Wook Kim

Catholic University of Korea, Sŏul, Seoul, South Korea

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Publications (54)136.03 Total impact

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    ABSTRACT: [This corrects the article on p. 123 in vol. 84.].
    Annals of surgical treatment and research. 07/2014; 87(1):51-52.
  • Liver international: official journal of the International Association for the Study of the Liver 05/2014; 34(5). · 3.87 Impact Factor
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    ABSTRACT: Adrenal metastasis following gastrectomy for gastric cancer is often encountered as part of advanced systemic dissemination, which is usually unresectable. Thus, there are very few published case reports describing metastasectomy for adrenal metastasis from gastric cancer. Herein we present our experience in treating two patients diagnosed and treated for adrenal metastasis 6 years following initial surgery for advanced gastric cancer (pT2bN1M0 and pT2bN0M0, respectively, according to the classification system set forth in the sixth edition of The TNM Classification of Malignant Tumours by the International Union against Cancer). They underwent successful en bloc R0 resections, followed by systemic chemotherapy with close postoperative follow-up for another recurrence, and have remained alive without recurrence for 1 year. These results suggest that active surgical treatment for resectable metastatic gastric cancer in the adrenal glands has an important role in prolonging survival in selected patients.
    World Journal of Surgical Oncology 04/2014; 12(1):116. · 1.09 Impact Factor
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    ABSTRACT: The present study aims to elucidate the treatment strategies of laparoscopic resection for gastroduodenal submucosal tumors (SMTs). Data of 125 gastroduodenal STMs were collected retrospectively resected from August, 2004 to February, 2013. Surgical outcomes according to tumor locations, pathologic results and survival data for gastrointestinal stromal tumors (GISTs) were collected and analyzed. There were 55 male and 70 female patients with mean age 57.9 ± 12.7 years old. Mean tumor size of gastric SMTs was 2.7 ± 1.64 cm (range, 0.4-8.5 cm). GIST was the most common (n = 70, 56%). Regarding the tumor location, all the fundic lesions were GISTs and leiomyoma was occurred 58.8% of cardiac lesions. Ectopic pancreas and schwannomas were mostly located at body portion, 73% and 80%, respectively. SMTs located at duodenal bulb comprise 4 GISTs and 3 carcinoids. Surgical results comparing between lesions located at cardia, near-pylorus and else had no difference in operation time, hospital stay and complications. In terms of outcome of GIST, all patients underwent curative resection except one case of peritoneal sarcomatosis. There was one recurrence in a high risk group following resection. The cumulative 5-year disease free survival rate was 93.5% in all GISTs. There were two postoperative complications, one gastric outlet obstruction and one leakage following wedge resection. Laparoscopic wedge resection is a safe and feasible procedure for the small to medium sized gastroduodenal SMTs even their locations are near cardia or pylorus.
    Annals of surgical treatment and research. 04/2014; 86(4):199-205.
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    ABSTRACT: Minimally invasive surgery has been slowly introduced into the field of advanced gastric cancer (AGC) surgery. However, the appropriate extent of omentectomy during laparoscopic gastrectomy for AGC is unknown. From July 2004 to December 2011, 146 patients with serosa-negative advanced gastric cancer were divided into the total omentectomy group (TO group, n = 80) and the partial omentectomy group (PO group, n = 66). The clinicopathologic characteristics, surgical outcomes, recurrence pattern and survival were analyzed. There were no significant differences in the clinicopathologic features between the two groups, except for depth of invasion; more T3 (subserosal invasion) cases (65%) were included in total omentectomy group (P = 0.011). The mean time for PO was significantly shorter (35.1 +/- 13.0 min) than TO (50.9 +/- 15.3 min) (P <0.001), and there were two omentectomy-related complications in the TO group: spleen and mesocolon injuries. Recurrence occurred in 14 (17.5%) and 5 (7.6%) cases in the TO and PO group, respectively (P = 0.054). Disease-free survival (TO versus PO: 81.5% versus 89.3%, P = 0.420) and disease-specific survival (TO versus PO: 89% versus 94.7%) were not significantly different between the two groups. In the case-matched analysis using propensity score matching, there was no difference in disease-free survival (TO versus PO: 83.3% versus 90.5%, P = 0.442). Partial omentectomy might be an oncologically safe procedure during laparoscopic gastrectomy for serosa-negative advanced gastric cancer, similar to early gastric cancer.
