Annals of Surgical Treatment and Research最新文献

{"title":"Knowledge of energy-based devices among surgical residents: a cross-sectional study.","authors":"Can Uc, Yigit Turk, Pınar Uc, Recep Temel, Murat Ozdemır, Ozer Makay","doi":"10.4174/astr.2024.107.5.300","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.300","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the knowledge of surgical residents in a tertiary hospital regarding the operational principles, potential complications, and mechanisms of energy devices used in surgery.</p><p><strong>Methods: </strong>A 16-question test was developed using educational materials in the \"Fundamental Use of Surgical Energy (FUSE)\" program, prepared by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for educational purposes, and from literature on energy devices. The test was shared online with surgical branch residents via Google Forms, and they were asked to complete it. Participants were given one week to complete the test and return the results online.</p><p><strong>Results: </strong>A total of 108 residents voluntarily participated in the study. The average number of correct answers was 6.5 out of 16. There was no significant difference between the correct answer rates for surgical branches. However, an increase in surgical seniority was associated with a higher number of correct answers (P < 0.001).</p><p><strong>Conclusion: </strong>Theoretical education about energy devices in surgical training needs to be improved. Surgical residents reported insufficient knowledge regarding the devices' operational principles and complication mechanisms.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"300-304"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635875","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":"Effectiveness and safety of chlorhexidine gluconate double-cleansing for surgical site infection prevention in neonatal intensive care unit surgical patients.","authors":"Jin Ah Kwon, Min Jeng Cho","doi":"10.4174/astr.2024.107.5.291","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.291","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the efficacy and safety of preoperative chlorhexidine gluconate (CHG) double-cleansing in reducing the incidence of surgical site infections (SSI) in surgical patients in neonatal intensive care units.</p><p><strong>Methods: </strong>A retrospective chart review involved 56 patients who underwent 73 surgical procedures in the neonatal intensive care unit (NICU) from 2013 to 2022. CHG double-cleansing involves the following 2 processes. Firstly, preoperative cleansing with 0.5% CHG for elective surgeries the night before or at least 1 hour before emergency surgery. The anterior trunk cleansing spanned from the neck to the pubis, including both axillary lines. Secondly, the surgical site underwent skin preparation using 2% CHG with 72% isopropyl alcohol before an incision. A control group (2013-2018) that used iodine and a CHG group (2019-2022) employing CHG double-cleansing were compared. The occurrence of SSIs within 30 days after the surgical procedure was assessed.</p><p><strong>Results: </strong>The overall SSI rate was 16.4% (n = 12) in the total procedures. The SSI rate was significantly higher (22.6%) in the control group; no SSI occurred in the CHG group (P = 0.029). No significant differences were observed in the other parameters. No adverse effects were observed in the CHG group.</p><p><strong>Conclusion: </strong>CHG double-cleansing, a modified approach for surgical patients in the NICU, effectively reduced the incidence of SSI compared to traditional iodine-based skin preparations. This study supports the safe use of CHG in neonates, including premature infants, without significant complications.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"291-299"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613541","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":"Primary tumor sidedness is not prognostic factor in resectable colorectal cancer liver metastasis: a retrospective observational cohort study.","authors":"Sung Jun Jo, Jongman Kim, Jung Kyong Shin, Jinsoo Rhu, Jung Wook Huh, Gyu-Seong Choi, Jae-Won Joh","doi":"10.4174/astr.2024.107.5.264","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.264","url":null,"abstract":"<p><strong>Purpose: </strong>Right-sided tumors have been reported to have a poorer survival rate than left-sided tumors; however, there remains debate regarding whether sidedness is an independent prognostic factor in colorectal cancer liver metastasis (CRLM). This study aimed to assess the impact of sidedness on prognosis in resectable CRLM and to identify prognostic factors.