Jae Won Jo, Jung Wook Suh, Sung Chul Lee, Hwan Namgung, Dong-Guk Park
{"title":"Current status of postoperative morbidity following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with peritoneal metastasis: a prospective single-center observational study.","authors":"Jae Won Jo, Jung Wook Suh, Sung Chul Lee, Hwan Namgung, Dong-Guk Park","doi":"10.4174/astr.2025.108.1.12","DOIUrl":"https://doi.org/10.4174/astr.2025.108.1.12","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate current morbidity rates following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with colorectal cancer and peritoneal metastasis.</p><p><strong>Methods: </strong>A total of 42 patients who underwent CRS and HIPEC for colorectal cancer with peritoneal metastasis at a single tertiary referral center between January 2022 and December 2022 were included. Perioperative outcomes and postoperative complications were prospectively assessed.</p><p><strong>Results: </strong>The mean peritoneal cancer index (PCI) was 16.0. The distribution of PCI scores was as follows: <10, 33.3%; 10-19, 26.2%; and ≥ 20, 40.5%. Completeness of the cytoreduction (CCR) scores were as follows: 57.1% of patients achieved CCR-0, 16.7% achieved CCR-1, 7.1% achieved CCR-2, and 19.0% achieved CCR-3. The mean operation time was 9.1 hours, and the median hospital stay was 17.0 days. Postoperative complications occurred within 30 days in 47.6% of cases and between 30 and 60 days in 11.9% of cases. Reoperation within 30 days was required in 5 cases, and 1 patient died within 30 days. The most common complications were pleural effusion (5 patients), anastomosis site leakage (3 patients), and pneumonia (3 patients). Patients with higher PCI scores were more likely to experience complications (P = 0.038).</p><p><strong>Conclusion: </strong>Although CRS and HIPEC are still associated with high morbidity and mortality compared to other colorectal surgeries, outcomes have improved with increased experience. These results suggest that the procedure is becoming a more acceptable treatment option over time.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 1","pages":"12-19"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"KLASS (Korean Laparoendoscopic Gastrointestinal Surgery Study Group) trials: a 20-year great journey in advancing surgical clinical research for gastric cancer.","authors":"Hyung-Ho Kim","doi":"10.4174/astr.2025.108.1.1","DOIUrl":"10.4174/astr.2025.108.1.1","url":null,"abstract":"<p><p>The Korean Laparoendoscopic Gastrointestinal Surgery Study Group (KLASS) trial series represents a comprehensive body of surgical clinical trials and studies focused on laparoscopic techniques in the treatment of gastric cancer. These trials, conducted and overseen by the KLASS, began with KLASS 01 in 2006 and have progressed to their 14th series as of December 2024. To date, approximately 36 papers, including pivotal publications, have been featured in high-impact journals, significantly advancing the field of gastric cancer treatment. Their findings have been incorporated into gastric cancer treatment guidelines in Korea, Japan, and China, underscoring their influence and clinical relevance. I take immense pride in being part of this remarkable journey, alongside esteemed seniors, colleagues, and numerous clinical researchers who initiated KLASS in 2004. This paper aims to review the studies conducted within the KLASS series to date and provide insights insight into the ongoing the ongoing research initiatives being developed by this esteemed group on their behalf.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 1","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoonkyung Woo, Ho Joong Choi, Sung Hak Lee, Yoonyoung Choi, Sung Eun Park, Tae Ho Hong, Young Kyoung You
