Yoon Soon Lee

Kyungpook National University Hospital, Sŏul, Seoul, South Korea

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Publications (32)49.15 Total impact

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    ABSTRACT: The purpose of this study was to classify anatomical variations of the internal iliac vein (IIV) in relation to robotic or laparoscopic extended lymphadenectomy. Between March 2011 and July 2012, 60 consecutive patients underwent robotic or laparoscopic extended lymphadenectomy. We retrospectively reviewed surgical video clips and analyzed the pattern of the IIVs in the presacral area. IIV variations were classified into seven types: Type A, normal (n = 39, 65.0%); Type A with a dilated middle sacral vein (n = 5, 8.3%); Type B, left IIV connecting centrally to the left external iliac vein (n = 5, 8.3%); Type C, a separated trunk of the left IIV draining into the left central common iliac vein (CIV; n = 1, 1.7%); Type D, a separated trunk of the right IIV draining into the left central CIV (n = 8, 13.3%); Type E, a separated trunk of the right IIV draining into the right central CIV (n = 0, 0%); and Type F, separated trunks of the bilateral IIV connecting with each other before draining into the left central CIV (n = 2, 3.3%). The prevalence of IIV anomalies was 26.7%; the incidence of separated IIV trunks was 18.3%. To prevent life-threatening IIV injury during extended lymphadenectomy or sacral colpopexy, the anatomical variations of the IIVs should be known exactly. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.
    Clinical Anatomy 11/2014; · 1.16 Impact Factor
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    ABSTRACT: The aim of this study was to determine the role of F-fluorodeoxyglucose positron emission tomography/computed tomography in estimating tumor aggressiveness in patients with clinical stage I endometrial cancer and the correlation between aggressiveness and expression of glucose transporter 1 (GLUT-1).
    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 10/2014;
  • Gun Oh Chong, Dae Gy Hong, Yoon Soon Lee
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    ABSTRACT: To evaluate single-port assisted extracorporeal cystectomy for the treatment of large ovarian cysts, and to compare its surgical outcomes, complications, and cystic content spillage rates with those of conventional laparoscopy and laparotomy.
    Journal of Minimally Invasive Gynecology 06/2014; · 1.61 Impact Factor
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    ABSTRACT: Abstract Objective: To evaluate the safety and effects on health-related quality of life (HRQOL) of radical excision of deeply infiltrating endometriosis (DIE) in the cul-de-sac. Patients and Methods: This study included 390 patients with pathologically proven DIE in the cul-de-sac who underwent laparoscopic surgery between January 2000 and December 2011. The preoperative and postoperative visual analog scale (VAS) pain scores and HRQOL data from the 36-item Short Form (SF-36) questionnaire were recorded in 343 patients. Surgical outcomes, complications, and HRQOL were compared between patients who underwent hysterectomy and those who did not. Data were analyzed using the paired t test, Student's t test, and Pearson's correlation analysis. Results: In the group overall, the VAS pain score and all SF-36 scales improved after surgery. In patients who underwent hysterectomy, all SF-36 scales improved except physical functioning, role-physical, general health, and vitality. In patients who did not undergo hysterectomy, all SF-36 scales improved except general health. There were significant associations between gonadotropin-releasing hormone agonist therapy and SF-36 mental health, SF-36 mental component summary, and oral medication use. The VAS pain score and SF-36 body pain score showed the greatest improvement, and the SF-36 general health score showed the least improvement. Patients who underwent hysterectomy had more severe disease and poorer surgical outcomes than those who did not undergo hysterectomy. Conclusions: Laparoscopic radical excision of DIE in the cul-de-sac is safe and significantly improves HRQOL, especially in terms of pain. The severity of endometriosis may affect the degree of improvement in HRQOL scores.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 03/2014; 24(3):165-70. · 1.07 Impact Factor