    World Journal of Surgical Oncology 03/2014; 12(1):64. · 1.09 Impact Factor
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    ABSTRACT: Aims/IntroductionLittle is known about the long-term effects of Roux-en-Y gastric bypass (RYGB) in severely obese Asian individuals.Methods and MaterialsA total of 33 severely obese patients with type 2 diabetes underwent RYGB. All patients were followed up for 2 years. Visceral and abdominal subcutaneous fat areas were assessed using computed tomography (CT) before, and 12 and 24 months after RYGB. The muscle attenuation (MA) of paraspinous muscles observed by CT were used as indices of intramuscular fat.ResultsThe mean percentage weight loss was 22.2 ± 5.3% at 12 months, and 21.3 ± 5.1% at 24 months after surgery. Compared with the baseline values, the visceral fat area was 53.6 ± 17.1% lower 24 months after surgery, and the abdominal subcutaneous fat area was 32.7 ± 16.1% lower 24 months after surgery. The MA increased from 48.7 ± 10.0 at baseline to 52.2 ± 8.9 (P = 0.009) 12 months after surgery. The MA after the first 12 months maintained changes until 24 months. Triglycerides and free fatty acids were reduced after surgery, whereas the high-density lipoprotein cholesterol levels were increased significantly after surgery. At the last follow-up visit, 18 patients (55%) had diabetes remission. The percentage of iron and vitamin D deficiency was 30% and 52%, respectively.Conclusions We found that patients subjected to RYGB had significant sustained reductions in visceral and intramuscular fat. There were durable improvements in the cardiometabolic abnormalities without any significant comorbidities. However, there were mild nutritional deficiencies in these patients despite daily supplementation with multivitamins and minerals.
    Journal of Diabetes Investigation. 03/2014; 5(2).
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    ABSTRACT: The oncologic outcomes of laparoscopy-assisted gastrectomy for the treatment of gastric cancer have not been evaluated. The aim of this study is to validate the efficacy and safety of laparoscopic gastrectomy for gastric cancer in terms of long-term survival, morbidity, and mortality retrospectively. The study group comprised 2,976 patients who were treated with curative intent either by laparoscopic gastrectomy (1,477 patients) or open gastrectomy (1,499 patients) between April 1998 and December 2005. The long-term 5-year actual survival analysis in case-control and case-matched population was conducted using the Kaplan-Meier method. The morbidity and mortality and learning curves were evaluated. In the case-control study, the overall survival, disease-specific survival, and recurrence-free survival (median follow-up period, 70.8 months) were not statistically different at each cancer stage with the exception of an increased overall survival rate for patients with stage IA cancer treated via laparoscopy (laparoscopic group; 95.3%, open group: 90.3%; P < .001). After matching using a propensity scoring system, the overall survival, disease-specific survival, and recurrence-free survival rates were not statistically different at each stage. The morbidity of the case-matched group was 15.1% in the open group and 12.5% in the laparoscopic group, which also had no statistical significance (P = .184). The mortality rate was also not statistically significant (0.3% in the open group and 0.5% in the laparoscopic group; P = 1.000). The mean learning curve was 42. The long-term oncologic outcomes of laparoscopic gastrectomy for patients with gastric cancer were comparable to those of open gastrectomy in a large-scale, multicenter, retrospective clinical study.
    Journal of Clinical Oncology 01/2014; · 18.04 Impact Factor
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    ABSTRACT: Peritoneal dissemination is one of the treatment failures following gastric cancer surgery. We present a case with very early peritoneal recurrence, detected 8 days following curative surgery. A 39-year-old man, with Borrmann-4 advanced gastric cancer with signet ring cell type, underwent curative open total gastrectomy. However, focal peritoneal nodules on the left side of the diaphragmatic surface, which did not exist at the initial operation, were incidentally found during the reoperation for a postoperative intestinal obstruction via a laparoscopic approach. The pathologic result of the biopsied nodule revealed signet ring cell carcinoma. The patient underwent combination chemotherapy for several months without tumor regression. He suffered from intestinal obstruction again due to carcinomatosis peritonei, and died 9 months following initial surgery. Through this case report, we can carefully suspect that very early progression of cancer cells to carcinomatosis can occur in just several days after an operation.