{"title":"Perioperative outcomes of sinusoidal obstruction syndrome in patients undergoing liver resection for colorectal metastases after neoadjuvant chemotherapy: a retrospective cohort research.","authors":"Yoonkyung Woo, Ho Joong Choi, Sung Hak Lee, Yoonyoung Choi, Sung Eun Park, Tae Ho Hong, Young Kyoung You","doi":"10.4174/astr.2024.107.6.346","DOIUrl":"10.4174/astr.2024.107.6.346","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated the factors that affect the occurrence of sinusoidal obstruction syndrome (SOS) and the effect of SOS on the patient's perioperative outcomes through histological review of liver resection specimens from patients who underwent chemotherapy.</p><p><strong>Methods: </strong>From December 2007 to December 2020, liver specimens from patients who underwent liver resection for colorectal liver metastasis after neoadjuvant chemotherapy were analyzed regarding liver damage in the nontumorous lesion. Through pathological review, patients with grade 1-3 sinusoidal dilatation were categorized into the SOS (+) group, compared to a control group (grade 0, SOS [-]).</p><p><strong>Results: </strong>Of 286 patients, 175 were included. Preoperative factors were similar between the groups. Although not statistically significant, the SOS (+) group had a shorter chemotherapy-free interval before resection (7.96 weeks <i>vs.</i> 10.0 weeks, P = 0.069). The SOS (+) group had higher intraoperative blood loss (889.1 ± 1,126.6 mL <i>vs.</i> 555.3 ± 566.7 mL, P = 0.012) and transfusion rates (46.6% <i>vs.</i> 25.3%, P = 0.003). SOS correlated with increased liver surgery-specific complications (40.9% <i>vs.</i> 26.4, P = 0.043). Patients with SOS experienced adverse effects on intrahepatic recurrent-free survival and overall survival (5-year survival, 46.0% <i>vs.</i> 33.9%; P = 0.014).</p><p><strong>Conclusion: </strong>SOS development during liver surgery is associated with increased intraoperative blood loss, transfusion volume, and liver surgery-specific complications and has a higher risk of early recurrence and decreased overall survival. Thus, it is crucial to exercise caution during liver surgery in these patients.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"346-353"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seoung Yoon Rho, Munseok Choi, Sung Hyun Kim, Seung Soo Hong, Brian Kim Poh Goh, Yuichi Nagakawa, Minoru Tanabe, Daisuke Asano, Chang Moo Kang
{"title":"ArtiSential laparoscopic cholecystectomy: a comparative analysis with robotic single-port cholecystectomy.","authors":"Seoung Yoon Rho, Munseok Choi, Sung Hyun Kim, Seung Soo Hong, Brian Kim Poh Goh, Yuichi Nagakawa, Minoru Tanabe, Daisuke Asano, Chang Moo Kang","doi":"10.4174/astr.2024.107.6.336","DOIUrl":"10.4174/astr.2024.107.6.336","url":null,"abstract":"<p><strong>Purpose: </strong>Laparoscopic cholecystectomy is the gold standard procedure for benign gallbladder disease. However, reducing ports still causes frustration when using various instruments. We investigated early perioperative outcomes of laparoscopic single site + 1 cholecystectomy using ArtiSential instruments (ArtiSential laparoscopic cholecystectomy [ALC], LIVSMED).</p><p><strong>Methods: </strong>From July 2022 to December 2022, 116 patients underwent ALC in Severance Hospital and Yongin Severance Hospital. From May 2019 to December 2022, 210 patients underwent robotic single-port cholecystectomy (RSPC). We compared clinical characteristics, perioperative outcomes, and postoperative pain scores between the ALC and RSPC groups.</p><p><strong>Results: </strong>Patients in the ALC group were significantly older than those in the RSPC group (51.9 years <i>vs.</i> 43.9 years, P < 0.001), and the ALC group had a larger proportion of male patients (50.9% <i>vs.</i> 24.8%, P < 0.001) and cases of acute cholecystitis with stones (21.6% <i>vs.</i> 0.5%, P < 0.001) than the RSPC group. The groups did not differ in their estimated blood loss, postoperative complications, or hospital stays. The mean operation time of the ALC group was shorter than that of the RSPC group (56.5 minutes <i>vs.</i> 94.8 minutes, P < 0.001). Although the pain scores reported on discharge day did not differ, the ALC group reported significantly lower immediate postoperative pain scores than the RSPC group (2.7 <i>vs.</i> 5.4, P < 0.001).</p><p><strong>Conclusion: </strong>ALC is a safe and feasible procedure. ALC patients reported markedly lower immediate postoperative pain scores than RSPC patients, with comparable operative outcomes for estimated blood loss, hospital stay, and postoperative complication rates.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"336-345"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yu Jeong Cho, Hyunhee Kwon, Yong Jae Kwon, Suhyeon Ha, Seong Chul Kim, Dae Yeon Kim, Jung-Man Namgoong