</p><p><strong>Methods: </strong>Patients who underwent liver resection for CRLM at Samsung Medical Center from January 2008 to December 2021 were included in the investigation. Overall survival (OS) and progression-free survival (PFS) were analyzed, and prognostic factors were identified.</p><p><strong>Results: </strong>A total of 497 patients were included in the study, with 106 on the right side and 391 on the left side. The right-sided group had a higher percentage of synchronous tumors (90.6% <i>vs.</i> 80.3%, P = 0.020). In survival analysis, the right side showed lower 5-year OS (49.7% <i>vs.</i> 54.2, P = 0.305) and 5-year PFS (57.1% <i>vs.</i> 60.2%, P = 0.271), but the differences were not statistically significant. In the analysis of prognostic factors, synchronous tumor (odds ratio [OR], 5.01; P < 0.001), CEA (OR, 1.46; P = 0.016), and maximum tumor size of hepatic metastasis (OR, 1.09; P = 0.026) were associated with OS.</p><p><strong>Conclusion: </strong>In resectable CRLM, there was no difference in prognosis based on sidedness. CEA level, synchronous tumor, and maximum tumor size of hepatic metastasis were identified as prognostic factors.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"264-273"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613660","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":"The efficacy of exosomes from human chemically derived hepatic progenitors in liver damage alleviation: a preclinical experimental study.","authors":"Min Kim, Tae Hun Kim, Elsy Soraya Silva Salas, Soyoung Jeon, Ji Hyun Shin, Dongho Choi","doi":"10.4174/astr.2024.107.5.252","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.252","url":null,"abstract":"<p><strong>Purpose: </strong>Over the past decade, interest in exosomes as therapeutics has surged. In particular, stem-cell-derived exosomes may be more effective as a treatment for liver disease than the stem cells themselves. We have previously developed human chemically derived hepatic progenitors (hCdHs) from human hepatocytes. hCdHs can differentiate into hepatocytes and cholangiocytes, regenerating the liver in mouse models. In this study, we evaluated the mitigating effects of hCdHs-derived exosomes (hCdHs-exo) on liver damage and compared them with those of exosomes from bone marrow mesenchymal stem cells (BMMSCs-exo).</p><p><strong>Methods: </strong>Exosomes were isolated from hCdHs and BMMSCs by culturing cells in large quantities and separating the exosomes from the culture medium using ultracentrifugation. Isolated exosomes were characterized by various methods before experimental use. <i>In vitro</i>, the ability of exosomes to inhibit activation of hepatic stellate cells (HSCs) by transforming growth factor beta 1 was evaluated. <i>In vivo</i>, exosomes were injected into mice with carbon tetrachloride (CCl₄)-induced liver damage, and their effectiveness in mitigating liver damage was assessed by histological staining and biochemical analysis.</p><p><strong>Results: </strong>The analyses confirmed the successful isolation of exosomes from both cell types. <i>In vitro</i>, hCdHs-exo significantly reduced the levels of transcription factors and activation markers in induced HSCs. <i>In vivo</i>, hCdHs-exo effectively alleviated liver damage caused by CCl₄. Furthermore, both <i>in vitro</i> and <i>in vivo</i> studies confirmed that hCdHs-exo had a greater effect in alleviating liver damage than did BMMSCs-exo.</p><p><strong>Conclusion: </strong>These results demonstrate that hCdHs-exo, similarly to hCdHs, have superior efficacy in alleviating liver damage compared with BMMSCs-exo.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"252-263"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613663","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":"The last chain of trauma survival: development of a scale for trauma-rehabilitation linkage in South Korea using a systematic review and expert consensus.","authors":"Shin Ae Lee, Yeon Jin Joo, Sam Yeol Chang, Jae-Woo Cho, Se-Woong Chun, Junsik Kwon, Hyun-Ho Kong, Kyung-Hag Lee, Gil Jae Lee, Goo Joo Lee, Ye Rim Chang","doi":"10.4174/astr.2024.107.5.274","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.274","url":null,"abstract":"<p><strong>Purpose: </strong>There is a high possibility of trauma patients being referred to an unsuitable medical institution for their rehabilitation treatment since the decision is made by them. This study sought to develop a standardized scale to evaluate the need for specialized rehabilitation in patients with multiple traumas and evaluate the effectiveness of the developed scale.