복강경 부신절제술과 개복 부신절제술 비교

장효중,곽금희,양근호,김기환,한세환,김홍주,김영덕,Hyo-Jung Chang,Geumhee Gwak,Keun-Ho Yang,Ki-Hwan Kim,Sehwan Han,Hong-Joo Kim and Young-Duck Kim 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.2

<B>Purpose: </B>Advancements in technology and surgical skill have extended the applications of minimally invasive surgery, and various studies have suggested that laparoscopic adrenalectomy (LA) might lead to better clinical outcomes compared to open surgery. We reviewed our experience in order to evaluate the clinical outcomes of laparoscopic and open adrenalectomy (OA). <B>Methods: </B>We retrospectively analyzed the clinical records of 41 patients who underwent surgery for adrenal lesions between 1998 and 2006. Outcome measurements included gender, age, diagnosis, lesion size, operative time, intraoperative blood loss, procedure-related complications, time to first oral intake, and postoperative hospital stay. <B>Results: </B>There were 19 LAs and 22 OAs. There were no significant differences in gender, age, lesion location (right or left), comorbidity, complications, or postoperative hospital stay. The mean operative time was longer in the LA group than in the OA group (OA 215, LA 273 min, P=0.048). Resumption of oral intake occurred at 3.4 days in the OA group and at 1.9 days in the LA group (P<0.001), and the incidence of bleeding that required transfusion was 58% in the OA group and 21% in the LA group (P=0.018). We divided the LA group into 14 pure LAs (pLA) and 5 conversions from laparoscopic procedures to open adrenalectomy (CA). Significant postoperative complications occurred in the OA, pLA, and CA groups at rates of 18%, 14%, and 80%, respectively (OA vs pLA, P=0.569 pLA vs CA, P=0.017 OA vs CA, P=0.017), and postoperative hospital stays were 11.1, 5.7, and 19.6 days for each group, respectively (OA vs pLA, P=0.005 pLA vs CA, P<0.001 OA vs CA, P=0.025). <B>Conclusion: </B>Patients who underwent pLA had similar postoperative complications, but shorter hospital stays and shorter times to first oral intake compared to OA. Patients in the CA group had longer operative times, longer postoperative hospital stays, and significantly higher rates of variable complications compared to the pLA and OA groups. Careful preoperative selection of patients for LA is important to avoid unnecessary CA. <B>(Ko</B><B></B><B>rean J Endocrine Surg 2008;8:112-117)</B>

유두갑상선암의 고식적 갑상선전절제술과 내시경하 갑상선전절제술 후 부갑상선 보존율 비교분석

김정빈,박인석,조현진,곽금희,양근호,배병노,김기환,한세환,Jungbin Kim,Inseok Park,Hyunjin Cho,Geumhee Gwak,Keunho Yang,Byungnoe Bae,Kiwhan Kim and Sehwan Han 대한갑상선-내분비외과학회 2012 The Koreran journal of Endocrine Surgery Vol.12 No.2

Purpose: Incidental parathyroidectomy is the most common and unexpected consequence of a total thyroidectomy. It can cause hypocalcemia symptoms such as muscle cramping and even seizures. We conducted this study to compare several factors including the preservation rate of parathyroid glands during both a bilateral axillo-breast approach endoscopic thyroidectomy (BABA) and a conventional open thyroidectomy (CT) for papillary thyroid carcinomas. Methods: We retrospectively reviewed the medical records of 299 papillary thyroid cancer patients who had a total thyroidectomy between January 2008 and December 2011. We grouped the patients into two groups: BABA (n=70) and CT (n=229). We analyzed age, tumor size, operation time, the number of preserved and removed parathyroid glands, amount and duration of seroma drainage, pain score, hypocalcemia symptoms, and serum total calcium level in both the BABA and CT groups. Results: We observed a younger age (under 45 years old) (P=0.000), smaller tumor size (P=0.000), longer operation time (P=0.000), larger amount of drainage (P=0.000), longer duration of drainage (P=0.007), and larger pain score (P=0.000) in the BABA group. Of the 70 patients that received an endoscopic thyroidectomy, we preserved all four parathyroid glands in 56 patients (78.6%). Of the 229 patients that received an open thyroidectomy, we preserved all four parathyroid glands in 141 patients (61.6%, P=0.004). Conclusion: BABA results in more extensive tissue damage over a longer period of time than CT. However, BABA was an excellent method for preserving parathyroid glands when compared with CT for thyroid carcinoma. Thus, it seems to be feasible performing BABA when it matches the indications. (Korean J Endocrine Surg 2012;12: 0-101)

