Nam Kyu Kim

Yonsei University Hospital, Sŏul, Seoul, South Korea

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Publications (173)388.26 Total impact

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    ABSTRACT: Abstract Background: Actinomycosis is a chronic granulomatous infection characterized by variable presentations, including disease states that can mimic neoplastic disease. A case is presented of actinomycosis that resembled metastatic carcinoma of the ovary. Methods: Case report and review of pertinent English-language literature. Case Report: A 52-year-old female presented with a four-month history of abdominal discomfort and general weakness, and a two-month history of weight loss (8 kg). She had no history of medical disease. She had undergone exploratory laparotomy in the past because of ectopic pregnancy and she had used an intra-uterine contraceptive device for many years. Abdominal-pelvic computed tomography (CT) and pelvic magnetic resonance imaging (MRI) revealed a 5.9 × 6.4 cm heterogeneous enhancing pelvic soft tissue mass with central necrosis, probably arising from the left adnexa, and was consistent with ovarian cancer. She also had multiple peripheral enhancing cystic lesions in the pelvis, abdominal wall, both paracolic gutters, the root of the small bowel mesentery, the omentum, and Morison pouch. She had a moderate amount of ascites with diffuse peritoneal thickening consistent with carcinomatosis. An exploratory laparotomy was performed, showing multiple large abscesses with adhesions and a large soft tissue mass in the left pelvic cavity. After resection and drainage, final pathology was reported as actinomycosis. After her operation, she was given intravenous penicillin for six weeks and discharged. Conclusion: Surgeons and clinicians should be aware of this infectious disease because of its atypical symptoms and potential to mimic soft tissue tumors or malignant neoplasms.
    Surgical Infections 10/2014; · 1.87 Impact Factor
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    ABSTRACT: Associated with reduced trauma, laparoscopic colon surgery is an alternative to open surgery. Furthermore, complete mesocolic excision (CME) has been shown to provide superior nodal yield and offers the prospect of better oncological outcomes.
    Canadian journal of surgery. Journal canadien de chirurgie. 10/2014; 57(5):331-336.
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    ABSTRACT: The aim of this study was to investigate oncologic outcomes, as well as perioperative and pathologic outcomes, of single-incision laparoscopic anterior resection (SILAR) compared with conventional laparoscopic anterior resection (CLAR) for sigmoid colon cancer using propensity-score matching analysis.
    Annals of Surgical Oncology 09/2014; · 4.12 Impact Factor
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    ABSTRACT: Anorectal malignant melanoma (AMM) is a very rare and aggressive disease. The purpose of this article is to review the clinical features of AMM, to understand treatment options, and optimal therapy by reviewing pertinent literature. Traditionally an abdominoperineal resection (APR) sacrificing the anal sphincter has been performed for radical resection of cancer, but recently, wide excision of AMM is attempted since quality of life after surgery is an important issue. Some authors reported that there was no difference in five-year survival between the patient who underwent an APR and wide excision. The goal of both APR and wide excision was to improve survival with R0 resection. Adjuvant chemoradiation therapy can be performed to achieve an R0 resection. AMM shows very poor prognosis. At this time, research on AMM is insufficient to suggest a treatment guideline. Thus, treatment options, and a therapeutic method should be selected carefully.
    Annals of surgical treatment and research. 09/2014; 87(3):113-7.
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    ABSTRACT: Techniques for robotic resection of the left colon are not well defined and have not been widely adopted due to limited range of motion of the robotic arms. We have developed a dual docking technique for both the splenic flexure and the pelvis. We report our initial experience of robotic left colectomy using this technique for left-sided colon cancer.
    Surgical endoscopy. 08/2014;
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    ABSTRACT: Total mesorectal excision (TME) for rectal cancer can be challenging to perform in the presence of difficult pelvic anatomy. In our previous studies based on open and laparoscopic TME, we found that pelvic MRI-based pelvimetry could well reflect anatomical difficulty of the pelvis and operative time increased in direct proportion to the difficulty. We explored different outcomes of robotic surgery for TME based on classifications of difficult pelvic anatomies to determine whether this method can overcome these challenges.
    Surgical endoscopy. 08/2014;
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    Nam Kyu Kim
    Annals of coloproctology. 08/2014; 30(4):155-6.
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    ABSTRACT: To investigate the long-term oncologic outcomes and risk factors for adverse effects in right-sided colon cancer patients who underwent modified complete mesocolic excision (mCME).
