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Tsauo, Jiaywei,Kim, Kun Yung,Song, Ho-Young,Park, Jung-Hoon,Jun, Eun Jung,Kim, Min Tae,Yoon, Sung-Hwan Elsevier 2017 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Vol.28 No.8
<P><B>Abstract</B></P> <P><B>Purpose</B></P> <P>To evaluate safety and effectiveness of fluoroscopic balloon dilation (FBD) for treating postoperative nonanastomotic strictures in proximal small bowel.</P> <P><B>Materials and Methods</B></P> <P>Data of 44 patients (26 men and 18 women; mean age, 53.7 y ± 13.0) treated with FBD for postoperative nonanastomotic strictures in the proximal small bowel between January 2000 and February 2016 were retrospectively reviewed. Site of stricture was located in the first portion of duodenum in 8 (18.2%) patients, second portion of duodenum in 8 (18.2%) patients, third portion of duodenum in 1 (2.3%) patient, fourth portion of duodenum in 1 (2.3%) patient, and proximal jejunum in 26 (59.1%) patients. Mean distance between the most anal-side lesion and the oral cavity was 63.9 cm ± 15.0.</P> <P><B>Results</B></P> <P>Technical success was achieved in 39 (88.6%) patients. Mean stricture length was 3.0 cm ± 1.8. Technical failure because of inability to negotiate the guide wire through the stricture occurred in 5 (13.6%) patients. Complete resolution of obstructive symptoms and resumption of oral intake of soft or solid food within 3 days occurred in 34 patients after 1 (n = 32) or 2 (n = 2) FBD sessions, rendering a clinical success rate of 87.2%. There were no major complications directly related to FBD. Median follow-up period was 1,406 days (interquartile range, 594–2,236 d). Nine (26.5%) patients had recurrence within a median 47 days (interquartile range, 20–212 d).</P> <P><B>Conclusions</B></P> <P>FBD may be safe and effective for treating postoperative nonanastomotic strictures in the proximal small bowel.</P>
Tsauo, J.,Yoo, M. W.,Song, H. Y.,Hwang, D. W.,Park, J. H.,Ryu, M. H.,Kim, S. C.,Lee, J. H.,Choi, K. D.,Kim, J. H. Springer Science + Business Media 2016 ABDOMINAL RADIOLOGY Vol. No.
<P>To compare the outcomes of partially covered self-expandable metallic stent (SEMS) placement with surgical gastrojejunostomy (GJ) in patients with gastroduodenal obstruction caused by pancreatic cancer. The medical records of 107 patients with gastroduodenal obstruction caused by pancreatic cancer who underwent fluoroscopic partially covered SEMS placement (n = 75) or surgical GJ (n = 32) at our institution were reviewed. The technical (100% vs. 100%; P > 0.999) and clinical (98.7% vs. 96.9%; P = 0.511) success rates were similar between the SEMS and GJ group. The mean gastric outlet obstruction scoring system score was higher in the SEMS group at 1 week after treatment (2.3 +/- A 0.5 vs. 1.2 +/- A 0.4; P < 0.001) but was similar between the two groups at 1 month (2.7 +/- A 0.5 vs. 2.8 +/- A 0.5; P = 0.242). The median hospital stay was shorter in the SEMS group than in the GJ group (7 vs. 14 days; P < 0.001). The overall complication (22.7% vs. 28.1%; P = 0.547) and reintervention (21.3% vs. 25.0%; P = 0.677) rates were similar between the two groups. The median patency (99 vs. 138 days; P = 0.102) and survival (106 vs. 140 days; P = 0.245) were also similar between the two groups. The outcomes of partially covered SEMS placement seem to be more favorable than surgical GJ in patients with gastroduodenal obstruction caused by pancreatic cancer.</P>
Self-expandable metal stent placement for recurrent cancer in a surgically-altered stomach
박정훈,Jiaywei Tsauo,송호영 소화기인터벤션의학회 2017 Gastrointestinal Intervention Vol.6 No.2
Gastric cancer is one of the most common malignancies and most frequent causes of cancer-related death worldwide. Radical surgical resection accomplished by total or distal gastrectomy represents the mainstay of curative treatment for gastric cancer; however, recurrent cancer still occurs in a significant amount of cases. Patients with recurrent cancer are generally incurable and often experience debilitating symptoms, such as nausea, vomiting, dysphagia, dehydration, and malnutrition, because of malignant gastric-outlet, duodenal, and jejunal obstructions. Consequently, such patients experience progressive deterioration of quality of life. If bypass surgery has not already been performed, it is not usually appropriated in the context of recurrent cancer and is associated with a high risk of morbidity and mortality. Endoscopic or fluoroscopic self-expandable metal stent placement represents an effective and safe method for palliative treatment of recurrent cancer in patients with the surgically-altered stomach. Therefore, it should be considered as the first-line option. Importantly, accurate knowledge of the surgically-altered anatomy and stricture location are critical to achieve successful treatment outcomes.