</p><p><strong>Methods: </strong>This study employed a systematic review of existing literature to inform the development of a specialized rehabilitation evaluation scale. An expert panel consisting of trauma surgeons, orthopedic surgeons, and rehabilitation medicine physicians collaborated to create a discharge-planning checklist by assessing the need for specialized rehabilitation. The checklist was validated using retrospective data from trauma patients treated at Seoul National University Hospital.</p><p><strong>Results: </strong>We identified 12 studies, providing factors influencing the discharge location and rehabilitation needs of trauma patients. The checklist was developed through expert consensus and comprised 3 criteria: discharge feasibility to specialized rehabilitation facilities, diagnostic eligibility for specialized rehabilitation, and functional assessment. Validation of the checklist demonstrated that the percentage agreement, likelihood ratio of a positive test, and Cohen's kappa value were 82.1%, 5.21, and 0.375, respectively when comparing whether the checklist was met and the actual discharge location, indicating its effectiveness.</p><p><strong>Conclusion: </strong>This study established standardized criteria for assessing the need for specialized rehabilitation in trauma patients, offering a practical tool for clinical use. Implementation of this assessment scale has the potential to improve the trajectory of trauma survivors by facilitating access to appropriate rehabilitation services.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"274-283"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613668","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":"Outcomes in emergency surgery following the implementation of an acute care surgery model: a retrospective observational study.","authors":"Sungyeon Yoo, Yang-Hee Jun, Suk-Kyung Hong, Min Jung Ko, Hogyun Shin, Narae Lee, Hak-Jae Lee","doi":"10.4174/astr.2024.107.5.284","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.284","url":null,"abstract":"<p><strong>Purpose: </strong>Over the past 3 years, approximately 23,000 emergency surgeries were performed annually in South Korea, accounting for >1% of all surgeries nationwide. With the growing necessity for treating these emergency cases with dedication and proficiency, acute care surgery (ACS) teams were appointed at various hospitals. Regarding the implications of the ACS team, many studies showed promising results with a shorter time from the emergency department (ED) to the operating room (OR), shorter length of stay, and fewer complications. This study aimed to demonstrate the overall effect of ACS implementation at a single institution in South Korea.</p><p><strong>Methods: </strong>This was a single-center, retrospective observational study. Patients aged >18 years who visited the emergency room and received emergency surgery between July 2014 and December 2016 (pre-ACS) and between July 2017 and December 2019 (post-ACS) were included.</p><p><strong>Results: </strong>Among 958 patients, 497 were in the pre-ACS group and 461 in the post-ACS group. After propensity score matching by age, sex, underlying disease, and Emergency Surgery Acuity Score, 405 patients remained in each group. Our analysis showed a reduction in time from ED presentation to operation (547.8 ± 401.0 minutes <i>vs.</i> 476.6 ± 313.2 minutes, P = 0.005) and complication rates (24.7% <i>vs.</i> 16.8%, P < 0.001) in the post-ACS group. There were no significant differences in total operation duration, length of hospital stay, and mortality between the groups.