    Annals of surgical treatment and research. 01/2014; 86(1):45-9.
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    ABSTRACT: An 85 year male patient complaining epigastric discomfort was admitted. From the esophagogastroduodenoscopy, three early gastric cancer (EGCa) lesions had been identified and these were diagnosed as adenocarcinoma with poorly differentiated cell type. The patient underwent operation. From the post-operative mapping, however, additional 4 EGCa lesions were found, and the patient was diagnosed with 7 synchronous EGCa. Out of the 7 EGCa lesions, 6 had shown invasion only to the mucosal layer and one had shown invasion into the 1/3 layer of submucosa. In spite of such superficial invasions, 28 of 48 lymph nodes had been identified as metastases. The multiple lesions of EGCa do not increase the risk of lymph node metastasis, but if their differentiations are poor or if they have lympho-vascular invasion, multiple lymph node metastases could incur even if the depth of invasion is limited to the mucosal layer or the upper portion of the submucosal layer.
    World Journal of Gastroenterology 11/2013; 19(44):8141-5. · 2.55 Impact Factor
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    ABSTRACT: There have been several attempts to develop a unique and easier way to perform esophagojejunostomy during laparoscopy-assisted total gastrectomy or laparoscopy-assisted proximal gastrectomy. The OrVilTM system (Covidien, Mansfield, MA, USA) is one of those methods, but its technical and oncologic feasibility have not been proven and need to be observed. Among 87 patients who underwent laparoscopy-assisted total gastrectomy (LATG; 79 cases) and laparoscopy-assisted proximal gastrectomy with double tract anastomosis (LAPG_DT; 8 cases) from April 2004, 47 patients underwent the conventional extracorporeal method (Group I; 2004--2008) were compared with 40 patients treated with the intracorporeal OrVilTM system (Group II; 2009--2012). There was no significant difference in clinicopathologic characteristics between the two groups except tumor location; more cardia lesions were involved in group II (p = 0.012). The mean time for esophagojejunostomy (E-J), defined as the time from anvil insertion to closure of the jejunal entry site has no significant difference (Group I vs II: 22.2 +/- 3.2 min vs 18.6 +/- 3.5 min, p = 0.623). In terms of anastomotic complication, there was no significant difference in E-J leakage and stricture. E-J leakage occurred in 2 out of 47 (4.3%) cases in group I and 2 out of 40 (5%) in group II (p = 0.628); half of them were treated conservatively in each group and the others underwent reoperation. E-J stricture occurred in 2 (4.3%) cases in group I and 1 (2.5%) in group II (p = 0.561), which required postoperative gastrofiberscopic balloon dilatation. Esophagojejunostomy using the OrVilTM system was a feasible and safe technique compared with the conventional extracorporeal method through mini-laparotomy in terms of anastomotic complications. Moreover, it can help to reduce surgeon's stress regarding esophagojejunostomy because it needs no purse-string procedure and serves a secure operation view laparoscopically.
    World Journal of Surgical Oncology 08/2013; 11(1):209. · 1.09 Impact Factor
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    ABSTRACT: Afferent loop (A-loop) obstruction is an uncommon postgastrectomy complication following Billroth-II (B-II) or Roux-en-Y reconstruction. Moreover, its development after laparoscopic gastrectomy has not been reported. Here we report 4 cases of A-loop obstructions after laparoscopic distal gastrectomy (LDG) with B-II reconstruction. Among the 396 patients who underwent LDG with a B-II anastomosis between April 2004 and December 2011, 4 patients had A-loop obstruction. Their data were obtained from a prospectively maintained institutional database and analyzed for outcomes. Four patients (1.01%) developed A-loop obstruction. All were male, and their median age was 52 years (range, 30 to 73 years). The interval between the initial gastrectomies and the operation for A-loop obstruction ranged from 4 to 540 days (median, 33 days). All 4 patients had symptoms of vomiting and abdominal pain and were diagnosed by abdominal computed tomographic (CT) scan. The causes of the A-loop obstructions were adhesions (2 cases) and internal herniations (2 cases) that were treated with Braun anastomoses and reduction of the herniated small bowels, respectively. All patients recovered following the emergency operations. A-loop obstruction is a rare but serious complication following laparoscopic and open gastrectomy. It should be considered when a patient complains of continuous abdominal pain and/or vomiting after LDG with B-II reconstruction. Prompt CT scan may play an important role in diagnosis and treatment.
