Hepato-gastroenterology

BACKGROUND/AIMS: Spontaneous rupture is a life-threatening complication of hepatocellular carcinoma (HCC). Although hemostasis can be achieved by transarterial embolization (TAE), the prognosis remains poor. The aims of this study were to evaluate the effectiveness of emergent TAE for ruptured HCC and to clarify the prognostic factors. METHODOLOGY: Thirty-six patients with spontaneously ruptured HCC were retrospectively analyzed. Prognostic factors of short-term (57 days) and long-term (>7 days) survival after HCC rupture were investigated by univariate and multivariate analyses...

BACKGROUND/AIMS: Liver transplantation (LT) is an effective treatment modality for acute liver failure (ALF). However, no reports have examined a large number of patients who underwent adult living donor LT (LDLT) for ALF. METHODOLOGY: Seventy-four adult patients who underwent LT including 72 LDLT in a single center over a period of 15 years were reviewed. RESULTS: Of 74 cases, there were 17 cases with acute type ALF and 57 cases with subacute type of ALF...

BACKGROUND/AIMS: Few studies have characterized the outcomes and clinical features of patients who undergo liver transplantation (LT) for hepatocellular carcinoma (HCC) due to non-viral causes. METHODOLOGY: We retrospectively analyzed 188 patients with HCC who underwent LT between February 1999 and October 2010. The clinicopathological factors and overall survival rates as well as recurrence rates of 17 patients with non-hepatitis B virus (HBV) and non-hepatitis C virus (HCV) infection (NBNC group) and 171 patients with HBV or HCV infection (HBV/ HCV group) were compared...

The chronic nature of Crohn's disease (CD) implicates necessity of multiple control assessments throughout patient's life. It is accepted that in patients with CD requiring disease monitoring, magnetic resonance enterography (MRE) and computed tomography enterography (CTE) are--apart from endoscopy--imaging studies of first choice. In practice, diagnostic imaging of patients with CD is troublesome, since MRE is an expensive and complicated study, and CTE exposes patients to high doses of ionizing radiation...

BACKGROUND/AIMS: In recent years, the side-to-side intestinal anastomosis has become a widely used technique. The purpose of this study was to evaluate the difference in the burst pressures and weak points using three different kinds of suture instruments. METHODOLOGY: Fresh pig esophagus and small bowel were used for all experiments. A side-to-side anastomosis was performed using three linear staplers, and the burst pressure was measured. Stapling devices used were the GIATM60-3...

BACKGROUND/AIMS: Adjuvant treatment with imatinib mesylate (IM) improves survival of patients with a high risk of recurrence of gastrointestinal stromal tumors (GISTs). However, the optimal adjuvant treatment strategy remains unknown. Thus, this study aimed to identify patients who do not require adjuvant IM treatment using the Ki-67 labeling index (LI). METHODOLOGY: The Ki-67 LI was calculated in 59 patients with gastric GISTs. A new risk classification using the Ki-67LI and tumor size was established using cut-off values determined by receiver operating characteristic analysis...

BACKGROUND/AIMS: To analyze our experience of segmental duodenectomy for tumors located at the third and fourth portion of the duodenum and attempt to explore the security and feasibility of this surgical procedure. METHODOLOGY: A retrospective cohort study of five patients who underwent segmental duodenectomy in our hospital, medical records were analyzed in this study. RESULTS: The initial symptoms in five patients are not specific. Five were surgically treated by segmental resection...

BACKGROUND/AIMS: To determine risk factors associated with mortality and increased drug costs in patients with nonvariceal upper gastrointestinal bleeding. METHODOLOGY: We retrospectively analyzed data from patients hospitalized with nonvariceal upper gastrointestinal bleeding between January 2001-December 2011. Demographic and clinical characteristics and drug costs were documented. Univariate analysis determined possible risk factors for mortality. Statistically significant variables were analyzed using a logistic regression model...

BACKGROUND/AIMS: We aimed to investigate the efficacy of second line treatment with modified FOLFOX6 (mFOLFOX6) following cisplatin- plus 5-fluorourasil (CF) chemotherapy in patients with metastatic esophagus cancer (mEC). METHODOLOGY: In our oncology clinic, between March 2011 and September 2014, we reviewed patients admitted with progressive mEC following first line CF chemotherapy and those with >60 kanofsky performance status performed second line mFOLFOX6 regimen...

BACKGROUND/AIMS: The purpose of this study is to assess the efficacy of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in predicting the pathological response of neoadjuvant chemoradiation (CRT) for clinically diagnosed T4 esophageal squamous cell carcinoma (SCC). METHODOLOGY: We examined 32 patients with T4 thoracic esophageal SCC who received neoadjuvant CRT followed by surgery. RESULTS: Pathological complete response (pCR) was achieved in 7 patients (21...