{"title":"Surgical treatment for intractable cholangitis with intrahepatic biliary cysts followed by Kasai operation in biliary atresia: a retrospective cohort study.","authors":"Yu Jeong Cho, Hyunhee Kwon, Yong Jae Kwon, Suhyeon Ha, Seong Chul Kim, Dae Yeon Kim, Jung-Man Namgoong","doi":"10.4174/astr.2024.107.6.363","DOIUrl":"10.4174/astr.2024.107.6.363","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic biliary cysts (IBCs) after Kasai portoenterostomy (KPE) are associated with intractable recurrent cholangitis. This study aimed to investigate the feasibility of its use as well as indication for surgical management of IBCs in pediatric patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records and imaging studies of patients who underwent KPE for biliary atresia from 2010 to 2020.</p><p><strong>Results: </strong>An imaging study identified IBCs in 28 of 129 patients who underwent KPE with biliary atresia (21.7%). Among them, 5 patients were subjected to surgical treatment for intractable cholangitis. The median time from KPE to the development of IBCs was 1.7 years. Four out of 5 patients had IBCs confined to the left lateral lobe, and in one patient, the IBCs were in the hepatic hilum. All 5 patients experienced more than one cholangitis. Although they received intravenous antibiotic treatment and percutaneous transhepatic cholangiodrainage as treatment, they were intractable. Three patients underwent hepatectomy, and 2 underwent cystojejunostomy. There was no recurrence of cholangitis during the median follow-up period of 2.9 years.</p><p><strong>Conclusion: </strong>Surgical treatment for IBCs after KPE could be considered a safe and effective surgical procedure for children if appropriate indications are applied.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"363-368"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of the postoperative complications for gastric cancer surgery before and during the medical crisis in South Korea: a retrospective observational study.","authors":"Kyoungdong Lee, Ba Ool Seong, Moon-Won Yoo","doi":"10.4174/astr.2024.107.6.354","DOIUrl":"10.4174/astr.2024.107.6.354","url":null,"abstract":"<p><strong>Purpose: </strong>In 2024, South Korea experienced a substantial shortage of medical practitioners, primarily residents and interns, owing to mass resignation from training hospitals. This study aimed to evaluate whether the quality of medical care declined because of this shortage by comparing postoperative complications before and during the period of mass resignation.</p><p><strong>Methods: </strong>This retrospective observational study assessed patient outcomes among patients with gastric cancer before and during a period of mass resignation at a single tertiary training hospital. Outcomes analyzed included operation duration, length of hospital stays, and complication rates. The effects of the medical crisis on complication rates were analyzed using logistic regression.</p><p><strong>Results: </strong>A total of 218 and 31 patients underwent surgery during the control and crisis periods, respectively. During the control period, approximately 73 surgeries were performed between February 20 and June 10 each year, which was reduced to 31 during the crisis period. The operation duration (minutes) was 164.5 before the medical crisis and 154.0 during it (P = 0.19). The incidence of postoperative complications before and during the medical crisis was 22.02% (48 of 218) and 9.68% (3 of 31), respectively (P = 0.15). No severe complications (Clavien-Dindo grade ≥IIIa) were observed during the crisis period. Multivariate logistic regression revealed that sex and body mass index were significant variables associated with postoperative complications, but the effects of medical crisis were not.</p><p><strong>Conclusion: </strong>Despite the medical crisis in South Korea, patient outcomes for gastric cancer surgery were sustained in terms of the frequency of postoperative complications.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"354-362"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeong-Moo Lee, In Woong Han, Oh Chul Kwon, Hye Rim Seo, Jipmin Jung, So Jeong Yoon, Ahram Han, Juhan Lee, Soo Young Lee, Hoseok Seo, Wooil Kwon, Bang Wool Eom, In-Seob Lee, Ji Won Park, Hae Won Lee, Ho Kyoung Hwang, Suk-Hwan Lee, Eung Jin Shin, Woo Yong Lee