    Journal of the Korean Surgical Society 05/2013; 84(5):281-6. · 0.21 Impact Factor
  • Dong Jin Kim, Wook Kim
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    ABSTRACT: Although the absolute indication for endoscopic resection (ER) in gastric cancer is widely accepted, expanded indication for endoscopic submucosal dissection (ESD) is still regarded as investigational because of the risk of concomitant lymph node (LN) metastasis or recurrence following ESD. However, LN metastasis in early gastric cancer confined to absolute indication for ER cannot be negligible. Herein we report a 72-year-old man who underwent laparoscopic distal gastrectomy for LN metastasis around the common hepatic artery following curative ESD to the lesion that had met as an absolute indication for ER 1 year ago. There was only one metastatic LN near the common hepatic artery (LN 8), without malignancy at the ESD site or other harvested LNs.
    Gastric Cancer 04/2013; · 3.99 Impact Factor
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    ABSTRACT: Abstract Background: Single-incision laparoscopic surgery is a new procedure used to treat a variety of diseases requiring surgical intervention. The aim of this prospective comparative study is to compare the technical feasibility and safety of single-incision and three-port laparoscopic appendectomy. Study Design: Between February 2009 and April 2010, 102 patients with appendicitis were enrolled in this study. The patients were randomly assigned to two groups: single-incision or three-port laparoscopic appendectomy. Patients with perforated appendicitis were not excluded. We analyzed the patients' clinical characteristics and surgical outcomes. Results: There were no significant differences in preoperative patient demographics between the two groups with respect to body mass index (22.03±4.07 kg/m2 in the single-incision group versus 21.97±3.49 kg/m2 in the three-port group, P=.930). The pain score on the visual analog scale on postoperative Day 1 was significantly lower in the single-incision group than in the three-port group (3.22±1.22 versus 3.90±1.46, P=.012). Additionally, recovery time to daily life was significantly shorter in the single-incision group than in the three-port group (3.22±1.04 versus 3.94±1.43 days, P=.005). In patients with perforated appendicitis, the single-incision procedure took approximately 10 minutes less than the three-port procedure (44.11±7.75 versus 54.14±32.21 minutes, P=.449), and the postoperative hospital stay (P=.033) and recovery time to daily life (P=.001) were significantly shorter in the single-incision group. Conclusions: Single-incision laparoscopic appendectomy is a feasible and safe procedure, even in patients with perforated appendicitis, and this procedure is even less invasive than three-port laparoscopic surgical techniques.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 03/2013; · 1.07 Impact Factor
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    ABSTRACT: A randomized controlled trial to evaluate the long-term outcomes of laparoscopic distal gastrectomy for gastric cancer is currently ongoing in Korea. Patients with cT1N0M0-cT2aN0M0 (American Joint Committee on Cancer, 6th edition) distal gastric cancer were randomized to receive either laparoscopic or open distal gastrectomy. For surgical quality control, the surgeons participating in this trial had to have performed at least 50 cases each of laparoscopy-assisted distal gastrectomy and open distal gastrectomy and their institutions should have performed more than 80 cases each of both procedures each year. Fifteen surgeons from 12 institutions recruited 1,415 patients. The primary endpoint is overall survival. The secondary endpoints are disease-free survival, morbidity, mortality, quality of life, inflammatory and immune responses, and cost-effectiveness (ClinicalTrials.gov ID: NCT00452751).
