Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Robotic surgery is expected to have advantages over laparoscopic surgery; however, there are limited data regarding the feasibility of robotic surgery for rectal cancer after preoperative chemoradiotherapy (CRT). Therefore, we evaluated the short-term outcomes of robotic surgery for rectal cancer. MATERIALS AND METHODS: Thirty-three patients with cT3N0-2 rectal cancer after preoperative CRT who underwent robotic low anterior resection (R-LAR) between March 2010 and January 2012 were matched with 66 patients undergoing laparoscopic low anterior resection (L-LAR). Perioperative clinical outcomes and pathological data were compared between the two groups. RESULTS: Patient characteristics did not differ significantly different between groups. The mean operation time was 441 minutes (R-LAR) versus 277 minutes (L-LAR, p < 0.001). The open conversion rate was 6.1% in the R-LAR group and 0% in the L-LAR group (p=0.11). There were no significant differences in the time to flatus passage, length of hospital stay, and postoperative morbidity. In pathological review, the mean number of harvested lymph nodes was 22.3 in R-LAR and 21.6 in L-LAR (p=0.82). Involvement of circumferential resection margin was positive in 16.1% and 6.7%, respectively (p=0.42). Total mesorectal excision (TME) quality was complete in 97.0% in R-LAR and 91.0% in L-LAR (p=0.41). CONCLUSION: In our study, short-term outcomes of robotic surgery for rectal cancer after CRT were similar to those of laparoscopic surgery in respect to bowel function recovery, morbidity, and TME quality. Well-designed clinical trials are needed to evaluate the functional results and long-term outcomes of robotic surgery for rectal cancer.

Comparision of Needlescopic Appendectomy versus Conventional Laparoscopic Appendectomy in Children / 대한내시경복강경외과학회지

PURPOSE: This clinical study evaluated the feasibility of needlescopic appendectomy (NA) in young patients with acute appendicitis, and we compare the outcome of this new technique with that of conventional laparoscopic appendectomy (LA). METHODS: Two groups of young patients who underwent laparoscopic appendectomy at Sanggye Paik Hospital between January 2009 and December 2009 were studied. In the first group, a 2-mm instrument appendectomy was performed in 13 patients. These patients were compared with the second group, which were 21 patients who underwent conventional laparoscopic appendectomy. Statistical significance was set at p values<0.05. RESULTS: The patient demographics and operative findings were similar in both groups. There was no conversion to open appendectomy in either group. Postoperative ileus was occurred in 3 patients who underwent LA, but there was no statistical difference between the both groups (p=0.154). The needlescopic group had a shorter mean operative time (p=0.65), but there was no statistically significance. The mean hospital stay was significantly shorter (p=0.026) in the needlescopic group than that in the conventional laparoscopic group. CONCLUSION: According to our experience, needlescopic laparoscopic appendectomy is a safe and feasible procedure as compared with that of conventional laparoscopic appendectomy in young patients.

The Significance of the Lymphatic Micro Vessel Density and Vascular Endothelial Growth Factor- C Expression for Colorectal Cancer

PURPOSE: Studying the prognostic factors of distant metastasis is quite important for predicting these patients' prognosis and also for providing standards for post-operative adjuvant chemotherapy. Microbiological studies currently enable researchers to look for new predictors of distant metastasis in patients with colon cancers. In this study, the VEGF-C expression and stain rate of D2-40 were investigated as prognostic factors. METHODS: 79 Specimens were collected from the patients who underwent colorectal operation and they were pathologicaly diagnosed with cancer at Chung-Ang University hospital from March, 2003 to Sept. 2005. The specimens were immunohistochemically stained to detect the VEGF-c expression and the D2- 40 stain rate. RESULTS: The VEGF-C expression was related to lymph node metastasis, tumor embolism and the frequency of the T- stage, but it was not related to progression of cancer. The D2-40 stained lymphatic density was significantly increased in the cases with lymph node metastasis and in the tumor embolism cases; furthermore, the density became higher in relation to the increased T-stage and progression of cancer. CONCLUSION: The VEGF-C expression and lymphatic vessel density appear to be prognostic factors for colon cancer.