{"title":"Development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program: a nationwide project to improve surgical quality and patient safety.","authors":"Jeong-Moo Lee, In Woong Han, Oh Chul Kwon, Hye Rim Seo, Jipmin Jung, So Jeong Yoon, Ahram Han, Juhan Lee, Soo Young Lee, Hoseok Seo, Wooil Kwon, Bang Wool Eom, In-Seob Lee, Ji Won Park, Hae Won Lee, Ho Kyoung Hwang, Suk-Hwan Lee, Eung Jin Shin, Woo Yong Lee","doi":"10.4174/astr.2024.107.6.305","DOIUrl":"10.4174/astr.2024.107.6.305","url":null,"abstract":"<p><strong>Purpose: </strong>Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems. To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.</p><p><strong>Methods: </strong>K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation.</p><p><strong>Results: </strong>Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea.</p><p><strong>Conclusion: </strong>This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"305-314"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hyo-Shin Kim, Da-Hyun Kim, Dong-Ik Kim, Joon-Kee Park, Shin-Seok Yang, Yang-Jin Park
{"title":"Validation of the Vascular Study Group of New England (VSGNE) risk prediction model for abdominal aortic aneurysm repair in Korea: a single-center retrospective study.","authors":"Hyo-Shin Kim, Da-Hyun Kim, Dong-Ik Kim, Joon-Kee Park, Shin-Seok Yang, Yang-Jin Park","doi":"10.4174/astr.2024.107.6.315","DOIUrl":"10.4174/astr.2024.107.6.315","url":null,"abstract":"<p><strong>Purpose: </strong>The Vascular Study Group of New England (VSGNE) risk prediction model is a simple method for estimating risk for elective abdominal aortic aneurysm (AAA) repair. The model considers both treatment methods and the physical characteristics of the aneurysm type as well as comorbidities. This research aimed to validate its effectiveness by analyzing retrospective data on Korean patients.</p><p><strong>Methods: </strong>Our single-center retrospective analysis included 1,227 patients who underwent elective open repair surgery (ORS) or endovascular aortic repair (EVAR) from 2005 to 2021. We assessed the discrimination of the risk score and the effects of several risk factors.</p><p><strong>Results: </strong>Most patients (66.7%) were classified as low risk in the model, with only 5.6% considered high risk. The mean risk score was 2.81, significantly lower than reported in previous studies. The actual 30-day mortality was only 0.7%, less than the predicted 1.1%. The accuracy of the model in predicting 30-day mortality was statistically significant (area under the curve, 0.822). Patients with high scores were associated with significantly increased mortality (odds ratio, 3.9; P < 0.001). Factors such as advanced age, cerebrovascular disease, and elevated creatinine levels were influential in mortality outcomes. However, a significant difference was not found in short-term mortality between ORS and EVAR.</p><p><strong>Conclusion: </strong>Although the VSGNE model is an objective tool for assessing death risk in elective AAA repair, the actual risk scores in our patient population were lower than predicted. To create a more representative tool for the Korean population, we suggest developing a novel model based on multicenter data collection.