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    Yoon Soon Lee
    Journal of Gynecologic Oncology 01/2014; 25(1):1-2. · 1.73 Impact Factor
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    ABSTRACT: To evaluate our short-term clinical outcomes of robot-assisted autonomic nerve-sparing extended systematic lymphadenectomy as part of nerve-sparing radical hysterectomy. Between March 2011 and June 2012, we observed prospectively 28 consecutive patients who underwent robot-assisted autonomic nerve-sparing extended systematic lymphadenectomy, including the superior and inferior gluteal, presacral (subaortic), common iliac, and lower para-aortic nodes. The predominant International Federation of Gynecology and Obstetrics stage was IB1 (15 patients), followed by IB2 (5 patients), IA2 (3 patients), IIA1 (3 patients), and IIA2 (2 patients). The mean ± SD total operating time was 308.8 ± 54.9 minutes, and the mean ± SD console time was 280.0 ± 46.0 minutes. The mean ± SD blood loss was 102.7 ± 153.8 mL. The mean ± SD acquired pelvic lymph node was 27.1 ± 9.3, the mean ± SD extended lymph node was 19.2 ± 9.6, and the mean ± SD total lymph node was 46.3 ± 14.5. A total of 10 patients (35.7%) had nodal metastasis; among them, 6 patients (21.4%) had single pelvic nodal metastasis, 3 patients (10.7%) had concurrent pelvic and extended nodal metastasis, and one patient (3.6%) had single extended nodal metastasis. No intraoperative complications that required treatment occurred; however, ureterovaginal fistula was identified in 4 patients (14.3%) and ureter stricture in 4 patients (14.3%) after radiotherapy. After a median follow-up of 10 months (range, 1-16 months), there was no pelvic recurrence; however, one patient had recurrence at transposition site of ovary. With the advantage of delicate movement of robot instrument, robot-assisted systematic extended lymphadenectomy with total preservation of pelvic autonomic nerves did not compromise the radicality, and its surgical technique was feasible and safe. By using this approach, we could harvest more lymph nodes and have a high rate of metastatic nodes without disturbing voiding function; however, there was increased rate of urological complications. Moreover, long-term survival benefit after an extended systematic lymphadenectomy must be evaluated.
    International Journal of Gynecological Cancer 07/2013; 23(6):1133-8. · 1.94 Impact Factor
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    ABSTRACT: INTRODUCTION: Aggressive angiomyxoma is a rare myxedematous mesenchymal tumor that mainly occurs in the female pelvis and perineum. The principle of treatment for aggressive angiomyxoma is surgical excision. The tumor can be removed by local excision alone when it occurs locally on the perineum. However, it cannot be completely excised by a perineal approach alone when it passes through the perineum and pelvic bone to extend into the retroperitoneal space. CASE PRESENTATION: A 34-year-old Asian woman presented with a rapidly growing left perineal mass and swelling in the left gluteal region. The swelling was associated with a mild, dull pain in the left gluteal region. In the present case of bulky aggressive angiomyxoma extending to the perineum and retroperitoneal space, the authors made an inverted Y incision through the buttock, removed the coccyx and lower portion of the sacrum, and excised the retroperitoneal mass and perineal lesion through a perineal approach. CONCLUSION: The inverted Y incision and trans-sacral approach can provide easy access to deep retroperitoneal aggressive angiomyxoma and reduce damage to neighboring organs.
    Journal of Medical Case Reports 06/2013; 7(1):153.
