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이상권 ( Sang Kuon Lee ),김응국 ( Eung Kook Kim ) 대한소화기학회 2007 대한소화기학회지 Vol.50 No.4
Gastroesophageal reflux disease (GERD) is a chronic disease deteriorating patient`s quality of life. With the advent of proton pump inhibitors, treatment failures have decreased considerably. However, surgical therapy offers the potential for cure in more than 90% of patients with GERD. Specific indications for antireflux surgery are: incomplete response to medical therapy, frequent recurrences despite the medical treatment, laryngopharyngeal, and/or respiratory symptoms, and complications of GERD, such as esophageal stricture, erosive esophagitis, esophageal ulcer, and/or Barrett`s esophagus. The introduction of laparoscopic surgery in early ninties had a profound impact on many surgical fields, including the treatment of GERD. In this review, laparoscopic Nissen fundoplication is described and controversial topics, such as total vs. partial fundoplication, and the natural history of Barrett`s esophagus after antireflux surgery are addressed. (Korean J Gastroenterol 2007;50:220-225)
식이유도 비만 흰쥐에서 루와이 위우회술이 체중, 그렐린 및 PYY<SUB>3-36</SUB>에 미치는 영향
이상권(Sang Kuon Lee),정헌(Hun Jung),전해명(Hae Myung Jeon),김응국(Eung Kook Kim) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.3
Purpose: Obesity is considered an epidemic worldwide. Nonsurgical treatment such as dietary, physical and pharmacological therapies have limited success and thus, bariatric surgery is the ultimate option. Roux-en-Y gastric bypass (RYGB) is a bariatric procedure, which is a restrictive and malabsorptive procedure simultaneously. The purpose of this study was to develop surgical rat models of bariatric surgery and analyze the effect of gastric bypass on body weight, ghrelin and polypeptide YY3-36 (PYY3-36) changes in rats. Methods: RYGB, sleeve gastrectomy (SG) and sham operation were performed in diet-induced obese rats and compared to obese control and normal control rats. Results: In RYGB group, 20.7±8.56% of weight loss was achieved on postoperative day 18 and maintained thereafter. This outcome was significant compared to SG (8.8±1.82%) and sham operated (6.2±2.45%) groups. When pre- and postoperative ghrelin levels were compared, there was a significant decrease in RYGB group (P<0.028); nonetheless, there was no difference in SG and sham operated groups. When pre- and postoperative PYY3-36 levels were compared, there was a significant increase in RYGB (P<0.028), SG (P<0.031) and sham operated (P<0.031) groups. Conclusion: We developed surgical rat models of RYGB and SG. Those rats that underwent RYGB lost significant body weight and maintained the weight thereafter. The decrease in ghrelin and increase in PYY3-36 may be associated with loss of appetite and delay in intestinal transit time with subsequent weight loss maintenance. In the future, this rat model would serve as a tool for further study on endocrine regulation of obesity.
Ji Yeon Park,Yoonseok Heo,Yong Jin Kim,Joong-Min Park,Seong-Min Kim,Do-Joong Park,Sang Kuon Lee,Sang-Moon Han,Kyung-Won Shim,Yeon Ji Lee,Ja Youn Lee,Jin-Won Kwon 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.96 No.6
Purpose: Long-term results following bariatric surgery compared to conventional treatments has never been reported in morbidly obese Korean patients. This study aimed to evaluate the long-term efficacy of bariatric surgery in morbidly obese Korean patients compared to conventional medical treatments. Methods: In this multicenter retrospective cohort study, we reviewed 137 obese subjects between January 2008 and February 2011 with a body mass index (BMI) > 30 kg/m2 who had more than 5 years of follow-up clinical data after bariatric surgery (surgery group, n = 49) or conventional treatment (conventional treatment group, n = 88). Anthropometric data and the status of comorbidities were compared between the 2 groups. Results: The median follow-up period was 72.1 months (range 19.3–109.7 months). At the last follow-up, the surgery group showed a greater amount of total weight loss than the conventional treatment group (24.9% vs. 2.8%, P < 0.001). The prevalence of diabetes and hypertension significantly decreased in the surgery group, while the conventional treatment group showed a marked increase in these comorbidities. In the surgery group, Roux-en-Y gastric bypass and sleeve gastrectomy achieved comparable long-term weight loss (26.5% vs. 22.4%, respectively; P = 0.087). Conclusion: In the long-term, bariatric surgery achieved and maintained significantly greater weight reduction, as well as a decrease in obesity-related comorbidities, than did conventional medical therapy in morbidly obese Korean patients
Bariatric surgery versus conventional therapy in obese Korea patients
Yoon-Seok Heo,Joong-Min Park,Yong-Jin Kim,Seong-Min Kim,Do-Joong Park,Sang-Kuon Lee,Sang-Moon Han,Kyung-Won Shim,Yeon-Ji Lee,Ja-Youn Lee,Jin-Won Kwon 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.6
Purpose: In Korea, the results of bariatric surgery have not been compared with those of nonsurgical treatment. The purpose of this study was to evaluate the effectiveness and safety of bariatric surgery vs. conventional nonsurgical treatment in severely obese Koreans. Methods: In this retrospective cohort study, we reviewed the medical charts of 261 consecutive subjects who underwent bariatric surgery and 224 subjects who were treated with weight control medication and lifestyle modification therapy between January 2008 and February 2011. Measures of clinical effectiveness, including change in weight (%) and comorbid diseases, and occurrence of complications, were investigated for 18 months after bariatric surgery. Results: Body mass index (BMI) was higher in the surgery group than in the conventionally treated group (mean ± standard deviation, 39.0 ± 6.2 vs. 34.3 ± 3.8). Diabetes was more prevalent in the surgery group than in the conventionally treated group (39.1% vs. 12.9%). The change in weight (%) between baseline and 18 months posttreatment was significantly greater in the surgery group (22.6%) than in the conventional therapy group (6.7%). While 57%, 47%, and 84% of subjects recovered from diabetes, hypertension, and dyslipidemia, respectively, in the surgery group, 10%, 20%, and 24% of subjects recovered from these conditions in the conventional group. Fifty-one subjects (19.5%) in the surgery group reported 61 complications (23.4%). Conclusion: Bariatric surgery in Korea was significantly more effective than conventional treatment for weight loss and recovery from comorbidities such as diabetes, hypertension, and dyslipidemia, with a reasonable complication rate.