Taeil Son

Eulji University, Sŏul, Seoul, South Korea

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Publications (14)42.48 Total impact

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    ABSTRACT: Although various liver-directed treatment modalities, such as liver resection and radiofrequency ablation (RFA), have been applied to treat liver metastases from gastric cancer, optimal management of them remains controversial. In patients with liver metastasis from gastric cancer, we investigated the short- and long-term outcomes of liver resection and RFA and analyzed factors influencing survival. A total of 98 gastric cancer patients with liver metastasis and no extrahepatic disease were treated by liver resection (n = 68) or RFA (n = 30). Short- and long-term outcomes were evaluated retrospectively for each of the liver-directed treatments. Severe complication rates did not differ between liver resection (18 %) and RFA (10 %) (p = 0.333). Only one treatment-related mortality occurred in the liver resection group. No statistically significant difference in survival was noted between the treatment groups. Median overall survival after liver resection was 24 months, with 3-year overall and progression-free survival rates of 40.6 % and 30.4 %, respectively. Median overall survival after RFA was 23 months, with 3-year overall and progression-free survival rates of 43.0 % and 37.4 %, respectively. Only the size of the metastases was shown to be an independent prognostic factor for gastric cancer patients with liver metastasis. In select patients with liver metastasis from gastric cancer, liver resection and RFA showed satisfactory and comparable short- and long-term results. Thus, systemic chemotherapy may not be the only therapeutic option for patients with liver metastasis, and possible liver-directed treatment options for such patients should be considered on an individual basis.
    Gastric Cancer 08/2015; DOI:10.1007/s10120-015-0522-z · 4.83 Impact Factor
  • Taeil Son · Woo Jin Hyung
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    ABSTRACT: Robotic surgery for gastric cancer overcomes technical difficulties with laparoscopic gastrectomy. Its benefits include reduced intraoperative bleeding and shorter hospital stays; it is also easier to learn. Because accuracy increases during lymphadenectomy, a larger number of lymph nodes is likely to be retrieved using robotic gastrectomy. Higher costs and longer operation times have hindered the widespread adaptation and use of robotic surgery. In this review, we summarize the current status and issues regarding robotic gastrectomy. J. Surg. Oncol. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 05/2015; DOI:10.1002/jso.23926 · 2.84 Impact Factor
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    Sunchul Yeom · Taeil Son · Young Ok Hong
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    ABSTRACT: Benign cystic mesothelioma is an uncommon tumor arising from the peritoneal mesothelium. It is characterized by multilocular grapelike, thin-, and translucent-walled cysts, or a unilocular cyst lined by benign mesothelial cells. It occurs predominantly in women of reproductive age, and shows a predilection for the surface of the pelvic peritoneum or visceral peritoneum. Patients usually present abdominal pain and palpable mass, but many cases have been found incidentally during laparotomy. Definite preoperative diagnosis is known to be difficult. Benign cystic mesothelioma has a tendency towards local recurrence, although the gross microscopic features are benign. Moreover, there is controversy over whether this disease is neoplastic or reactive. Initial complete surgical resection and cytoreductive surgery for recurred cases are standard treatments. In the following report, we describe a case of complicated benign cystic mesothelioma in a postpartum woman, involving the pelvic peritoneum and mesoappendix, which was initially misdiagnosed as a periappendiceal abscess.
    Annals of Surgical Treatment and Research 03/2015; 88(3):170-3. DOI:10.4174/astr.2015.88.3.170
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    ABSTRACT: Abstract Background: Although laparoscopic appendectomy (LA) has been performed widely, the role of LA for complicated appendicitis remains controversial, and its role for periappendiceal abscess (PA) remains undefined. This study compared the clinical outcomes of LA and open appendectomy (OA) for PA diagnosed by radiologic investigation. Patients and Methods: We conducted a retrospective review of 84 patients who underwent surgery for PA diagnosed by radiologic investigation between 2010 and 2013. Twenty-five patients underwent LA, and the remaining patients underwent OA. Patient characteristics, operative outcomes, and surgical complications were compared between the two groups. Results: Three patients required conversion from LA to OA (12%). There were no significant differences in the overall complication (28% versus 25.4%; P=.8), wound infection (15.3% versus 4%; P=.27), stump leakage (4% versus 1.7%; P=.51), and postoperative ileus (4% versus 8.5%; P=.66) rates between the groups. The incidence of intraabdominal abscess (IAA) was significantly higher in the LA group (20% versus 3.4%; P=.02). In multivariate analysis, the risk factors for IAA were duration of drainage (P=.04) and type of operation (P=.006). The major complications rate was 2.4% in the total cohort, and the rate was significantly higher in the LA group (8% versus 0%; P=.02). Conclusions: For patients with PA, the rates of overall complications, wound infection, stump leakage, and postoperative ileus were similar for both procedures. However, LA resulted in a significantly higher incidence of IAA and major complications than OA.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 10/2014; 24(11). DOI:10.1089/lap.2014.0224 · 1.19 Impact Factor
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    Taeil Son · In Gyu Kwon · Woo Jin Hyung
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    ABSTRACT: Minimally invasive surgery, which has been extensively used to treat gastric adenocarcinoma, is now regarded as one of the standard treatments for early gastric cancer, and its suitability for advanced gastric cancer is being investigated. The use of cutting-edge techniques for minimally invasive surgery enables surgeons to deliver various treatment options to minimize a patient's distress and to maintain oncologic safety. Ongoing multicenter prospective studies aim to validate the efficacy of these surgical techniques and to expand the indications of minimally invasive surgery for the treatment of gastric cancer. In this review, we summarize the current status and issues regarding minimally invasive surgery for the treatment of gastric cancer.