</p><p><strong>Conclusion: </strong>As expected, time from ED to OR and complication rates were significantly reduced in the post-ACS group. Implementing an ACS team dedicated to emergency surgery provides better clinical outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"284-290"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613648","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":"New classification of Amyand's hernia, our experience: a retrospective observational study with a literature review.","authors":"Cem Kaya, Alparslan Kapisiz, Ramazan Karabulut, Zafer Turkyilmaz, Sibel Eryilmaz, Merve Altin Gulburun, Kaan Sonmez","doi":"10.4174/astr.2024.107.4.237","DOIUrl":"https://doi.org/10.4174/astr.2024.107.4.237","url":null,"abstract":"<p><strong>Purpose: </strong>Amyand's hernia (AH) is the name given to the type of hernia in which the appendix is found in a hernial sac. We aimed to share our clinical experience with a literature review for AH.</p><p><strong>Methods: </strong>A total of 1,774 inguinal hernias and 13 AH cases were repaired in our clinic between 2009 and 2020. In addition, detailed clinical features about AH were extracted by including unpublished data of 165 cases, which were gathered from the extensive literature on childhood AHs using PubMed, Web of Science, and Cochrane databases.</p><p><strong>Results: </strong>The rate of AH was 0.73% in all inguinal hernias; this rate was 8.6% for incarcerated hernias. The average age was 5.74 ± 7.27 months for AH. Our AH cases were seen in males and on the right side. AH is seen in 97.3% of males according to a review of 69 articles. The average age was 16.78 ± 30.46 months. One hundred sixty-five of the AH cases were on the right (88.7%). The main symptoms were swelling or redness in the inguinal region, pain, fever, and vomiting, along with patients presenting septic or with stercoral fistula.</p><p><strong>Conclusion: </strong>If the appendix is normal and easily reduced, high ligation is sufficient. In cases where reduction is difficult and/or the appendix is inflamed, appendectomy and hospitalization should be performed.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 4","pages":"237-244"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456657","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":"Safety and efficacy of total one-day perioperative completion for inguinal hernia repair during the COVID-19 pandemic: a retrospective cohort study.","authors":"Sung Ryul Lee","doi":"10.4174/astr.2024.107.4.221","DOIUrl":"https://doi.org/10.4174/astr.2024.107.4.221","url":null,"abstract":"<p><strong>Purpose: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, frequent perioperative interactions between patients and medical staff increased the risk of nosocomial infections. Total 1-day perioperative completion (TODPC) involves conducting preoperative evaluations, performing the operation, and facilitating discharge within a single day. This study aimed to evaluate the safety of TODPC in reducing perioperative contact by utilizing online and telephone appointment systems for inguinal hernia (IH) repairs.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed data from patients who underwent IH repairs. The study was divided into 2 periods relative to the COVID-19 pandemic: 18 months pre-pandemic (Group 1, September 2018-February 2020) and 18 months post-pandemic onset (Group 2, March 2020-August 2021). We compared the frequency of TODPC, daycare surgeries (which require hospital visits for preoperative evaluations and admission on the day of surgery), preoperative contacts, hernia types, incarcerations, organ resections, and instances of COVID-19 transmission among medical staff and patients.</p><p><strong>Results: </strong>The study included 5,728 participants, comprising 4,614 pediatric and 1,114 adult patients. The rate of TODPC implementation was higher in Group 2 than in Group 1 (91.0% <i>vs.</i> 75.0%, P < 0.001). The incidence of organ resections was low and did not differ significantly between the 2 groups. Throughout the study, there were no reported nosocomial COVID-19 infections among patients, parents, caregivers, or medical staff.</p><p><strong>Conclusion: </strong>TODPC for IH repair was a safe strategy for minimizing the need for organ resections and reducing the risk of mass COVID-19 infections during the pandemic period from March 2020 to August 2021.