The Clinical Outcome of Combined Organ Resection during Radical Gastrectomy

PURPOSE: Combined organ resection is a common operation in gastric cancer surgery. The aim of this study is to investigate the risk of combined minor organ resection (GB, gynecologic organ, appendix etc) in gastric cancer surgery. METHODS: The clinical data from 673 consecutive patients who underwent gastrectomy for gastric cancer at a single center were retrospectively analyzed. We investigated clinical data between open groups (OG) and laparoscopy groups (LAG), and we divided the patients into 3 groups: no resection group, minor organ resection group and major organ (spleen, pancreas, and colon) resection group. RESULTS: There were higher complication rates in major organ resection group (59.3%, 53.8%) than no resection (32.3%, 19.1%) or minor organ resection groups (38.7%, 20%) both in OG and LAG (P<0.05). However, there were longer hospital stays in minor (22.2 days) and major resection groups (24.1) than no resection group (16.2) in OG, but stays were longer in major resection group (30.9) than minor (14.5) and no resection group (16.2) in LAG (P<0.01). Operative times were longer in minor (287 min) and major organ resection group (310) than no resection group (243) in OG (P<0.00). However, operation time was longer in major resection group (505) than minor (415) and no resection group (370) in LAG (P=0.00). CONCLUSION: Combined minor organ resection with gastrectomy does not increase morbidity, and there is no statistical difference in hospital stay and op time than no resection group in LAG.

Use of Angioembolization to Replace Operative Management for Blunt Splenic Injury

PURPOSE: Over the past few decades, the treatment of traumatic splenic injuries has shifted to nonoperative management from surgical intervention. Although some nonoperative management failure have been reported, in most trauma centers, nonoperative management is now believed to be the treatment of choice in hemodynamically stable patients. Then, in this study, we have retrospectively evaluated our experience with traumatic splenic injury. METHODS: From January 2005 to July 2009, 150 patients with blunt splenic injuries were managed in our hospital. Patients' charts were retrospectively reviewed to analyze their treatment, the patients were grouped according to those who had been admitted before October 2006, defined as the "early group", and those who had been admitted after October 2006, defined as the "late group". After the patients had been divided into two group, physiologic parameters and differences between the treatments were compared. RESULTS: 150 patients were admitted to our hospital with blunt splenic trauma. In late group, both the surgical management rate and the nonoperative management failure rate were lower than they were in the early group. CONCLUSION: We expect angioembolization to effectively replace surgery for the treatment of selected patients with blunt splenic injury and to result in fewer complications.

The Feasibility of Laparoscopic Hepatectomy for the Patients with Left Intrahepatic Stones

PURPOSE: Recently, there have been several studies on the early results of hepatectomy for various intrahepatic lesions. We report the early experience of our hospital after total laparoscopic left hepatectomy in patients with intrahepatic stones in the left hemi-liver. METHODS: We retrospectively analyzed the medical records of patients who were diagnosed with left intrahepatic stones and underwent hepatectomy between January 2007 and June 2009. The patients were grouped according to operative procedure into open hepatectomy, laparoscopy-assisted hepatectomy, and total laparoscopic hepatectomy. RESULTS: There were 31 patients who underwent Lt hemihepatectomy and Lt lateral sectionectomy during this period. Hepatectomy with open method, laparoscopy-assisted method, and total laparoscopy method were performed in 10, 14, and 7 cases. There were no significant differences between the three methods for operating time and postoperative complications. But the number of fasting times and hospital days was shorter with total laparoscopic hepatectomy than with others. CONCLUSION: Total laparoscopic liver resection is a safe and useful method for treating patients with intrahepatic stones and offers the advantage of quick patient recovery. Careful selection of appropriate patients and further development in the laparoscopic surgical technique resulting from accumulated experiences will help enable the laparoscopic hepatectomy to be performed more easily and safely in patients with intrahepatic stones.

Adrenal Pseudocyst Mistaken as Mucinous Cystadenoma of the Pancreas: A Case Report / 대한내분비외과학회지

Adrenal cysts are a relatively uncommon disorder and most such cases are discovered at autopsy. According to the overseas cases, the reported incidence is 0.06~0.18% and the incidence is increasing due to the widespread use of ultrasonography and computed tomography scanning. Adrenal cysts are usually asymptomatic and they need to be differentiated from other cystic lesions including liver, pancreas and kidney cystic lesions. We report here on a case of a 39-year-old female with an adrenal pseudocyst that was misdiagnosed preoperatively as a pancreas mucinous cystic neoplasm.