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    ABSTRACT: OBJECTIVE: The aim of the study was to compare the initial surgical outcomes and learning curve of nerve-sparing robotic radical hysterectomy (RRH) with nerve-sparing total laparoscopic radical hysterectomy (TLRH) for the treatment of early-stage cervical cancer in the first 50 cases. METHODS: Between January 2008 and March 2012, 50 consecutive patients underwent nerve-sparing RRH. These patients were compared with a historic cohort of the first 50 consecutive patients who underwent nerve-sparing TLRH. RESULTS: Both groups were similar with respect to patients and tumor characteristics. The mean operating time in the RRH group was significantly longer than that in the TLRH group (230.1 ± 35.8 vs 211.2 ± 46.7 minutes; P = 0.025). The mean blood loss for the robotic group was significantly lower compared with the laparoscopic group (54.9 ± 31.5 vs 201.9 ± 148.4 mL; P < 0.001). There was no significant difference in the mean pelvic lymph nodes between the 2 groups (25.0 ± 9.9 vs 23.1 ± 10.4; P = 0.361). The mean days to normal residual urine were 9.6 ± 6.4 in RRH and 11.0 ± 6.2 in TLRH (P = 0.291). The incidence of intraoperative complication was profoundly lower in RRH compared with that of TLRH (0% vs 8%; P = 0.041). Moreover, no intraoperative transfusion was required in RRH, whereas 4 (8%) were required in TLRH (P = 0.041). In both groups, we found no evidence of a learning effect during the first 50 cases. CONCLUSIONS: During the first 50 cases, surgical outcomes and complication rates of nerve-sparing RRH were found to be comparable to those of nerve-sparing TLRH. Moreover, the mean blood loss and intraoperative complication rate in the robotic group were significantly lower than those in the laparoscopic group. Surgical skills for nerve-sparing TLRH easily and safely translated to nerve-sparing RRH in case of experienced laparoscopic surgeon.
    International Journal of Gynecological Cancer 06/2013; · 1.94 Impact Factor
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    ABSTRACT: We report a case of a viable abdominal pregnancy with successful outpatient management until fetal lung maturation and planned delivery. Advanced abdominal pregnancy is a very rare extrauterine pregnancy, which results in serious maternal and fetal morbidity. A 28-year-old nullipara was referred from the local clinic to our tertiary center at 18 weeks' gestation. We diagnosed an extrauterine fetus on sonographic examination. The patient had weekly antenatal sonographic examinations. We performed a planned laparotomy at 34 weeks' gestation, and a female baby weighing 2,100 g was delivered. The placenta was completely removed and the uterus was preserved. Both the mother and the baby had no postoperative morbidity. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012.
    Journal of Clinical Ultrasound 11/2012; · 0.70 Impact Factor
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    ABSTRACT: To compare the perioperative surgical outcomes and complication rates between single-port total laparoscopic hysterectomy and conventional four-port total laparoscopic hysterectomy. Between June 2009 and April 2011, 56 patients underwent total laparoscopic hysterectomy. Of these 56 patients, 28 underwent single-port (Octoport™) total laparoscopic hysterectomy and 28 underwent conventional four-port total laparoscopic hysterectomy. We analyzed the following parameters for all the patients: age, body mass index, operative time, blood loss, change in hemoglobin level, vaginal stump suture time and length of hospital stay. The general characteristics of the patients were similar in both groups. There were no statistically significant differences in blood loss, hemoglobin change, length of postoperative hospital stay and complication rate. However, the mean operative time of the single-port group was significantly longer than that of the four-port group (93.5±24.0min vs. 78.7±17.4min; P=0.011). The operative time for vaginal stump suture was profoundly decreased with experience in the single-port group. With the exception of operative time, the surgical outcomes and incidence of complications of the single-port group were comparable to those of the four-port group. However, the operative time decreased in the single-port group with increasing experience.
    European journal of obstetrics, gynecology, and reproductive biology 01/2012; 161(2):215-8. · 1.97 Impact Factor
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    ABSTRACT: Very few studies have reported on the occurrence and accumulation profiles of polycyclic aromatic hydrocarbons (PAHs) and synthetic musk compounds (SMCs) in human adipose tissue. In this study, concentrations of PAHs and SMCs in adipose tissues collected from Korean women in 2007 and 2008 were determined. Total concentrations of PAHs and SMCs in adipose tissues ranged from 15 to 361 (mean: 119) ngg(-1) lipid weight and from 38 to 253 (mean: 106) ngg(-1) lipid weight, respectively. Concentrations of SMCs in Korean adipose tissues were lower than those reported for European countries and the United States. Naphthalene was the most predominant PAH and HHCB was the dominant SMC found in adipose tissues. The concentrations of PAHs and SMCs were not correlated with each other, suggesting that the sources of human exposure to these two classes of compounds are different. No correlation was found between donor's age and residue levels of PAHs and SMCs. The results of this study provide baseline information on exposure of PAHs and SMCs to the general population in Korea.