    Annals of surgery. 07/2014;
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    ABSTRACT: Kruppel-like factor 4 (KLF4) is involved in many important cellular processes such as growth, development, differentiation, proliferation, and apoptosis. The purpose of this study was to determine the significance of KLF4 in both tumors and normal tissues of patients with colorectal cancer (CRC).
    World Journal of Surgical Oncology 07/2014; 12(1):232. · 1.09 Impact Factor
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    ABSTRACT: Laparoscopy offers some evidence of benefit compared to open rectal surgery. Robotic rectal surgery is evolving into an accepted approach. The objective was to analyze and compare laparoscopic and robotic rectal surgery learning curves with respect to operative times and perioperative outcomes for a novice minimally invasive colorectal surgeon.
    Surgical endoscopy. 07/2014;
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    ABSTRACT: Background: We examined cytokine profiles and evaluated the association between cytokine levels, pathological stages, and neutrophil/lymphocyte ratio (NLR). Materials and Methods: Patients with colorectal cancer (n=20, TNM stage I, II, and III) were enrolled. Levels of nine cytokines [interleukin (IL)-4,-6, -8, -10, -12, tumor necrosis factor-alpha (TNF-α), granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-gamma (IFN-γ), and vascular endothelial growth factor (VEGF)] were measured in serum, normal mucosa, and tumor using the Bio-Plex® cytokine assay. Results: The mean IL8, GM-CSF and VEGF levels were higher in tumors, whereas the mean IL6 level was higher in serum. Cytokine levels correlated with TNM stage (IL6 and IL8 in serum, and IL8 and VEGF in tumor) and with NLR (IL6 and IL8 in serum, and IL8 in tumor). Conclusion: Different cytokine profiles were observed in serum, normal mucosa, and tumor tissue. The elevation of specific cytokines in sera or tumors reflects features of advanced disease.
    Anticancer research 07/2014; 34(7):3481-7. · 1.71 Impact Factor
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    ABSTRACT: Robotic surgery has advantages to perform rectal cancer by its ergonomic designs and advanced technologies. However, it was uncertain whether these core robotic technologies could shorten the learning curve. The aim of this study is to investigate the learning curve of robotic rectal cancer surgery and to compare the learning curve phases with respect to perioperative clinicopathologic outcomes.
    Surgical endoscopy. 06/2014;
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    ABSTRACT: Compared to the stapling technique, the fold-over technique (FO) has the benefit of avoiding the sacrifice of the bowel segment. The aim of this study was to compare short-term outcomes between the FO and a conventional resection.
    Annals of coloproctology. 06/2014; 30(3):118-21.
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    ABSTRACT: Although the initial clinical efficacy of self-expandable metal stents is acceptable, doubt still remains about long-term clinical outcomes and complications. The aim of this study was to evaluate the stoma formation rate and risk factors for complications after successful stenting in patients with obstructive metastatic colorectal cancer. This was a tertiary-care center retrospective study. From January 2000 to December 2010, 130 patients with unresectable obstructive colorectal cancer received successful self-expandable metal stent placement. Among them, 14 patients received primary colectomy after successful stenting. Self-expandable metal stent placement and primary colectomy were performed. The stoma formation rate and complications were measured. In patients with successful stenting, stoma formation rates at 1 and 2 years were 15.6% (95% CI, 8.74-22.4) and 24.4% (95% CI, 13.8-35.0), and the median patency duration was 157 days (range, 2-1590 days). However, long-term complications occurred in 58 patients (44.6%), including reobstruction (32.6%), stent migration (10.3%), and perforation (7.8%), and a large number of reinterventions (45.7%) and hospitalizations (37/9%) were needed to manage complications. In multivariate analysis, primary colectomy after successful endoscopic stenting was a negative predictive factor for reobstruction (OR, 0.12; 95% CI, 0.02-0.99; p = 0.04). This was a retrospective, single-center study. To reduce stent-related late complications, primary colectomy after successful endoscopic stenting could be a therapeutic option in patients who have unresectable colorectal cancer with obstruction, especially in those who expect long-term survival.
    Diseases of the Colon & Rectum 06/2014; 57(6):694-9. · 3.34 Impact Factor