    Gut and Liver 05/2014; 8(3):229-236. DOI:10.5009/gnl.2014.8.3.229 · 1.49 Impact Factor
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    ABSTRACT: Robotic systems recently have been introduced to overcome technical limitations of conventional laparoscopic surgery, especially for complex procedures. Laparoscopic spleen-preserving total gastrectomy with D2 lymph node (LN) dissection (LTGD2) is one of the most complicated procedures. We hypothesized that robotic LN dissection would be more thorough and accurate. We compared robotic spleen-preserving total gastrectomy with D2 LN dissection (RTGD2) with LTGD2 to investigate the impact of robotics. Clinicopathologic characteristics and short-term and long-term outcomes of RTGD2 (n = 51) versus LTGD2 (n = 58) in gastric adenocarcinoma patients were extracted from a prospectively designed database and analyzed retrospectively. There was no difference of patients' characteristics between groups. Mean operation time of RTGD2 was longer than LTGD2 (p < 0.001), and no differences in tumor histology, size, location, and TNM stage were seen. Total retrieved LNs from RTGD2 was similar to LTGD2 (mean 47.2 vs. 42.8, respectively), as were retrieved LNs at splenic hilum (1.3 vs. 0.8). However, mean numbers of retrieved LNs along the splenic artery from RTGD2 was higher than LTGD2 (2.3 vs. 1.0, respectively; p = 0.013), as was also the case at the splenic hilum and artery (3.6 vs. 1.9, p = 0.014). Postoperative complication (16 vs. 22 %, p = 0.374) and overall and disease-free survival between the two groups were not significantly different (p = 0.767 and p = 0.666, respectively). Robotic spleen-preserving total gastrectomy with D2 LN dissection is feasible. Operation time and retrieved total LNs and splenic hilar LNs in the robotic procedure are acceptable.
    Surgical Endoscopy 04/2014; 28(9). DOI:10.1007/s00464-014-3511-0 · 3.31 Impact Factor
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    ABSTRACT: Currently, gastric cancer staging systems do not consider the anatomic extent of metastatic lymph nodes (mLNs) as a prognostic factor. We therefore investigated the prognostic impact of the anatomic extent of mLNs on gastric cancer. The prognoses of 4,043 gastric cancer patients who underwent curative resection were analyzed. Patients with mLNs in lymph node (LN) stations 1-6 (n = 1,980) comprised the perigastric LN-positive (PLN) group, and patients with mLNs in LN stations 7-12 and 14 (n = 2,063) were assigned to the extraperigastric LN-positive (ELN) group. Overall survival was estimated using the Kaplan-Meier method, and hazard ratios (HRs) were calculated by the Cox proportional hazard model. The ELN group exhibited worse survival than the PLN group (p < 0.001), although there were differences in their clinicopathological features. When patients were stratified according to tumor-node-metastasis stage, the ELN groups had unfavorable prognoses compared with the PLN groups (p < 0.05). There were significant differences in long-term survival when the nodal stage of the current staging systems were subdivided according to anatomic nodal extent (p < 0.05), although there was a strong association between the probability of having extraperigastric mLNs and N classification. In multivariate analysis using age, gender, tumor size, tumor location, histology, T classification, and the extent of mLNs as covariates, presence of extraperigastric mLNs was an independent prognostic factor (HR 1.89, 95 % CI 1.73-2.07), along with age, tumor size, tumor location, and T classification. The anatomic extent of mLNs significantly affects patient prognosis. Including the anatomic extent of mLNs in the current staging system may predict gastric cancer prognosis more accurately in patients with the same stage of cancer.
