Varicose Veins that Well Treated by Sclerosing Agents in Lower Extremity

In the early period (B'C) the definition of the primary varicose vein in lower extremity was dilate, tortuous and elongated vein. It has been known that the varicose vein in lower extremity is more involved in western people than orintal. However nowadays this disease is also well involved in oriental because of incresed economic level and well equipped culture. BACKGROUNDS: We has been tried the clinical reserch because of good result & possibility of therapy by only sclerotheray in well defined selected indication of primary varicose vein. MATERIAL AND METHOD: We reviewed primary varicose vein involved in lower extremity of 23cases that was well treated by sclerosing agents to Dept of Surg, Kangbuk Samsung Hosp, SungKyunKwan University College of Medicine, From January 1996 To December 1997. RESULTS: 1. The distribution of the age were the first in 5th decade (39.1%), followed by 6th decade, 4th decade. The ratio of sex were more prevalent in female than male (6.7:1). The median age was 47.3 years-old. 2. Sx & sign were showed cosmetic problem (82.6%) in most patients, followed by heaviness (47.8%), numbness (39.1%), pain (21.7%). 3. The duration of illness were over 10years in 17cases (73.9%). 4. The size of varicose vein were type II in 16case (69.6%), follwed by type I (21.7%), type III (8.7%) according to the classification by Dr. Weiss. 5. The frequency of injection were 1st injection in 12cases (52.2%), 2nd-4th injection (26.1%), over 5th injection (21.7%). 6. Post injection complication were pigmentation in 1case and thrombosis in 1case. 7. The predisposing factors were corelated with pregnancy in most patients, others were long standing position, familiar tendency, trauma. CONCLUSION: Double therapy (operation and sclerotherapy) has been tried in primary varicose vein, however if we are well select indication of therpy, sclerotherapy is also choice of treatment in the primary varicose vein.

33 Cases of Anal Cancer

PURPOSE: Malignant disease of the anus is rare. Abdominoperineal resection was formerly considered to be the treatment of choice. But, in recent, less ablative and more effective combined therapeutic modalities have been developed. METHODS: we analyzed 33 patients who were diagnosed and treated as anal cancers at the Department of Surgery, Gospel Hospital, Kosin Medical Collage, from July 1, 1988 to Nov. 30, 1997. RESULTS: The ratio of male to female was 1.4:1 and mean age was 56.7 years old. Twenty-two (84.8%) of these cancers were located in the anal canal and 5 (15.2%) in the anal margin. Three main histologic types of the anal cancers were identified: squamous cell carcinoma was the most common lesion, accounted for 17 cases (51.1%), adenocarcinoma accounted for 8 cases (24.2%), malignant melanoma accounted for 8 cases (24.2%). The overall 3-year survival rate and 5-year survival rate of anal cancer were 54.1%, 41.7%. Eleven patients with squamous cell carcinoma were treated curatively: 6 patients were treated with chemoradiotherapy, 3 patients with abdominoperineal resection, one patient with chemoradiotherapy and abdominoperineal resection, one patient with local excision. CONCLUSION: In survival rate, there were no significant differences between chemoradiotherapy group and surgical treatment group. In squamous cell carcinomas, chemoradiotherapy had anal sparing benefit without loss of survival. On univariate analysis, T, N, type of treatment, histologic type had no statistical significances on survival. On multivariate analysis, location of lesion and distant metastasis had statistical significances.

Clinical Review of Early Postoperative Intestinal Obstruction after Colorectal

This study was undertaken to identify the causative factors that predispose to early postoperative intestinal obstructions after the radical resection due to colorectal cancer, and to determine their preventive operative techniques. The records of 722 patients that had undergone radical resection due to colorectal cancer at the Department of General Surgery, Kangbuk Samsung Hospital, between January 1, 1986 and December 31, 1995, were reviewed. Among them, operative treatments due to early postoperative intestinal obstructions were performed in 39 patients(5.4%). The most common cause of intestinal obstruction in early postoperative period was bowel adhesion, that was developed in 20 cases(51.3%), and next common cause was internal herniation of bowel into the space between colostomy loop and lateral peritoneal wall(3 cases, 7.7%), incarcerated herniation of small bowel into the reperitonealized pelvic cavity(3 cases, 7.7%), pelvic abscess(1 case, 2.6%), and unknown causes(9 cases, 23.1%) in descending frequency. Use of closed suction drains was responsible to development of the 3rd and 4th causes. As a result, during the radical resection due to colorectal cancer, meticulous manupulation of bowels not to injure the bowel serosa, reperitonealization of pelvic floor at narrow interval with inversion of its dissected edge, complete closure of the space between colostomy loop and lateral wall of peritoneum, and adequate alternative use of closed suction drain and natural drain according to the operative condition, should be considered. In conclusion, surgeons should pay more attention to the operating procedures to lower the incidence of early postoperative intestinal obstruction.