    Chemosphere 11/2011; 86(5):485-90. · 3.14 Impact Factor
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    ABSTRACT: Studies on residue levels and accumulation profiles of persistent organic pollutants (POPs) in human adipose tissues of Korean populations are scarce. In this study, concentrations and accumulation features of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), and polybrominated diphenyl ethers (PBDEs) were measured in adipose tissues of Korean women age 40-68 years. The highest concentrations were found for PCBs and DDTs, which were 1-2 orders of magnitude greater than the concentrations of hexachlorocyclohexanes, chlordanes, and PBDEs. The concentrations of PCBs and OCPs were lower than those reported for other countries. However, PBDE concentrations were greater than those reported for other countries, suggesting that ongoing exposure to PBDEs is a concern in Korea. The profiles of PBDEs were characterized by the predominance of BDE 209, followed by nona- and octa-BDEs, which are consistent with the consumption patterns of products containing PBDEs in Korea. The concentrations of PCBs and some OCPs were significantly correlated with each other, whereas PBDEs showed low or moderate correlations with other POPs, suggesting differences in exposure routes and biotransformation potentials of the compounds studied. The concentrations of organochlorines and PBDEs were not correlated with subjects' age and body mass index. The results of this study provide baseline information on POPs in adipose tissues of the general population in Korea.
    Archives of Environmental Contamination and Toxicology 05/2011; 62(1):176-84. · 2.01 Impact Factor
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    ABSTRACT: We compared the clinical outcomes of laparoscopic surgery with those of laparotomy in second-look operations for ovarian cancer. We retrospectively reviewed the medical records of 35 patients treated between January 2000 and December 2005. They were categorized into two groups: Laparoscopy versus laparotomy group. Among 35 patients, 18 patients (51.4%) were treated with laparoscopy, and 17 patients (48.6%) were treated with laparotomy. There were no statistically significant differences except for hospital stay (laparoscopy vs. laparotomy five days vs. nine days, p < 0.05). Eight patients (44.4%) in the laparoscopy group and six (35.3%) in the laparotomy group were found to be pathologically positive after the second look operation. There were two recurrences (20.0%) in the laparoscopy group and four (36.4%) in the laparotomy group pathologically negative in the second-look operation (p = 0.557). There were no differences in disease-free survival rates (p = 0.705) between the two groups. The second look operation is an ideal method for histologic comfirmation of recurrent or persistent ovarian cancer. Laparoscopic surgery seems a safe and accurate method for the second-look examination, and can also reduce patient discomfort, hospital stay and morbidity associated with laparotomy.
    Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 03/2011; 20(6):346-51. · 1.33 Impact Factor
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    ABSTRACT: Reports on residue levels and accumulation profiles of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in human adipose tissue are scarce in Korea. In this study, concentrations and accumulation features of PCDD/Fs and DL-PCBs were determined in the samples of adipose tissue collected from Korean women in 2007-2008. The total dioxin-like toxic equivalent (TEQ) concentrations (3.4-42 pg g(-1) lipid wt) in Korean adipose tissues were similar to those reported in European and other Asian countries. The relative contributions of individual compounds to total TEQs were as follows: non-ortho PCBs (mean: 45%) > PCDFs (28%) > PCDDs (24%) > mono-ortho PCBs (3%), a pattern similar to those reported for seafoods in Korea. The dominant PCDD/F congeners found in adipose tissues were OCDD and 2,3,4,7,8-PeCDF and dominant PCBs were 118, 156 and 105. No correlation was found between subject's age and concentrations of dioxin-like contaminants. Body mass index was not correlated with concentrations of PCDD/Fs and was negatively (p < 0.001) correlated with concentrations of DL-PCBs. The results of this study provide baseline information on PCDD/Fs and DL-PCBs in adipose tissues of the general population in Korea.