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"315-326"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic implications of ductal carcinoma <i>in situ</i> components in <i>BRCA1/2</i>-positive breast cancer: a retrospective cohort study.","authors":"Kyung-Hwak Yoon, Eun-Kyu Kim, Hee-Chul Shin","doi":"10.4174/astr.2024.107.6.327","DOIUrl":"10.4174/astr.2024.107.6.327","url":null,"abstract":"<p><strong>Purpose: </strong>Although the breast cancer susceptibility gene <i>(BRCA)</i>-associated invasive breast cancer is well studied, there are limited reports on ductal carcinoma <i>in situ</i> (DCIS) in patients with <i>BRCA1/2</i> mutations. This study aims to evaluate the differential prognostic effect of DCIS in breast cancer patients with pathologic variants of <i>BRCA1/2</i> genes.</p><p><strong>Methods: </strong>Breast cancer patients who tested positive for <i>BRCA1/2</i> mutations between August 2003 and January 2022 at a single tertiary referral center were retrospectively analyzed. Survival outcomes were compared between patients with both invasive ductal carcinoma (IDC) and DCIS (IDC-DCIS group, n = 121) and those with IDC alone (IDC group, n = 36).</p><p><strong>Results: </strong>Of the 157 patients, 65 (41.4%) exhibited mutations in <i>BRCA1</i>, 90 (57.3%) in <i>BRCA2</i>, and 2 (1.3%) in both <i>BRCA1/2</i>. DCIS components were more frequently found in <i>BRCA2</i> pathological variants (<i>BRCA1</i>, 46 [38.0%] <i>vs.</i> <i>BRCA2</i>, 76 [62.4%]; P = 0.030). No statistically significant difference was found in 10-year recurrence-free survival (IDC-DCIS, 89.3% <i>vs.</i> IDC, 83.6%; P = 0.989). Subgroup analysis indicated that the DCIS component correlated with improved survival outcomes in the <i>BRCA1</i> subgroup (<i>BRCA1</i> IDC-DCIS, 85.5% <i>vs.</i> <i>BRCA1</i> IDC, 51.0%; P = 0.024). Conversely, in the <i>BRCA2</i> subgroup, IDC-DCIS patients exhibited a worse prognosis (<i>BRCA1</i> IDC-DCIS, 85.5% <i>vs.</i> <i>BRCA2</i> IDC-DCIS, 65.8%; P = 0.045).</p><p><strong>Conclusion: </strong>The presence of a DCIS component carries varied prognostic significance in <i>BRCA1</i> and <i>BRCA2</i> mutations. A tailored approach may be necessary when determining treatment options for breast cancer patients with <i>BRCA1/2</i> mutations based on the presence of DCIS.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"327-335"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mortality and associated factors among patients who underwent liver transplantation in South Korea from 2017 to 2021: a retrospective observational study.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.4174/astr.2024.107.5.245","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.245","url":null,"abstract":"<p><strong>Purpose: </strong>Liver transplantation (LT) in South Korea dates back to 1988. However, Asians may be reluctant to donate their organs because of the influence of their traditional religious and philosophical beliefs. We aimed to investigate the mortality and associated factors among patients admitted after LT in South Korea.</p><p><strong>Methods: </strong>The South Korean National Health Insurance Service database was used as a data source. All adult patients who underwent LT between January 1, 2017 and December 31, 2021 (5 years) were included in the study.</p><p><strong>Results: </strong>A total of 7,316 patients were included in the analysis (living donor LT [LDLT], 5,412; deceased donor LT [DDLT], 1,904). The 1-year mortality rate was 12.8% (LDLT, 8.2%; DDLT, 25.9%; P < 0.001), and the postoperative complication rate was 26.8% (LDLT, 16.7%; DDLT, 55.6%; P < 0.001). The average length of hospital stay was 30.8 days, and that in the intensive care unit was 6.1 days. The total mean cost was 69,954 US dollars, and the self-cost was 6,008 US dollars. After adjusting confounders, DDLT (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.79-5.20; P < 0.001), re-LDLT (HR, 4.82; 95% CI, 3.10-7.40; P < 0.001), re-DDLT (HR, 4.65; 95% CI, 3.55-7.12; P < 0.001), and postoperative complications (HR, 1.72; 95% CI, 1.39-2.12; P < 0.001) were potential risk factors for higher 1-year mortality after transplantation.</p><p><strong>Conclusion: </strong>LDLT was performed at a higher rate in South Korea and was associated with lower mortality and fewer postoperative complications than DDLT. Redo LT led to higher mortality rates.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"245-251"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}