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 4","pages":"221-228"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456659","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":"A prospective randomized trial comparing the efficacy of temperature-responsive gel with local anesthetics <i>versus</i> local anesthetic infusion pump device for postoperative pain control after bariatric surgery.","authors":"Mira Yoo, Du-Yeong Hwang, Guan Hong Min, Heeyoung Lee, So Hyun Kang, Sang-Hoon Ahn, Yun-Suhk Suh, Young Suk Park","doi":"10.4174/astr.2024.107.4.229","DOIUrl":"https://doi.org/10.4174/astr.2024.107.4.229","url":null,"abstract":"<p><strong>Purpose: </strong>Bariatric surgery is the gold standard for the treatment of morbid obesity, but postoperative pain impedes recovery. Currently available pain-recovery treatments have patient safety concerns. This led to a noninferiority study of Welpass (Genewel Co., Ltd.) <i>vs.</i> On-Q PainBuster (B. Braun), each used alongside a traditional method of continuous local anesthetic administration, in patients undergoing bariatric surgery.</p><p><strong>Methods: </strong>In this single-center prospective randomized clinical trial, patients were assigned in a 1:1 ratio to the treatment group (Welpass) and the control group (On-Q PainBuster), with ketorolac administered as needed after surgery according to the protocol. To assess efficacy, the total amount of ketorolac used up to 72 hours postoperatively was measured. Additionally, ketorolac usage and numerical rating scales (NRS) were recorded at 6, 24, 48, and 72 hours after operation.</p><p><strong>Results: </strong>The total amounts of ketorolac used in the 72 hours postoperatively were 188.0 ± 84.6 mg in the treatment group and 198.7 ± 50.0 mg in the control group. The efficacy of the treatment group was noninferior to that of the control group, since the lower limit (-29.9 mg) of the confidence interval for the difference with the control group was greater than the prespecified noninferiority margin (-35.0 mg). Furthermore, when the NRS was evaluated after bariatric surgery, there was no significant difference in scores between the 2 groups at each time point (P > 0.05).</p><p><strong>Conclusion: </strong>We found no difference in effect on pain between the 2 groups, supporting the use of Welpass in clinical practice for pain management in patients undergoing bariatric surgery.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 4","pages":"229-236"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456654","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":"Optimal withdrawal time in initial surveillance colonoscopy after colorectal cancer surgery: comparison between anterior/low anterior resection and right hemicolectomy.","authors":"Jun Woo Bong, Ji Young Kim, Yeonuk Ju, Chinkock Cheong, Sanghee Kang, Sun Il Lee, Byung Wook Min","doi":"10.4174/astr.2024.107.4.212","DOIUrl":"https://doi.org/10.4174/astr.2024.107.4.212","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the optimal withdrawal time (WT) for initial surveillance colonoscopy after curative resection for colorectal cancer (CRC) by comparing anterior/low anterior resection (AR/LAR) and right hemicolectomy (RHC) groups.</p><p><strong>Methods: </strong>This retrospective study analyzed 1,212 patients who underwent initial surveillance colonoscopy after CRC resection between 2015 and 2022. The patients were divided into the AR/LAR (n = 846) and RHC (n = 366) groups. The optimal WT was determined using receiver operating characteristic curve analysis and validated using logistic regression models. The adenoma and advanced neoplasia detection rates (ADR/ANDR) were evaluated based on the optimal WT.</p><p><strong>Results: </strong>The optimal WT was 7 and 6 minutes in the AR/LAR and RHC groups, respectively. In multivariate analysis, WT ≥7 and ≥6 minutes in the AR/LAR (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.75-3.24; P < 0.001) and RHC (OR, 2.64; 95% CI, 1.59-4.39; P = 0.001) groups, respectively, were significant factors for adenoma detection. In the AR/LAR group, ADR was 41.5% for WT ≥7 minutes compared to 21.9% for WT <7 minutes (P < 0.001). In the RHC group, ADR for WT ≥6 minutes was 33.9% compared to 15.8% for WT <6 minutes (P < 0.001). The ANDR also significantly improved with longer WTs in both groups.</p><p><strong>Conclusion: </strong>This study suggests that a minimum WT of 7 and 6 minutes for AR/LAR and RHC patients, respectively, during the initial surveillance colonoscopy after CRC resection is optimal for maintaining a satisfactory ADR and ANDR. These findings highlight the importance of tailoring colonoscopic procedures according to the type of surgical resection.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 4","pages":"212-220"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456658","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}