    Journal of the Korean Surgical Society 02/2013; 84(2):123-30. · 0.21 Impact Factor
  • Junhyun Lee, Wook Kim
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    ABSTRACT: BACKGROUND: Laparoscopic gastrectomy (LG) for locally advanced gastric cancer (AGC) as well as early gastric cancer (EGC) has gradually gained popularity. However, long-term experiences of LG for AGC as well as EGC rarely have been reported. METHODS: A total of 528 patients with gastric cancer were enrolled in the study, and clinical experiences of LG were evaluated. RESULTS: The study included 332 men and 196 women. The mean age was 61.3 ± 11.8 years. Of the 528 patients, 432 underwent distal gastrectomy, 87 had a total gastrectomy, and 9 had a proximal gastrectomy. There were 198 T1a, 139 T1b, 63 T2, 83 T3, and 45 T4a lesions. In 127 patients, lymph node metastasis was observed, and the rate of it was 1.5% in T1a, 12.2% in T1b, 34.9% in T2, 59.0% in T3, and 80.0% in T4a. The median follow-up period was 24 months (range, 1-83 months). The 5-year survival and disease-free survival rates according to the stage of tumor were 99.3% and 97.8% in stage I, 95.4% and 89.7% in stage II, and 44.4% and 31.3% in stage III, respectively. Operation related morbidities occurred in 45 patients, and there were 2 mortalities. Tumors recurred in 36 patients consisting of 2 in T1a, 2 T1b, 2 T2, 12 T3, and 18 T4a. Carcinomatosis peritonei was observed most commonly. CONCLUSION: In our experience, oncologic results and the safety of LG for EGC and serosa-negative AGC were acceptable. This treatment may be considered as an alternative operative approach.
    Surgery 01/2013; · 3.37 Impact Factor
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    ABSTRACT: Serum bone morphogenic protein- (BMP-) 4 levels are associated with human adiposity. The aim of this study was to investigate changes in serum levels of BMP-4 and inflammatory cytokines after Roux-en-Y gastric bypass (RYGB). Fifty-seven patients with type 2 diabetes underwent RYGB. Serum levels of BMP-4 and various inflammatory markers, including high-sensitivity C-reactive protein (hsCRP), free fatty acids (FFAs), and plasminogen activator inhibitor- (PAI-) 1, were measured before and 12 months after RYGB. Remission was defined as glycated hemoglobin <6.5% for at least 1 year in the absence of medications. Levels of PAI-1, hsCRP, and FFAs were significantly decreased at 1 year after RYGB. BMP-4 levels were also significantly lower at 1 year after RYGB than at baseline (P = 0.024). Of the 57 patients, 40 (70%) had diabetes remission at 1 year after surgery (remission group). Compared with patients in the nonremission group, patients in the remission group had lower PAI-1 levels and smaller visceral fat areas at baseline. There was a difference in the change in the BMP-4 level according to remission status. Our data demonstrate a significant beneficial effect of bariatric surgery on established cardiovascular risk factors and a reduction in chronic nonspecific inflammation after surgery.
    International Journal of Endocrinology 01/2013; 2013:681205. · 2.52 Impact Factor
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    ABSTRACT: Although laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy for early gastric cancer (EGC) is technically feasible and oncologically safe, it has not been popularized because of the frequent occurrence of reflux esophagitis associated with loss of the lower esophageal sphincter (LES). Herein, we present surgical outcomes in patients with LES-preserving LAPG (LES-p LAPG), which may contribute to protecting against postoperative gastroesophageal reflux or stricture in the treatment of proximal EGC. From November 2009 to May 2010, LES-p LAPG was performed in nine patients with clinical EGC, located at the proximal one-third of the stomach with the upper margin of the tumor 3-4 cm from the esophagogastric junction. After the resection of the proximal stomach with D1 + β lymph node dissection, gastrogastrostomy was performed using a 25-mm circular stapler through a mini-laparotomy wound at the epigastrium. The median operating time was 137.5 min (range 120-180). The median number of retrieved lymph nodes and length of the proximal resection margin were 27 (range 7-49) and 2.4 cm (range 0.7-5), respectively. The postoperative complications included one gastrogastrostomy stricture and one case of leakage, which were managed by endoscopic balloon dilation and conservative treatment, respectively. None of the patients suffered from symptoms of reflux esophagitis during the follow-up period (median 15 months; range 8-28 months). This technique of LES-p LAPG for the treatment of proximal EGC could be a simple, safe, and useful technique to prevent esophageal reflux or stricture. This technique requires prospective validation.
