Role of Metastasectomy on Overall Survival of Patients with Metastatic Gastric Cancer

PURPOSE: The role of metastasectomy has been debatable and unclear in the treatment for patients with metastatic gastric cancer. Therefore, this study was designed to evaluate the role of metastasectomy on the overall survival of these patients. MATERIALS AND METHODS: In 2,406 patients who underwent gastrectomy for gastric cancer between 1998 and 2010, 188 (7.8%) patients had their first surgery for metastatic gastric cancer. To minimize the bias of systemic chemotherapy, 99 patients who received postoperative chemotherapy (fewer than 2 cycles) were excluded. The primary gastrectomy or metastasectomy had not been enforced in the following cases. Patients with far advanced peritoneal dissemination, multiple liver and lung metastasis (more than 2), and a poor general condition (Eastern Cooperative Oncology Group>2) were excluded. Based on the metastasectomy, the patients were classified into two groups, gastrectomy with metastasectomy and gastrectomy only group. RESULTS: There was no significant difference between both groups in clinicopathological characteristics except for the mean age (P=0.047). The univariate analysis for overall survival show statistical significances in metastasectomy (P=0.026), distal gastrectomy (P=0.047), and combined resection of another organ (P=0.047) group. With a multivariate analysis, metastasectomy was a significant factor in patient survival after surgery (odds ratio 1.679; P=0.034). CONCLUSIONS: Based on our results, we assume that a detailed strategy for surgery is needed to improve the overall survival of patients with metastatic gastric cancer. Therefore, we suggest that a metastasectomy can help prolong overall survival in some patients with metastatic gastric cancer.

Kimura's Disease of The Distal Arm: A Case Report / 대한정형외과학회잡지

Kimura's disease is an uncommon, chronic inflammatory disorder of unknown etiology that is seen in an endemic form in the Orient. It usually presents as a mass in the subcutaneous tissue of the head and neck region or the major salivary glands, and is often associated with a regional lymphadenopathy. The patients have peripheral blood eosinophilia and elevated IgE levels but are otherwise usually healthy. We encountered the case of a 33-year-old man who had a soft tissue mass in his left distal arm which was diagnosed as being Kimura's disease.

Ganglion of the Posterior Cruciate Ligament: 1 case report / 대한정형외과학회잡지

Ganglia of the cruciate ligament are quite rare. About 60 cases were reported previously in the world and 6 cases were reported at two articles in korea. It's symptoms may be similar to those of internal derangement of knee, especially meniscal lesion. We report a case of isolated ganglion of posterior cruciate ligament with brief of literatures.

The Use of Ender nails in Distal One-Third Fractures of Tibia / 대한정형외과학회잡지

The distal one-third fractures of tibia have much difficulty in treatment due to enumerous complications such as skin necrosis, angular deformity and delayed union. As for using Ender nails in distal tibial fractures, the stability of fixation can be strengthened with fanning of the nails in distal fragments and using more than 3 nails and 1cm longer nail. Twenty-two patients having distal tibial fractures, were carried out Ender nailing at Department of Orthopaedic Surgery, Maryknoll Hospital from May 1989 to September 1992. The results were as follows; 1. The distal end of fracture line was situated from 3cm to 9cm above plafond, and the mean duration of radiological bony union was 14.9 weeks except one case of nonunion. 2. Mild angulation developed in two cases and complications such as nonunion, superficial infection and backing out of nail were noted, but it did not affect the results.

Bipolar Endoprosthesis between Femoral Neck Fracture and Avascular Necrosis of Femoral Head: Comparison of the Acetabular Migration and Function / 대한정형외과학회잡지

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.

Treatment of the tibial shaft fractures with ender nails / 대한정형외과학회잡지

No abstract available.

A clinical study of fracture of the neck of the talus / 대한정형외과학회잡지

No abstract available.

The treatment of the lateral malleolar fracture of the ankle with a gripper plate / 대한정형외과학회잡지

No abstract available.

Femoral trochanteric fracture treated with ender nail in elderly patients / 대한정형외과학회잡지

No abstract available.

A Treatment of Ipsilateral Shaft Fracture of the Femur and Tibia in Adult / 대한정형외과학회잡지

Twenty-eight cases of fracture of the femur and tibia on the same leg were treated in Pusan Maryknoll Hospital during the period from April 1981 to Jun 1988. We studied all of these patients, divided by five groups according to the method of treatment, with analysis of treatment and end results. The following results were obtained. 1. The incidence of trauma was high in the young man, and most frequent in the third decade (42.9%). 2. The main cause of injuries was traffic accident; 22 patients (78.6%). 3. The common fracture site was middle one-third in femur and tibia respectively. 4. The most common associsted injury was head trauma (9 case). 5. The average healing time of fracture was 20.7 weeks in femur and 22.7 weeks in tibia of group 3, 4, 5. 6. The best results were obtained in cases both fractures stabilized surgically.

