Oncologic evaluation of obesity as a factor in patients with rectal cancer undergoing laparoscopic surgery: a propensity-matched analysis using body mass index

PURPOSE: This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. METHODS: The records of 483 patients with stage I–III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The threshold for obesity was BMI ≥ 25 kg/m2 or VFA ≥ 130 cm2. RESULTS: The score matching model yielded 119 patients with a BMI ≥ 25 kg/m2 (the obese group) and 119 patients with a BMI < 25 kg/m2 (the nonobese group). Surgical outcomes including operation time, estimated blood loss, nil per os periods, and length of hospital stay did not differ between the obese and the nonobese group. The retrieved lymph node numbers and pathologic CRM positive rate were also similar in between the 2 groups. After a median follow-up of 48 months (range, 3–126 months), OS and DFS rates were similar between the 2 groups. A tumor location-adjusted model for overall surgical complications showed that a BMI ≥ 25 kg/m2 were not risk factors. Multivariable analyses for OS and DFS showed no significant association with a BMI ≥ 25 kg/m2. CONCLUSION: Obesity was not associated with long-term oncologic outcomes in patients undergoing laparoscopic surgery for rectal cancer in the Asian population.

Effects of an Internet-based informational video on preoperative anxiety in patients with colorectal cancer

PURPOSE: Surgery is the primary curative treatment for colorectal cancer; however, it remains a frightening procedure that can cause stress and pain in affected patients. Therefore, patients typically experience significant anxiety during the preoperative period, which has been associated with poorer outcome after surgery. This study aimed to evaluate the effect of an Internet-based informational video on preoperative anxiety level in patients with colorectal cancer.

Discrepancy of Medical Terminology Regarding Colorectal Surgery Between South and North Korea

PURPOSE: We aimed to investigate the extent of heterogeneity in medical terminology between South and North Korea by comparing medical terms related to the colorectal system. METHODS: North Korean medical terms were collected from the sections on diseases of the small intestine and colon in a surgery textbook from North Korea, and those terms were compared with their corresponding terms in a South Korean medical terminology textbook. The terms were categorized as either identical, similar, showing disparity, or not used in South Korea. In a subsection analysis, the terms were allocated to pathophysiology, diagnosis, symptoms and examination, drugs, testing, treatment, or others according to the categorization used in the textbook. RESULTS: We found 705 terms in the North Korean textbook, most of which were pathophysiological terms (206, 29.2%), followed by diagnostic terms (165, 23.4%) and symptom and examination terms (122, 17.3%). Treatment-, drug-, and testing-related terms constituted 15.5%, 5.8%, and 4.1% of the 705 terms, respectively. There were 331 identical terms (47.0%) and 146 similar terms (20.7%); 126 terms (17.9%) showed disparity. Another 102 terms (14.5%) were not used in South Korea. The pathophysiological terms were the least heterogeneous, with 61.2% being identical terms used in both countries. However, 26.8% of the terms in the drug category were not used in South Korea. CONCLUSION: The present study showed that less than 50% of the terms for the colorectal system used in South and North Korea were identical. As the division between South and North Korea persists, the heterogeneity of medical terminology is expected to increase.

Discrepancies in general surgery medical terminology between South and North Korea / 한국의학교육

PURPOSE: The purpose of this study was to categorize surgery-related medical terminologies used in South and North Korea and to compare and analyze discrepancies observed in the terms. METHODS: This study collected medical terminology used in the North Korean medical book “Surgery” and compared it to medical terminology found in the medical glossary of South Korea. The order of the subtitle was described according to the Instruction to Authors. RESULTS: In total, there were 2,168 individual medical terms, of which only 1,004 words (46.3%) were identical to South Korean medical terms. There were 581 similar terms (26.8%), 265 different terms (12.2%), and 318 terms that are nonexistent in South Korea (14.7%). CONCLUSION: Less than half of the medical terms used in North Korea match those used in South Korea. It is expected that the prolongation of the current division of South and North Korea will only worsen this discrepancy. Further efforts to bridge the gap through academic exchange between South Korea and North Korea are required in preparation for an era of reunification.

Transmissibility of the Campaign for Colorectal Cancer Awareness in Korea Among Twitter Users

PURPOSE: The Korean Society of Coloproctology holds its annual colorectal awareness month every September. This study analyzed the users and the contents of Korean tweets regarding colorectal cancer and estimated the transmissibility of the awareness campaign among Twitter users. METHODS: Prospective data collection was employed to accumulate Korean tweets containing the keywords "colorectal cancer," "colorectal cancer awareness campaign," "gold ribbon," and/or "love handle," from August 1 to September 30, 2014. Twitter users and contents were analyzed, and the credibility of information-sharing tweets throughout the study period was evaluated. RESULTS: In total, 10,387 tweets shared by 1,452 unique users were analyzed. As for users, 57.8% were individuals whereas 5.8% were organizations/communities; spambots accounted for a considerable percentage (36.4%). As for content, most tweets were spam (n = 8,736, 84.1%), repetitively advertising unverified commercial folk remedies, followed by tweets that shared information (n = 1,304, 12.6%) and non-information (n = 347, 3.3%). In the credibility assessment, only 80.6% of the information-sharing tweets were medically correct. After spam tweets had been excluded, a significant increase was seen in the percentage of information-sharing tweets (77.1% to 81.1%, P = 0.045) during the awareness campaign month. CONCLUSION: Most Korean tweets regarding colorectal cancer during the study months were commercial spam tweets; informative public tweets accounted for an extremely small percentage. The transmissibility of the awareness campaign among Twitter users was questionable at best. To expand the reach of credible medical information on colorectal cancer, public health institutions and organizations must pay greater attention to social media.

Reduced Port Laparoscopic Reversal of Hartmann's Procedure Using the Colostomy Site

Utilization of the colostomy site for laparoscopic reversal of Hartmann's procedure was recently introduced, and several studies have shown the feasibility of the procedure, which allows the colostomy site to serve as an access port for the operation. We demonstrate a method utilizing an accessory 5 mm trocar to assist in the operation while employing a colostomy-deepened glove port.