    Journal of Environmental Monitoring 02/2011; 13(4):1096-101. · 2.09 Impact Factor
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    ABSTRACT: To determine the impact of uterine artery ligation in laparoscopic myomectomy, according to surgical results and clinical outcomes. Single-center, nonrandomized, comparative study. University hospital, tertiary referral center. Ninety women undergoing laparoscopic myomectomy. Laparoscopic myomectomy with or without uterine artery ligation. Surgical results and clinical outcomes. Fifty-one patients (56.6%) underwent laparoscopic myomectomy with uterine artery ligation (group A), and 39 patients (43.3%) underwent laparoscopic myomectomy alone (group B). The mean operating time was 100.0 ± 33.8 minutes in group A and 90.0 ± 37.1 minutes in group B. Both groups were similar with respect to mean blood loss (72.3 ± 109.0 mL vs. 62.6 ± 77.3 mL). The myoma recurrence rate in group A was significantly less than in group B after a median follow-up period of 11.1 months (2% vs. 13%). Both groups were similar with respect to surgical results. However, the recurrence rate was significantly lower in group A compared with group B.
    Fertility and sterility 02/2011; 95(2):775-8. · 3.97 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate a long-term follow-up data for oncologic results and surgical morbidity of a laparoscopic nerve-sparing radical hysterectomy (NSRH) in the treatment of FIGO stage IB cervical cancer. This was a retrospective study that comprised consecutive 125 patients with cervical cancer stage IB1 (n = 105) and IB2 (n = 20) who underwent a laparoscopic NSRH (Piver type III) by a gynecologic oncologist without selecting patients from January 1999 to December 2007. In regression analysis, the operating time (R linear = 0.311, P < 0.001) and estimated blood loss (R linear = 0.261, P < 0.001) were decreased, whereas the number of harvested pelvic lymph nodes (R linear = 0.250, P < 0.001) was increased. Seventeen patients (13.6%, 17/125) were found to have pelvic node metastasis. Para-aortic node metastasis had occurred in 2 patients (5.1%, 2/39). There were high urological complications (13/125, 10.4%) related to radical surgery. Forty-one patients (33%) needed transfusions. Positive surgical margins did not exist. Patients were able to self-void at a mean of 10.3 days postoperatively. The return rates to normal voiding function at postoperative 14 and 21 days were 92.0% and 95.2%, respectively. Thirteen patients (IB1 n = 9, IB2 n = 4) experienced a recurrence postoperatively. Six patients (IB1 n = 3, IB2 n = 3) died of recurrent disease. Five-year disease-free survival rates of cervical cancer IB1 and IB2 were 92% and 78%, respectively (P = 0.1772). Five-year overall survival rates of cervical cancer IB1 and IB2 were 96% and 83%, respectively (P = 0.0437). A laparoscopic NSRH for FIGO stage IB cervical cancer was comparable to open NSRH in terms of early recovery of bladder function. It did not compromise surgical radicality, but revealed high urological complications, long operating time, and much blood loss, compared with conventional radical hysterectomy. However, these surgical morbidities were corrected with increase in experiences.
    International Journal of Gynecological Cancer 02/2011; 21(2):355-62. · 1.94 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate the safety and feasibility of robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy using the da Vinci surgical system. Three patients who were diagnosed with early-stage cervical cancer underwent robotic uterine artery preservation and nerve-sparing radical trachelectomy with bilateral lymphadenectomy from January 2010 to March 2010. The data were compared with those of 4 cases of total laparoscopic nerve-sparing radical trachelectomy that were performed from July 2004 to May 2005 and were previously reported. In the robotic group, the mean console time was 275 minutes (range, 240-305 minutes). The mean postoperative hemoglobin change was 0.4 g/dL (range, 0.2-0.6 g/dL). The mean estimated blood loss was 23 mL (range, 15-40 mL), which is less than that of the laparoscopic group. There were no metastases detected in any of the cases, and the resection margins were negative in both groups. The robotic uterine artery preservation and nerve-sparing radical trachelectomy with pelvic lymphadenectomy were efficient in reducing blood loss and feasible methods such as other approaches.