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    ABSTRACT: Numerous molecular markers have been investigated as potential predictors of tumor responses to preoperative chemoradiotherapy (preCRT) for rectal cancer. To develop a system in which biomarkers are used to predict the likelihood of a pathologic complete response (pCR) to preCRT. This is a retrospective analysis of tumor specimens collected prior to preCRT from 81 patients who underwent curative resection for primary rectal adenocarcinoma between June 2008 and February 2012. Using tissue microarrays and immunohistochemistry, expression levels of twelve candidate biomarkers (p53, p21, Bcl2, Bax, EGFR, Cox-2, MLH-1, MSH-2, Ku70, VEGF, TS, Ki-67) were evaluated in paraffin-embedded tumor samples collected before preCRT. The correlation between biomarker expression levels and the pathologic response to preCRT was assessed based on histopathological staging (pTNM) and tumor regression grade (TRG). Expression levels of 4 biomarkers (p53, VEGF, p21, Ki67) correlated with pCR. Patients showing low expression of p53 and/or high expression of VEGF, p21, and Ki67 exhibited a significantly greater pCR rate. A scoring system devised so that one point was given for each biomarker whose expression level correlated with pCR (score range: 0-4) showed that 1 of 26 patients with scores of 0 to 1 achieved pCR, whereas 26 of 55 patients with scores of 2 to 4 achieved pCR (3.8% vs. 47.3%, p < 0.001). For prediction of pCR, the scoring system showed 96.3% sensitivity, 46.3% specificity, a 47.3% positive predictive value, and a 96.2% negative predictive value. Immunohistochemistry has limitations related to reproducibility and the ability to provide quantitative information. In addition, this study lacks test and validation sets. Expression levels of 4 biomarkers correlated with pCR after preCRT for rectal cancer. A scoring system based on levels of biomarker expression showed good sensitivity and negative predictive value for pCR.
    Diseases of the Colon & Rectum 05/2014; 57(5):592-601. · 3.34 Impact Factor
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    ABSTRACT: The objective of this study is to ascertain the impact of laparoscopic colorectal surgery (LCS) experience on the learning curve of robotic rectal cancer surgery (RRS). Whether LCS experience is mandatory on overcoming the learning curve of RRS or not remains undetermined. Before starting the robotic procedure, surgeon A had a limited experience of less than 30 LCS cases, whereas surgeon B had performed more than 300 cases of LCS. From the beginning, 100 consecutive, unselected RRS cases performed by each of the two surgeons were retrospectively analyzed (groups A and B). Perioperative surgical and oncologic outcomes were compared between the two groups. Clinicopathological characteristics between the two groups were similar. One case in group A was converted to open surgery. Mean operation time was shorter in group A than that of group B (272 vs. 344 min, p < 0.001). Overall perioperative morbidity rates were not different between the two groups (17.0 vs. 10.0 %, p = 0.214). There was no difference of circumferential resection margin positivity rate and retrieved lymph node numbers. In group A, the operation time decreased with a steep slope until 17 cases on the moving average curve. The slope in group B maintained a steady state and showed no remarkable changes throughout the study period. A one-step transition from open to robotic rectal cancer surgery can be achieved without having extensive prior laparoscopic experience.
    International Journal of Colorectal Disease 04/2014; · 2.24 Impact Factor
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    ABSTRACT: This study aimed to assess the learning curve in laparoscopic right hemicolectomy and compare the long-term oncologic outcomes of the learning curve period. We retrospectively reviewed 97 patients who underwent a laparoscopic right hemicolectomy by a single surgeon between July 2006 and January 2009. Among them, 87 patients, excluding patients with stage IV (n=10) disease, were evaluated for long-term oncologic outcomes. They were divided into 2 phases: phase 1 (the learning curve period) and phase 2 (the expert period). The cumulative sum method was used for estimating the learning curve. The learning curve was determined at the 42nd case. Patient characteristics and postoperative clinicopathologic outcomes were similar in both groups except for the operation time (212.5±65.0 min vs. 146.4±37.1 min; P<0.001) and length of stay (10.7±5.4 d vs. 8.4±2.9 d; P=0.015). The 5-year overall survival rates were similar in both groups throughout all stages. The 5-year disease-free survival rate of stage III disease in phase 2 (85%) was better than that of phase 1 (53.3%; P=0.046). Laparoscopic right hemicolectomy during the learning curve period showed acceptable clinicopathologic outcomes. However, the 5-year disease-free survival rate was compromised in patients with stage III disease in phase I.
    Surgical laparoscopy, endoscopy & percutaneous techniques 04/2014; · 0.88 Impact Factor
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    ABSTRACT: The aim of this study was to compare the outcomes in colorectal cancer (CRC) patients with synchronous unresectable metastases who received either primary tumor resection (PTR) or chemotherapy as the first treatment and to investigate the clinical course of asymptomatic patients who received chemotherapy as the first treatment. We retrospectively analyzed 324 CRC patients with synchronous unresectable metastases. Overall survival (OS) was analyzed for the two groups (upfront PTR group [n = 72] vs. upfront chemotherapy group [n = 252]). Surgical morbidity and mortality were recorded. In the asymptomatic patients who received upfront chemotherapy, the incidences of primary tumor-related complications were analyzed. In patients who underwent PTR as the first treatment, the median OS period was superior to those who received upfront chemotherapy (17.2 vs. 13.6 months, P = 0.002). In the PTR group, surgical morbidity and mortality were 11.6% and 1.9%, respectively. Of the 252 asymptomatic patients, the incidence of primary tumor-related complications was 35%. Emergent surgery was ultimately done in 14% of the 252 patients. CRC patients with synchronous unresectable metastases who underwent PTR followed by chemotherapy had significantly longer survival times compared to patients who received chemotherapy as the first treatment. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 03/2014; · 2.64 Impact Factor