Self-expandable metal stent placement for recurrent cancer in a surgically-altered stomach
박정훈,Jiaywei Tsauo,송호영 소화기인터벤션의학회 2017 International journal of gastrointestinal interven Vol.6 No.2
Gastric cancer is one of the most common malignancies and most frequent causes of cancer-related death worldwide. Radical surgical resection accomplished by total or distal gastrectomy represents the mainstay of curative treatment for gastric cancer; however, recurrent cancer still occurs in a significant amount of cases. Patients with recurrent cancer are generally incurable and often experience debilitating symptoms, such as nausea, vomiting, dysphagia, dehydration, and malnutrition, because of malignant gastric-outlet, duodenal, and jejunal obstructions. Consequently, such patients experience progressive deterioration of quality of life. If bypass surgery has not already been performed, it is not usually appropriated in the context of recurrent cancer and is associated with a high risk of morbidity and mortality. Endoscopic or fluoroscopic self-expandable metal stent placement represents an effective and safe method for palliative treatment of recurrent cancer in patients with the surgically-altered stomach. Therefore, it should be considered as the first-line option. Importantly, accurate knowledge of the surgically-altered anatomy and stricture location are critical to achieve successful treatment outcomes.
Self-Expandable Metallic Stent Placement for the Palliation of Esophageal Cancer
김건영,Jiaywei Tsauo,송호영,김평화,박정훈 대한의학회 2017 Journal of Korean medical science Vol.32 No.7
Esophageal stents have been used to palliate patients with dysphagia caused by esophageal cancer. Early rigid plastic prostheses have been associated with a high risk of complications. However, with the development of self-expanding stents, it has developed into a widely accepted method for treating malignant esophageal strictures and esophagorespiratory fistulas (ERFs). The present review covers various aspects of self-expanding metallic stent placement for palliating esophageal cancer, including its types, placement procedures, indications, contraindications, complications, and some of innovations that will become available in the future.
Developmental endothelial locus-1 prevents development of peritoneal adhesions in mice
Fu, Yan,Tsauo, Jiaywei,Sun, Yucheng,Wang, Zhe,Kim, Kun Yung,Lee, Seung-Hwan,Kim, Dong-Young,Jing, Feifeng,Lim, Dahae,Song, Ho-Young,Hyun, Hoon,Choi, Eun Young Elsevier 2018 Biochemical and biophysical research communication Vol.500 No.3
<P><B>Abstract</B></P> <P>Postoperative peritoneal adhesions, fibrous bands formed in the peritoneal cavity following surgery, represent a common, challenging and costly problem faced by surgeons and patients, for which effective therapeutic options are lacking. Since aberrant inflammation is one of the key mechanisms underlying peritoneal adhesion formation, here we set out to study the role of developmental endothelial locus-1 (Del-1), which has been recently identified as an endogenous inhibitor of inflammation, in the formation of postoperative peritoneal adhesions using a mouse model of peritoneal adhesions induced by ischemic buttons. Del-1-deficient mice had a higher incidence of adhesions, and their adhesions had higher quality and tenacity scores. Del-1 deficiency also led to enhanced inflammation mediators and collagen production. Finally, Del-1 supplementation decreased the incidence and severity of postoperative peritoneal adhesions. Taken together, these results indicate a protective role for Del-1 in postoperative peritoneal adhesion formation.</P>
He Zhao,Jiaywei Tsauo,Tao Gong,Jinggui Li,Xiao Li 소화기인터벤션의학회 2018 Gastrointestinal Intervention Vol.7 No.3
Background: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). Methods: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. Results: A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. Conclusion: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.
He Zhao,Jiaywei Tsauo,Tao Gong,Jinggui Li,Xiao Li 소화기인터벤션의학회 2018 International journal of gastrointestinal interven Vol.7 No.3
Background: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). Methods: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. Results: A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. Conclusion: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.