    International Journal of Gynecological Cancer 02/2011; 21(2):391-6. · 1.94 Impact Factor
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    ABSTRACT: Uterine artery pseudoaneurysm is a rare disease and it can be diagnosed using conventional doppler ultrasongraphy. Damaged uterine arteries from cesarean section, myomectomy, dilatation & curettage, etc. are known as causes of the disease. Massive bleeding in the rupture can cause fatal result. We observed an increase in β-hCG and uterine artery pseudoaneurysm a year after the performance of dilatation & curettage for hydatidiform mole and treated it with arterial embolization and chemotherapy. We report the case and give a brief review of the literature.
    Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 01/2011; 20(1):50-3. · 1.33 Impact Factor
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    ABSTRACT: To evaluate the usefulness of serum albumin level as a marker of severity in pregnancy-related hypertension. Of 454 patients with pregnancy-related hypertension who were admitted to Kyungpook National University Hospital between May 1999 and April 2008, the medical records and laboratory tests of 354 patients who met the inclusion criteria for the current study were reviewed. A comparison of the characteristics of each hypertension group and the correlation between serum albumin levels and the time to delivery, 24-h urine protein, and/or pregnancy outcomes were statistically analyzed using SPSS 12.0 (SPSS Korea, Korea). Serum albumin level had a negative correlation with 24-h urine protein (Pearson's correlation coefficient = -0.481) and a positive correlation with time to delivery (= 0.389). Serum albumin ≤3.0 g/dL was highly associated with severe proteinuria (>2 g/day). There were significant differences in maternal or perinatal morbidity as a function of serum albumin level. If serum albumin level fell below 2.5 g/dL, the risks of ascites, hemolysis elevated liver enzyme low platelet (HELLP) syndrome and perinatal mortality significantly increased (odds ratio [OR] and 95% confidence interval [CI]: 3.5 [1.5-8.1], 12 [3.1-45], and 6.1 [1.7-22], respectively). Serum albumin level in pregnancy-related hypertension is a significant determinant of disease severity and may be considered as a useful marker for predicting time to delivery, severe proteinuria, and pregnancy outcomes.
    Journal of Obstetrics and Gynaecology Research 10/2010; 36(6):1165-73. · 0.84 Impact Factor
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    ABSTRACT: This workshop was held on July 31-August 1, 2010 and was organized to promote the academic environment and to enhance the communication among Asian countries prior to the 2nd biennial meeting of Australian Society of Gynaecologic Oncologists (ASGO), which will be held on November 3-5, 2011. We summarized the whole contents presented at the workshop. Regarding cervical cancer screening in Asia, particularly in low resource settings, and an update on human papillomavirus (HPV) vaccination was described for prevention and radical surgery overview, fertility sparing and less radical surgery, nerve sparing radical surgery and primary chemoradiotherapy in locally advanced cervical cancer, were discussed for management. As to surgical techniques, nerve sparing radical hysterectomy, optimal staging in early ovarian cancer, laparoscopic radical hysterectomy, one-port surgery and robotic surgery were introduced. After three topics of endometrial cancer, laparoscopic surgery versus open surgery, role of lymphadenectomy and fertility sparing treatment, there was a special additional time for clinical trials in Asia. Finally, chemotherapy including neo-adjuvant chemotherapy, optimal surgical management, and the basis of targeted therapy in ovarian cancer were presented.
    Journal of Gynecologic Oncology 09/2010; 21(3):137-50. · 1.73 Impact Factor

Publication Stats

118 Citations
49.15 Total Impact Points

Institutions

  • 2008–2014
    • Kyungpook National University Hospital
      • Department of Obstetrics and Gynecology
      Sŏul, Seoul, South Korea
  • 2011
    • Hanyang University
      • College of Science and Technology
      Sŏul, Seoul, South Korea
  • 2009–2010
    • Kyungpook National University
      • Department of Obstetrics and Gynecology
      Daikyū, Daegu, South Korea