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Abstract Endoscopic Finding in Corrosive Ingestion Suphakan Techapongsatorn MD Pong Kanjanasuthirak MD Satit Srimantayamas MD Objective: To review the endoscopic finding within 48 hours after corrosive agent ingestion. Study design: Descriptive study. Subjects: One hundred and seventy-one patients were admitted in Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital during January 2001 to December 2005, from corrosive ingestion. Methods: Hospital records and endoscopic records were collected and analyzed. Main outcome measure: Endoscopic finding which were classified into 4 groups: no injury, 1st degree injury, 2nd degree injury and 3rd degree injury. The sites of injuries were divided into proximal esophagus, distal esophagus, proximal stomach (cardia, fundus and body), distal stomach (antrum and pylorus) and 1st part duodenum. Results: Demographic data showed that 124 patients (72.5%) were female and the average age was 26.2 years. Intentional ingestion was the cause in 166 patients (97.1%). Hydrochloric acid existing in hard surfaces Cleaner especially toilet and bowl cleaners was the most common corrosive agent in 126 patients (73.7%). The prevalence of injury in upper esophagus, lower esophagus, proximal stomach, distal stomach A and duodenum were 35.0%, 69.4%, 64.9%, 33.1% and 17.2% consecutively. Conclusion: These findings were different from the developed countries. In those countries, the most common corrosive agents were sodium hydroxide and potassium hydroxide that were strong bases in drain or pipe cleaner. Furthermore, lower esophagus especially esophagogastric junction and proximal stomach were the most susceptible sites of injuries. Then, management and teaching should be conversely from the developed countries as mentioned in many textbooks and journals. Key Words: endoscopic finding, corrosive ingestion Vajira Med J 2006 ; 50 : 33 - 38
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Abstract Solid Pseudopapillary Tumor of the Pancreas: A Case Report Suphakan Techapongsatorn MD, FICS Waigoon Stapanavatr MD, FICS Satit Srimantayamas MD Wisit Kasetsermwiriya MD Department of Surgery, BMA Medical College and Vajira Hospital Solid pseudopapillary tumor is an uncommon low-graded malignant tumor of the pancreas. Definite diagnosis usually comes from pathological study of the surgical specimens. The prognosis is good whenever the tumor is completely removed. We herein present a case report of 19-year-old Myanmese woman suffered from intra-abdominal mass for 7 years. The computed tomography showed huge solid and cystic mass at body and tail of pancreas. She underwent enbloc resection included distal pancreatectomy and splenectomy. The pathological finding revealed solid pseudopapillary tumor. The patient was follow-up for 24 months with an uneventful post-operative course. She was free from tumor recurrence. Key words: pseudopapapillary tumor, pancreas Vajira Med J 2006 ; 50 : 193 - 197
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Abstract A Comparative Study between Compressible Brassiere and Conventional Pressure Dressing for Seroma Prevention after Mastectomy in Breast Cancer Suphakan Techapongsatorn MD, FICS Wisit Kasetsermviriya MD Satit Srimantayamas MD Vasin Chotivanich MD Anan Manomaipiboon MD, MSc, FICS Department of Surgery, BMA Medical College and Vajira Hospital Objective: To evaluate the effectiveness between compressible brassiere without axillary compression and conventional pressure dressing for seroma prevention after mastectomy in breast cancer. Study design: Prospective, randomized controlled trial. Subjects: A total of 56 female patients with breast cancer managed by modified radical mastectomy in BMA Medical College and Vajira Hospital during December 2004 to October 2005 were enrolled. They were divided into two groups. First, conventional dressing was applied in 29 patients as control group. Second, compressible brassiere without axillary compression was applied in 27 patients as study group. Methods: All subjects were randomly assigned into two groups after surgical wound closing. Surgeons and the patients never knew the dressing techniques until finishing the operation. Patients' characteristics, clinical data, intra-operative data and outcomes were collected and analysed. Main outcome measures: Occurrence of seroma, amount of drainage serum, length of hospital stay after operation and other post-operative wound complications. Results: Patients' characteristics, clinical data and intra-operative data were not different significantly between two groups. Amount of drainage serum, length of hospital stay and occurrence of seroma in control group and study group were 725.0 ± 511.6 ml vs 774.3 ± 535.6, 9.3 ± 5.4 days vs 11.1 ± 4.9 days and 4/29 vs 6/27 patients (p-value \> 0.05). These final outcomes were not different significantly too. Conclusion: Pressure dressing with compressible brassiere without axillary compression after modified radical mastectomy in breast cancer could not reduce seroma, drainage serum and length of hospital stay. Vajira Med J 2007 ; 51 : 87 - 94
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Abstract Quality of Life in Breast Cancer Patients Suphakan Techapongsatorn MD, FICS* Supada Techapongsatorn MD** Wisit Kasetsermviriya MD* Satit Srimantayamas MD* Vasin Chotivanich MD* *Department of Surgery, BMA Medical College and Vajira Hospital **Department of Preventive Medicine, BMA Medical College and Vajira Hospital Objectives: To study the quality of life in patients with stage 1-3 breast cancer and affecting factors in BMA Medical College and Vajira Hospital. Study design: Descriptive study. Subjects: One hundred and five patients with stage 1-3 breast cancer attending breast cancer clinic, BMA Medical College and Vajira Hospital during December 2004 to November 2005 were enrolled. Methods: Quality of life was assessed by using self-administered questionnaire (WHOQOL- BREF, Thai version). The socioeconomic and status of treatment were collected and analyzed. Main outcome measures: Quality of life score and affecting factors. Results: The mean quality of life score were 87.8 ± 8.6 with classified to medium level. The incomes and educational status affected with the quality of life score significantly (p-value \< 0.05). Conclusion: The quality of life in breast cancer patient stage 1-3 was in medium level. Incomes and educational status were the affecting factors to the quality of life. Vajira Med J 2007 ; 51 : 33 - 40