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오정렬,박성찬,박성실,손병훈,오형민,김번,김민정,홍창원,한경수,손대경,오재환 대한대장항문학회 2018 Annals of Coloproctolgy Vol.34 No.6
Purpose: This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator. Methods: From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery. Results: Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size. Conclusion: RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.
오정렬,박보람,이성대,한경수,육의곤,이두한,김도선,이두석,홍창원,김병창,김분,김민정,박성찬,손대경,장희진,오재환 대한암학회 2019 Cancer Research and Treatment Vol.51 No.4
Purpose Predicting lymph node metastasis (LNM) risk is crucial in determining further treatment strategies following endoscopic resection of T1 colorectal cancer (CRC). This study aimed to establish a new prediction model for the risk of LNM in T1 CRC patients. Materials and Methods The development set included 833 patients with T1 CRC who had undergone endoscopic (n=154) or surgical (n=679) resection at the National Cancer Center. The validation set included 722 T1 CRC patients who had undergone endoscopic (n=249) or surgical (n=473) resection at Daehang Hospital. A logistic regression model was used to construct the prediction model. To assess the performance of prediction model, discrimination was evaluated using the receiver operating characteristic (ROC) curves with area under the ROC curve (AUC), and calibration was assessed using the Hosmer-Lemeshow (HL) goodness-of-fit test. Results Five independent risk factors were determined in the multivariable model, including vascular invasion, high-grade histology, submucosal invasion, budding, and background adenoma. In final prediction model, the performance of the model was good that the AUC was 0.812 (95% confidence interval [CI], 0.770 to 0.855) and the HL chi-squared test statistic was 1.266 (p=0.737). In external validation, the performance was still good that the AUC was 0.771 (95% CI, 0.708 to 0.834) and the p-value of the HL chi-squared test was 0.040. We constructed the nomogram with the final prediction model. Conclusion We presented an externally validated new prediction model for LNM risk in T1 CRC patients, guiding decision making in determining whether additional surgery is required after endoscopic resection of T1 CRC.
장정렬 ( Jeong Ryeol Jang ),최선화 ( Sun Hwa Choi ),권순국 ( Soon Kuk Kwun ) 한국물환경학회 2004 한국물환경학회지 Vol.20 No.5
A sedimentation basin (SB) at the inlet of an irrigation reservoir which was constructed using an auxiliary dam was monitored to evaluate its pollutant removal efficiency. Water sampling at three points, i.e., inflow stream, upstream and downstream of the reservoir, were taken 5 times before and after the construction of the SB in 1999 and 2003, respectively. No significant water quality variations in inflow stream were observed during these periods. The COD, T-N, T-P and SS removal efficiencies were 38, 24, 35 and 49%, respectively. The results indicated that those removal efficiencies significantly increased during the rainy season and COD removal efficiency, especially, was higher than others studies. The scale of SB in this study was rational as aspects of pollutant removal efficiency and hydraulic detention time. And it is recommended that SB, at inlet of an reservoir, should be constructed as completely separated structure from reservoir water body and having SAR Index from 0.7% to 1.0%.