The Clinical analysis of Acetabular Fracture / 대한정형외과학회잡지

If the treatment of acetabular fractures are not satisfactory, there will be serious complication such as traumatic arthritis or avascular necrosis of the femoral head. There is much continuing discussion as to where conservative or surgical treatment should be used. The authors experienced 41 cases of acetabular fractures, that wrere treated at the Department of Orthopaedic surgery, Maryknoll Hospital from January 1981 to September 1987. The results of 29 cases who were followed over a 1 year period are as follows:1. According to Letournel's classification, the most common type of elementray fracture was posterior wall(24.1%) and a T- shsped fracture was 10.3 % and both column fractures were 10.3%. 2. Complications were traumatic arthritis(14 cases), superficial infection(5 cases), ectopic ossification(5 cases), osteomyelitis(1 case), AVN of the femoral head(1 case), and iartrogenic femoral shaft fracture(1 case). 3. According to matta's assessment, satisfactory results of conservative treatment were 38% clinically and 38% radiologically, and by surgical treatment, 73% clinically and 64% radiologically. 4. Surgical treatment in acetabular fractures, such as an anatomical reduction and rigid fixation fixation followed by early joint motion were improved the result and decresed the rate of traumatic arthritis.

The Fractured Carpal Scaphoid / 대한정형외과학회잡지

The carpal scaphoid is the commonest of the carpal bones to be fractured, and this injury is the commonest to befall the wrist of working man. There is still some disaggrement as to the optimum treatment and as to how long immobilization should be maintained. The twenty seven cases of the carpal scaphoid were treated at department of orthopaedic surgery, Maryknoll Hospital. They were analyzed in regared to the clinical and radiological aspects. The results were summarized as follows. l. Of 27 cases 24 cases were in the age group 20 to 39, and all cases were male patients. 2. In 17 cases, the fracture was found in right side. 3. In 19 cases (70.4%), the fracture was found on the middle 1/3 of the carpal scaphoid and in 18 cases(66.8%), the fracture line was transverse. 4. The union rate of fracture was 100% in the distal 1/3 fracture, 89.5% in the middle 1/3 fracture and 66.3% in the proximal fracture. The average period of immobilization were 10.3, 14.9 and 15.3 weeks respectively. 5. By Maudsley's assessment, the end result was good in all cases of the distal 1/3 fracture, 84.2% in the middle 1/3 fracture and 66.7% in the proximal 1/3 fracture. 6. Traumatic arthritis developed in 3 cases, avascular ncerosis in 7 cases, nonunion in 4 cases.

Two / 대한정형외과학회잡지

One of the serious and challenging problems confronting orthopaedic surgeons is an open un-united fracture of tibia. Especially, there are some difficulties in getting bone union on the condition of combining soft tissue defect with infection. In the management of infected un-united fracture of tibia with significant soft tissue loss we attempted a two-stage reconstruction : the first stage consisted of radical sequestrectomy, soft tissue reconstruction, and external fixation, and the 2nd stage consisted of various types of bone grafting and bone fixation. Fifteen patients with open infected un-united fractures of tibia treated with staged reconstruction from September 1982 to August 1987 at Department of Orthopaedic Surgery, Dae-Jeon's St. Mary's Hospital, Catholic University Medical College, were analyzed in clinical aspects and the results of treatment obtained were as follows : 1. Satisfactory bone union was obtained in an average of 6 months after bone graft with a range of 4 months to 12 months. 2. The duration from the injury to bone union was 13 months on an average with a range of 8 months to 19 months. 3. The soft tissue rer.onstruction at the first stage were performed with local flap in 11 cases and muscular flap in 2 cases and musculocuteneous flap in 2 cases. 4. The time interval between 1st stage and 2nd stage was from 1.5 months to 3 months. 5. At the 2nd stage, bone graft were performed with autogenous cancellous bone graft in 11 cases, vascularized osteocutaneous fibular graft in 2 cases and ipsilateral vascularized fibular transference in 2 cases. In summary, a two-stage reconstruction for open infected un-united fracture of tibia is a advisable procedure that leads to bone union with satisfactory return of function.

Bilateral Recurrent Dislocation of the Peroneal Tendon: A Case Report / 대한정형외과학회잡지

Recurrent dislocation of the peroneal tendon is infrequent but often the injury is a disabling one, and the result of conservative treatment is unsatisfactory. Dislocation of these tendons may be the result of a congenitally shallow groove in the lateral malleolar or of a complete abscence of the groove and the dislocation may be present at birth or may be caused by trauma. We are reporting one case of bilateral recurrent dislocation of the peroneal tendons with- out any history of trauma in which disturbed superior peroneal retinaculum was reconstructed by transposition of the calcsneofibular ligament to the lateral side of the peroneal tendons. The calcaneal insertion of the calcaneofibular ligament was mobilised with a small bone block and reinserted in its bed after the transposition. After a follow up of 13 months, the result was satisfactory.

The Use of Long-Acting Anesthetics Through Indwelling Catheter Afer Flexor Tenolysis / 대한정형외과학회잡지

The surgical release of flexor tendons from their restricting adhesions has historically been a somewhat controversial procedure. Especially clinical efficacy of tenolysis is dependent on early active digital motion. The administration of long acting anesthetics (Bupivacaine) through indwelling catheter after tenolysis relieved pain and so achieved early active digital motion in 12 cases. The times for tenolysis following tendon repair and the followup period were 3 months and 6 months on an average. According to flexor zones classification, in 4 patients the lesion was in zone II, 5 in zone III, 1 in zone IV and 2 in zone V. The results were as follows; 1. The functional results after tenolysis showed up 7 excellent, 4 good and 1 fair. 2. The subjective results of the postoperative pain relief showed up 8 excellent and 4 good out of 12 cases.