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    ABSTRACT: The aim of this study is to evaluate long-term oncologic outcomes of robotic surgery for rectal cancer compared with laparoscopic surgery at a single institution. Robotic surgery is regarded as a new modality to surpass the technical limitations of conventional surgery. Short-term outcomes of robotic surgery for rectal cancer were acceptable in previous reports. However, evidence of long-term feasibility and oncologic safety is required. Between April 2006 and August 2011, 217 patients who underwent minimally invasive surgery for rectal cancer with stage I-III disease were enrolled prospectively (robot, n = 133; laparoscopy, n = 84). Median follow-up period was 58 months (range, 4-80 months). Perioperative clinicopathologic outcomes, morbidities, 5-year survival rates, prognostic factors, and cost were evaluated. Perioperative clinicopathologic outcomes demonstrated no significant differences except for the conversion rate and length of hospital stay. The 5-year overall survival rate was 92.8% in robotic, and 93.5% in laparoscopic surgical procedures (P = 0.829). The 5-year disease-free survival rate was 81.9% and 78.7%, respectively (P = 0.547). Local recurrence was similar: 2.3% and 1.2% (P = 0.649). According to the univariate analysis, this type of surgical approach was not a prognostic factor for long-term survival. The patient's mean payment for robotic surgery was approximately 2.34 times higher than laparoscopic surgery. No significant differences were found in the 5-year overall, disease-free survival and local recurrence rates between robotic and laparoscopic surgical procedures. We concluded that robotic surgery for rectal cancer failed to offer any oncologic or clinical benefits as compared with laparoscopy despite an increased cost.
    Annals of surgery 03/2014; · 7.90 Impact Factor
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    ABSTRACT: A concept of complete mesocolic excision (CME) and central vascular ligation for colonic cancer has been recently introduced. The aim of this study was to evaluate and compare perioperative and oncologic outcomes after laparoscopic-assisted CME (LCME) and open CME (OCME) for right-sided colon cancers. The study group included 128 patients who underwent an LCME and 137 patients who underwent an OCME for right-sided colon cancer between June 2006 and December 2008. The propensity scoring matching for sex, body mass index, tumor location, and pathologic T and TNM stage produced 85 matched pairs. The median time to soft diet (LCME 6 days vs. OCME 7 days, p < 0.001) and the possible length of stay (7 vs. 13 days, p < 0.001) were significantly shorter in the laparoscopic group. The median operation time (179 vs. 194 minutes, p = 0.862) and number of harvested lymph nodes (27 vs. 28, p = 0.337) were comparable between groups. The morbidity within 30 days after surgery was comparable between the groups (12.9 vs. 24.7 %, p = 0.050). The 5-year overall survival rates of the OCME and LCME groups were 77.8 and 90.3 % (p = 0.028), and the 5-year disease-free survival rates were 71.8 and 83.3 % (p = 0.578), respectively. Herein, we demonstrated the feasibility and safety of LCME for right-sided colon cancer, and in terms of better short-term outcomes, LCME was more advantageous than OCME. Although LCME for right-sided colon cancer was associated with better 5-year overall survival, compared with an open approach, the long-term oncologic outcomes between the groups were comparable.
    Annals of Surgical Oncology 03/2014; · 4.12 Impact Factor

Publication Stats

1k Citations
388.26 Total Impact Points

Institutions

  • 2002–2014
    • Yonsei University Hospital
      • • Surgery
      • • Department of Internal Medicine
      Sŏul, Seoul, South Korea
    • Yonsei University
      • • Department of Sport and Leisure Studies
      • • Department of Surgery
      • • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2013
    • Dana-Farber Cancer Institute
      • Department of Medical Oncology
      Boston, MA, United States
  • 2010–2012
    • Korea Institute of Radiological & Medical Sciences
      Sŏul, Seoul, South Korea
    • Chungnam National University Hospital
      Sŏul, Seoul, South Korea
  • 2011
    • Gachon University
      • Department of Surgery
      Seongnam, Gyeonggi, South Korea
    • CHA University
      Seoul, Seoul, South Korea
  • 2008
    • Wonju Severance Christian Hospital
      Genshū, Gangwon, South Korea
  • 2004
    • National Cancer Center Korea
      • Colorectal Cancer Branch
      Goyang, Gyeonggi, South Korea