Capsular Contracture Rate in Augmentation Mammoplasty With Motiva Breast Implant Insertion: A Single-Center Experience in Korea.

BACKGROUND: Capsular contracture is the most common complication following breast implant surgery, and the implant shell characteristics are important in preventing this complication. OBJECTIVES: The aim of this study was to evaluate the capsular contracture rate for SmoothSilk Motiva implants (Establishment Labs Holdings Inc., New York, NY) in females who underwent primary and revisional breast augmentation over a 3-year period. METHODS: A total of 1324 cases that took place from 2017 to 2020 were retrospectively analyzed, with 1027 being primary surgeries and 297 being revisional surgeries. RESULTS: In the 1324 cases of augmentation mammoplasty with SmoothSilk Motiva implants, the overall capsular contracture rate was 1.8% (n = 24). The capsular contracture rate in the 1027 primary surgery cases was 1.07% (n = 11), and the capsular contracture rate in the 297 revisional surgery cases was significantly different at 4.39% (n = 13, P = .0001). More specifically, the capsular contracture rate in 182 revisional surgery for cases without capsular contracture was 1.12% (n = 2), and it showed no statistically significant difference from the rate in primary surgery cases (P = .965). However, the rate in 115 revisional surgery for cases with capsular contracture was 9.57% (n = 11), and it showed a statistically significant difference from the rate in primary surgery cases (P = .000) and the rate in revisional surgery for cases without capsular contracture (P = .001). CONCLUSIONS: Augmentation mammoplasty with SmoothSilk Motiva implants demonstrated a lower rate of capsular contracture than traditional smooth or textured implants. Revisional surgery for cases without capsular contracture showed a similar rate of capsular contracture to primary surgery cases, but the rates were higher in revisional surgery for cases with capsular contracture.

Expression of estrogen receptors in gastric cancer and their clinical significance.

BACKGROUNDS AND OBJECTIVES: The male predominance of gastric cancer suggests that female sex hormones may have a protective effect against gastric cancer. We evaluated the expression of estrogen receptors in gastric cancer tissue and cells and the clinical significance of ER-ß expression in gastric cancer. METHOD: ER-α, ER-ß proteins extracted from normal stomach, gastric cancer tissues, and cultured gastric cancer cells (KATO-III, mkn28, mkn45, and mkn74) were assessed by Western blot analysis. The clinical significance of ER-ß was explored using tissue microarray methods and immunohistochemical staining of specimens from 148 gastric cancers. RESULTS: Both ER-α and ß protein expression were noted in normal and gastric cancer tissues. However, in cultured gastric cells, only ER-ß was noted in mkn28 and mkn74. Of 148 gastric cancers, 67 (45.3%) were ER-ß positive. The ER-ß positive group was associated with lower tumor stage, Lauren's intestinal type, negative perineural invasion, and free of recurrence. The ER-ß positive group had a better 3-year survival compared with the negative group in survival analysis. CONCLUSION: Our results suggest that the presence of ER-ß in gastric cancer could have a protective effect against invasiveness of gastric cancer. Further studies are needed to clarify the role of ER-ß in gastric cancers.

Laparoscopic resection of a hepatocellular carcinoma arising from an ectopic liver.

Ectopic livers are rarely seen intra-abdominal lesions. Ectopic hepatocellular carcinoma (HCC) can be defined as an HCC arising from hepatic parenchyma located in an extrahepatic organ or tissue. The authors report a case of a primary, well-differentiated HCC arising from ectopic liver tissue in the left subphrenic space at the upper portion of the gastrorenal ligament that was successfully treated by laparoscopic resection. A 59-year-old man was referred to our department for the management of an intra-abdominal mass, which was incidentally found in a follow-up abdominal computed tomography scan for splenic laceration. The preoperative diagnosis suggested that it was a nonspecific stomach mass of maximal diameter 4.5 cm, such as, a gastrointestinal stromal tumor, located between the diaphragm and spleen. A computed tomography scan identified no mass in the liver. Laparoscopic resection was performed, and the final pathologic result confirmed that it was a HCC. The patient's postoperative course was unremarkable. This is the first reported case of a laparoscopically treated ectopic HCC. Moreover, laparoscopic resection was found to be safe and reliable in this case.

Laparoscopic treatment of a huge cystic lymphangioma: partial aspiration technique with a spinal needle.

A cystic lymphangioma is a rare intra-abdominal lesion. Treatment is a complete excision of the cyst because of complications and a rare chance of malignancy. In this paper we report on 2 patients with a huge cystic lymphangioma who were treated by laparoscopic surgery successfully. Each of the cysts were 13 and 11 cm in diameter, were diagnosed by ultrasonography and computed tomography scan. After partial aspiration of the cysts, using a spinal needle, we were prone to grasp the cysts without spillage. Traction and dissection were easy without spillage or injury of the mesenteric vessels. The laparoscopic approach can be successfully and safely performed by an experienced surgeon in keeping with oncologic principles.

Prognostic factors for advanced gastric cancer: stage-stratified analysis of patients who underwent curative resection.

PURPOSE: Advanced gastric cancer patients have a poorer prognosis as compared to the patients with early gastric cancer. This study was conducted to define the prognostic factors for advanced gastric cancer. MATERIALS AND METHODS: 606 patients with advanced gastric cancer who underwent curative gastric resection at our hospital were retrospectively examined. The patients were divided into two groups: group 1 was comprised of patients with a survival time <5 years, and group 2 patients had a survival time >or=5 years. We compared clinicopathological characteristics of the two groups by performing univariate and multivariate analysis. We also investigated the prognostic factors according to the stage. RESULTS: On univariate analysis, 7 factors (age, tumor size, Borrmann type, resection type, distal resection margin, depth of invasion and lymph node status) were found to be different, and multivariate analysis revealed that patient age, depth of invasion and lymph node metastasis were the only significantly differences between the two groups. On the other hand, age and the Borrmann type for stage I b patients, age and the number of retrieved lymph nodes for stage II patients, tumor size for stage III patients, and the type of resection for stage IV patients were found to be the independent prognostic factors. CONCLUSION: The age of patients had prognostic value in the early stages of advanced gastric cancers such as stage I b or II. The number greater than 20 retrieved lymph nodes affected the survival, particularly for the patients with stage II disease, and the tumor size was a significant prognostic factor for patients with stage III disease. Therefore, physicians are advised to pay special attention to lymph node dissection for those patients with stage II or III disease.