BACKGROUND/AIMS: The aim of this study was to investigate the incidence and risk factors for anastomotic stricture after esophagectomy with gastric tube reconstruction. METHODOLOGY: A total of 150 consecutive patients with esophageal cancer who underwent esophagectomy with gastric tube reconstruction were analyzed in this study. Anastomotic stricture was de fined as disturbance of the passage of a standard endo scope, with no evidence of locoregional cancer recurrence...

BACKGROUND/AIMS: The optimal treatment for locally advanced esophageal carcinoma has not yet been determined. We report results of neoadjuvant hyperthermo-chemoradiotherapy (HCRT) using weekly low-dose docetaxel followed by surgery in patients with advanced esophageal squamous cell carcinoma. METHODOLOGY: Twenty-four patients were enrolled. 7 patients were considered to have inoperable tumors or rejected surgery after HCRT, and the remaining 17 patients had an esophagectomy...

BACKGROUND/AIMS: To detect the cellular sensitivity to adriamycin (ADR) by assessing autophagy, apoptosis, and multidrug resistance gene 1 (mdr1) expression in LoVo/Adr cells. METHODOLOGY: LoVo/Adr cells were designated accordingly into ADR group, Rapamycin (RAPA) group, ADR plus RAPA, and control group in main observations. Autophage, cell death and mdr1 were examined. RESULTS: IC50 value of ADR in LoVo/Adr was significantly decreased in response to RAPA (P < 0...

BACKGROUND/AIMS: Colorectal cancer is the fourth most common cancer diagnosed in the United States, and the third most common cause of death from cancer. Approximately 20% of the patients with colorectal cancer have distant metastasis during diagnosis. Primary tumor resection is controversial in unresectable metastatic colorectal cancer (CRC). We studied the survival effect of primary tumor resection in unresectable metastatic CRC according to kirsten ras (KRAS) mutation status. METHODOLOGY: Seventy eight CRC cases with unresectable metastasis were included in the study...

BACKGROUND/AIMS: Reduced port laparoscopic surgery has recently emerged as a method to improve the cosmetic results of conventional laparoscopic surgery. We reported our technique of reduced port laparoscopic colectomy using 3-port and short-time outcomes. METHODOLOGY: Between 2005 and 2012, we performed 161 reduced port laparoscopic colectomies using the 3-port technique. Data analyzed in-cluded age, gender, body mass index (BMI), duration of surgery, number of harvested lymph nodes, and duration of hospital stay...

BACKGROUND/AIMS: The efficacy and safety of neoadjuvant chemotherapy in patients with highly advanced rectal cancer for whom radical surgery was considered difficult were evaluated. METHODOLOGY: From June 2007 to February 2011, 10 advanced lower rectal cancer patients with factors contraindicative of curative surgery with total mesenteric excision were eligible for this study. Neoadjuvant chemotherapy consisting of modified OPTIMOX1 (mFOLFOX6 and sLV5FU2 alternating administration) plus bevacizumab was administered...

BACKGROUND/AIMS: Transanal minimally invasive surgery (TAMIS) has received attention as an alternative to transanal endoscopic microsurgery for rectal lesions. We review the effectiveness and safety of TAMIS for the treatment of rectal lesions. METHODOLOGY: The MEDLINE, Web of Science, and Cochrane Library databases were searched using predefined inclusion criteria. The primary outcomes were positive margin rate, recurrence rate, conversion rate, range of applications, and complication rates...

BACKGROUND/AIMS: Complete resection of tumors is possible after heavy chemotherapy in a few patients with unresectable colorectal cancer (UCRC). This study evaluated the ability of new prognostic score to identify such patients. METHODOLOGY: Four peripheral blood markers were evaluated in 50 patients diagnosed with UCRC at the time of patients' first visit to the hospital: C-reactive protein (CRP), albumin (ALB), neutrophil/lymphocyte ratio (NLR), and carcinoembryonic antigen (CEA)...

BACKGROUND/AIMS: Despite recent advances in medical therapy, the role of surgery for severe ulcerative colitis remains important and determining the timing and indications for colectomy are difficult for both gastroenterologists and surgeons. We compared the clinical characteristics and postoperative complications of emergency surgeries for ulcerative colitis to those of elective surgeries. METHODOLOGY: We retrospectively examined 77 patients with ulcerative colitis who underwent colectomy without cancer or dysplasia in our institute in 1989-2012...

BACKGROUND/AIMS: Laparoscopic approaches are increasingly used in selected patients with either colorectal or liver disease. The aim of this study was to evaluate the safety and feasibility of laparoscopy-assisted combined colorectal and liver resection for primary colorectal cancer (CRC) with synchronous liver metastases. METHODOLOGY: Thirteen patients with CRC with synchronous liver metastases who underwent simultaneous laparoscopic colectomy and hepatic resection from January 2009 through July 2013 were evaluated...