    Gastric Cancer 10/2012; · 3.99 Impact Factor
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    ABSTRACT: Gastroduodenal intussusception is an infrequent cause of gastrointestinal obstructive disease. Benign neoplasms, gastrointestinal stromal tumors and pedunculated adenocarcinomas of less than 5 cm have been reported to cause gastroduodenal intussusception. We report a case of 76-year-old woman who was presented with a 3-day history of nausea and vomiting due to upper gastrointestinal obstruction. Computed tomography revealed gastroduodenal intussusception with the transpyloric herniation of alarge gastric hyperplastic polyp. The patient underwent laparoscopic wedge resection with the eversion method.
    Journal of gastric cancer. 09/2012; 12(3):201-4.
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    ABSTRACT: Although various bariatric surgeries are widely known for their effect of ameliorating type 2 diabetes mellitus (T2DM), there are only a few reports demonstrating the effect of duodenojejunal bypass on T2DM. The aim of this study was to evaluate and report the clinical effects of laparoscopic duodenojejunal bypass (LDJB) in non-morbidly obese patients with T2DM. Twelve non-morbidly obese patients with T2DM underwent LDJB. Changes in fasting blood glucose, body mass index glycosylated hemoglobin (HbA1c), and dose of antidiabetic medications were recorded prospectively during a 1-year period. Reduction in HbA1c occurred 3 months after surgery and was maintained up to 1 year, and hyperglycemia was reversed within 1 month after surgery and remained controlled at 12 months. BMI decreased significantly 1 month after surgery and then remained steady through the year. Three patients (25.0 %) stopped antidiabetic medication, seven (58.3 %) patients maintained or decreased doses, and two (16.7 %) increased doses. Seven (58.3 %) patients had a decline in HbA1c. LDJB demonstrated a glycemic control effect up to 1 year on T2DM in non-morbidly obese patients.
    Surgical Endoscopy 06/2012; 26(11):3287-92. · 3.43 Impact Factor
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    ABSTRACT: In laparoscopic distal gastrectomy for gastric cancer, most surgeons prefer extra-corporeal anastomosis because of technical challenges and unfamiliarity with intra-corporeal anastomosis. Herein, we report the feasibility and safety of intra-corporeal Billroth-II anastomosis in gastric cancer. From April 2004 to March 2011, 130 underwent totally laparoscopic distal gastrectomy with intra-corporeal Billroth-II reconstruction, and 269 patients underwent laparoscopy-assisted distal gastrectomy with extra-corporeal Billroth-II reconstruction. Surgical efficacies and outcomes between two groups were compared. There were no differences in demographics and clinicopathological characteristics. The mean operation and reconstruction times of totally laparoscopic distal gastrectomy were statistically shorter than laparoscopy-assisted distal gastrectomy (P = 0.019; P < 0.001). Anastomosis-related complications were observed in 11 (8.5%) totally laparoscopic distal gastrectomy and 21 (7.8%) laparoscopy-assisted distal gastrectomy patients, and the incidence of these events was not significantly different. Post-operative hospital stays for totally laparoscopic distal gastrectomy were shorter than laparoscopy-assisted distal gastrectomy patients (8.3 ± 3.2 days vs. 9.9 ± 5.3 days, respectively; P = 0.016), and the number of times parenteral analgesic administration was required in laparoscopy-assisted distal gastrectomy patients was more frequent after surgery. Intra-corporeal Billroth-II anastomosis is a feasible procedure and can be safely performed with the proper experience for laparoscopic distal gastrectomy. This method may be less time consuming and may produce a more cosmetic result.
    Journal of the Korean Surgical Society. 03/2012; 82(3):135-42.

Publication Stats

700 Citations
136.03 Total Impact Points

Institutions

  • 2004–2014
    • Catholic University of Korea
      • • Department of Internal Medicine
      • • College of Medicine
      Sŏul, Seoul, South Korea
  • 2011
    • Incheon St. Mary’s Hospital, Catholic Medical Center
      Bucheon, Gyeonggi Province, South Korea
  • 2010
    • Ajou University
      • School of Medicine
      Seoul, Seoul, South Korea