저위험군의 유두상 갑상선암에서 수술 후 국소 재발에 영향을 미치는 인자들에 대한 분석

임승우,박성진,조현진,곽금희,양근호,배병노,김기환,김홍주,김영덕,한세환,Seung-woo Lim,M,D,Sung-jin Park,M,D,Hyunjin Cho,M,D,Geumhee Gwak,M,D,Keun-Ho Yang,M,D,Byung-Noe Bae,M,D,Ki-Whan Kim,M,D,Hong-Joo Kim,M,D,Young-Duck Kim,M,D,and 대한갑상선-내분비외과학회 2008 The Koreran journal of Endocrine Surgery Vol.8 No.2

<B>Purpose:</B> This study analyzed factors affecting local recurrences in AGES low risk papillary thyroid carcinomas (PTCs). <B>Methods:</B> The clinical records of 89 patients who underwent thyroidectomy because of PTC were reviewed. Seventy patients had belonged to low risk PTC according to the AGES classification scheme. The clinical data of these patients concerning disease recurrence was analyzed considering age, gender, operative methods, tumor size, lymph node (LN) metastasis, postoperative radioactive iodine scan (RI scan <SUP>131</SUP>I), and Synthyroid<SUP>Ⱂ</SUP> intake. <B>Results:</B> Of the 70 patients, 56 were female (80%). Thirty- seven patients underwent total thyroidectomy with central neck LN dissection and 33 patients underwent partial thyroidectomy with ipsilateral central neck LN dissection. Mean tumor size was 2 cm (0.4∼6 cm) and 31 patients had LN metastasis. Levels were <1Ռg/L in all patients who underwent total thyroidectomy but were 1∼10Ռg/L in patients who received partial thyroidectomy thyroglobulin. Local recurrencein AGES low risk papillary carcinomas was significantly associated with tumor size >2 cm (P=0.030) and partial thyroidectomy (P=0.045). There was no significant association between local recurrence and age, gender, extrathyroidal extension, LN metastasis, RI scan <SUP>131</SUP>I, or Synthyroid<SUP>Ⱂ</SUP> intake. <B>Conclusion: </B>Partial thyroidectomy and tumor size >2 cm are significantly associated with local recurrence in AGES low risk papillary thyroid carcinomas. <B>(Ko</B><B>rean J Endocrine Surg 2008;8:118-122)</B>

유방암 환자에서 항암 치료 중 생긴 체중 변화와 재발과의 상관 관계

서광욱(Kwangwook Seo),조현진(Hyunjin Cho),안훈(Hoon An),박인석(Insuk Park),곽금희(Geumhee Gwak),양근호(Keunho Yang),배병노(Byungnoe Bae),김기환(Kihwan Kim) 대한종양외과학회 2013 Korean Journal of Clinical Oncology Vol.9 No.2

Purpose: Weight change during chemotherapy is reported to be associated with a worse prognosis in breast cancer. Our study was aimed to evaluate the relation of weight change during AC (anthracycline+cyclophosphamide) +taxanes chemotherapy and recurrence. Methods: Patients included 89 women diagnosed with breast cancer who have been treated by AC+taxenes chemotherapy regimen. The weight variation between prechemotherapy and postchemotherapy was calculated ([weight at postchemotherapy-weight at prechemotherapy]/weight at prechemotherapy×100) and categorized into either weight change (≥5%) or stable (<5%). And then, we evaluated the relation of weight change and recurrence through the radiologic image tests (positron emission tomography-computed tomography, breast sonography, mammography, bone scan, magnetic resonance imaging, abdomino-pelvic computed tomography) each group. Results: During chemotherapy, 37of total 89 patients (41.6%) presented notable weight change and 52 patients (58.4%) were not weight change. Median follow-up period was 45.1 months, 17 of total 89 patients (19.1%) presented recurrence on the radiologic image tests. Eight of 17 recurrence patients were presented notable weight change, 9 patients were not weight change. In univariate analyses, weight change was not associated with recurrence. Conclusion: In our study, weight change during AC+taxanes chemotherapy in breast cancer was not associated with recurrence. Many studies that relation of weight change and recurrence were presented various result. So, we need more clinical studies many patients included and well designed.