemorrhagic necrosis. Diagnosis of GANT was based on histological, immunohistochemical staining, and electron microscopy. The patient did not receive any adjuvant therapy and was discharged without complications on the tenth postoperative day.
대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm<SUP>Ⓡ</SUP>과 Adept<SUP>Ⓡ</SUP>가 수술 후 장운동 회복에 미치는 영향에 대한 임상적인 비교
홍윤화(Yoon-Hwa Hong),이원석(Won-Suk Lee),백정흠(Jeong-Heum Baek),이정남(Jung-Nam Lee),이운기(Woon-Ki Lee),최상태(Sang-Tae Choi) 대한종양외과학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2
목적 : 대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm<SUP>ⓡ</SUP> 과 Adept<SUP>ⓡ</SUP> 의 임상 결과를 대조군과 비교하여 장유착으로 인한 술후 합병증을 줄이고 예방하고자 본 연구를 시행하였다. 방법 : 2008년 2월부터 2010년 1월까지 가천의과대학교 길병원 외과에서 대장암 수술을 받은 454 명의 환자중 114명은 Seprafilm<SUP>ⓡ</SUP> 그룹으로, 180명은 Adept<SUP>ⓡ</SUP> 그룹으로, 160명의 환자는 아무 것도 사용하지 않은 대조군으로 분류되었다. 각 그룹간의 나이, 성별, 수술 시간은 유사하였다. 결과 : 소장 폐쇄은 Adept<SUP>ⓡ</SUP> 그룹에서는 16명(8.9%), Seprafilm<SUP>ⓡ</SUP> 그룹에서는 5명(4.4%), 대조군에서 11명(6.9%)이 발생하였다. 특히, Adept<SUP>ⓡ</SUP> 그룹에서는 Seprafilm<SUP>ⓡ</SUP> 그룹과 대조군에 비해 통계적으로 상당히 높은 결과로 보고 되었다. (Adept<SUP>ⓡ</SUP> vs Seprafilm<SUP>ⓡ</SUP>; P = 0.043 Adept<SUP>ⓡ</SUP> vs Control group,P = 0.002) 결론 : 대장암 환자에서 Seprafilm<SUP>ⓡ</SUP>의 사용이 대조군과 비교했을 때 술후 소장 폐쇄의 전체적인발생율은 감소시키지 못하고 Adept<SUP>ⓡ</SUP>의 사용은 소장 폐쇄의 발생율을 현저히 증가시키므로 수술중 사용함에 있어서 신중히 고려되어야 할 것이다. Purpose : The purpose of this study was to compare the clinical outcomes between Seprafilm<SUP>ⓡ</SUP>, Adept<SUP>ⓡ</SUP> groups and control group in colorectal surgery for colorectal cancer. Methods : we retrospectively reviewed the medical records of patients who had undergone a colorectal surgery between February 2008 and January 2010.The patient’s demographic and operative outcomes were also evaluated. Of the 454 patients, 114 patients received Seprafilm, 180 patients received Adept<SUP>ⓡ</SUP> and 160 patients in the no additive control group. The age, gender and operative times among three groups were similar. Results : Small bowel obstruction developed in 16 patients in the Adept<SUP>ⓡ</SUP> group (8.9%), in Seprafilm<SUP>ⓡ</SUP> group 5 patients (4.4%), in the control group 11 patients (6.9%) had small intestinal obstruction. The overall incidence was significantly higher in Adept<SUP>ⓡ</SUP> group than in the Seprafilm<SUP>ⓡ</SUP> group and the control group with statistical significance (Adept<SUP>ⓡ</SUP> vs Seprafilm<SUP>ⓡ</SUP>; P = 0.043 Adept<SUP>ⓡ</SUP> vs Control group, P = 0.002) Conclusion : The application of Seprafilm<SUP>ⓡ</SUP> did not reduce the rate of small bowel obstruction in patients undergoing colorectal surgery for colorectal cancer as compared with no additive group and the application of Adept<SUP>ⓡ</SUP> increased the rate of small bowel obstruction . Thus, it should be considered when using of Adept<SUP>ⓡ</SUP> in colorectal cancer operation as an adhesion reduction agents.
송슬기(Seul Ki Song),최상태(Sang Tae Choi),김건국(Keon Kuk Kim),이정남(Jung Nam Lee),오재환(Jae Hwan Oh),박연호(Yeon Ho Park),백정흠(Jeong Heum Baek),이운기(Woon Ki Lee),정민(Min Chung) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1
Purpose: This study was undertaken to describe the clinicopathologic characteristics and evaluate the appropriate management of appendiceal tumors. Methods: During 5 years between Sep. 2000 and Sep. 2005, 28 appendiceal tumors were identified in a retrospective review of 3,744 cases of appendectomy or right hemicolectomy pathology. Results: Carcinoids were found incidentally as appendicitis. Mucinous cystadenomas were common in women older than 50 aged; half of the cases presented with appendicitis and the other half presented with non??specific abdominal symptoms such as palpable mass, intestinal obstruction and intussusception. Carcinomas were common in the older patients(mean age: 62.8 years) and this presented as periappendiceal abscess. Right hemicolectomy was undertaken when there was evidence of tumor spread beyond the resection margin, and carcinoma and tumors were located in the appendiceal base. Recurrence and metastasis were identified only in the carcinoma cases. Conclusion: Most appendiceal tumors presented with appendicitis and periappendiceal abscess. One stage curative resection was possible in more than 76% of the patients, and the prepoperative diagnosis rate was less than 35%. The preoperative diagnosis did not have much impact on the clinical course, and the postoperative pathology was important in determining the additional treatment. Close follow??up is needed for the early detection of recurrence, and all the carcinomas that were advanced as serosal involvement, peritoneal seeding and liver metastasis.