    Annals of Surgical Oncology 11/2013; DOI:10.1245/s10434-013-3403-x · 3.94 Impact Factor
  • T Son · W J Hyung · J H Lee · YM Kim · S H Noh
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    ABSTRACT: Although surgeons normally use minimally invasive surgery (MIS) for patients with early gastric cancer, in Korea and Japan the procedure is also indicated for serosa-negative tumors. Serosal invasion is regarded to be a potential risk factor for peritoneal dissemination as a result of the effect of pneumoperitoneum and tumor manipulation during the operation. We compared operative outcomes between MIS and conventional open surgery for serosa-involved advanced gastric cancer patients who had a preoperative diagnosis of cancer without serosal invasion. A total of 61 patients (39 patients treated by MIS and 22 by open surgery) treated between 2003 and 2009 who were first diagnosed preoperatively as serosa negative on the basis of computed tomography, endoscopy, and endoscopic ultrasound but then diagnosed as serosa positive upon final pathology were studied. We retrospectively compared recurrence and survival between the two treatment groups. Clinicopathologic characteristics, clinical stage, extent of surgery, and short-term operative outcome did not differ between the groups. 5-year overall survival (73.5 vs. 67.5 %, p = 0.518, respectively) and disease-free survival (67.8 vs. 54.2 %, p = 0.296, respectively) were comparable between the MIS and open surgery groups. There were recurrences in 12 patients in the MIS group and 11 patients in the open surgery group, with a median follow-up period of 64 months. Recurrence patterns did not differ between the groups; moreover, MIS did not increase peritoneal recurrences compared to open surgery (42.0 vs. 54.5 %, p = 0.537, respectively). In multivariate analyses, the type of surgery was not an independent prognostic factor. Similar survival and recurrence patterns were observed in advanced gastric cancer patients preoperatively diagnosed as serosa negative who were treated either by MIS or open surgery. MIS may be safely applied in patients with serosa-positive tumors.
    Surgical Endoscopy 10/2013; 28. DOI:10.1007/s00464-013-3236-5 · 3.31 Impact Factor
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    ABSTRACT: OBJECTIVE:: Anemia after gastrectomy is commonly neglected by clinicians despite being an important and frequent long-term metabolic sequela. We hypothesized that the incidence and timing of the occurrence of iron deficiency after gastrectomy is closely associated with the extent of gastrectomy and the reconstruction method, and we investigated the treatment outcomes of iron supplementation to understand iron metabolism and determine the optimal reconstruction method after gastrectomy. PATIENTS AND METHODS:: Using a prospective gastric cancer database, we identified 381 patients with early gastric cancer with complete hematologic parameters who underwent gastrectomy between January 2004 and May 2008. Kaplan-Meier methods, Cox regression, and logistic regression were used to evaluate the associations of the extent of gastrectomy and reconstruction method with iron metabolism. RESULTS:: The prevalence of iron deficiency 3 years after gastrectomy was 69.1%, and iron-deficiency anemia was observed in 31.0% of patients. Iron deficiency developed in 64.8% and 90.5% of patients after distal gastrectomy and total gastrectomy within 3 years after surgery (P < 0.0001), respectively. Iron deficiency was significantly more frequent in women than in men (P < 0.0001) and after gastrojejunostomy than after gastroduodenostomy (P < 0.0001). Serum ferritin levels were different according to the extent of gastrectomy and reconstruction method. The proportion of patients treated for iron-deficiency anemia was also significantly different according to the extent of gastrectomy (P = 0.020). CONCLUSIONS:: Iron deficiency occurs in most patients with gastric cancer after gastrectomy, and its incidence was different according to the extent of gastrectomy and reconstruction method. To improve iron metabolism after distal gastrectomy, gastroduodenostomy would be the method of reconstruction whenever possible.
    Annals of surgery 01/2013; 258(6). DOI:10.1097/SLA.0b013e31827eebc1 · 7.19 Impact Factor
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    ABSTRACT: The seventh edition of the tumor, lymph node (LN), metastasis (TNM) staging system increased the required number of examined LNs in gastric cancer from 15 to 16. However, the same staging system defines lymph node-negative gastric cancer regardless of the number of examined LNs. In this study, the authors evaluated whether gastric cancer can be staged properly with fewer than 15 examined LNs. The survival rates of 10,010 patients who underwent curative gastrectomy from 1987 to 2007 were analyzed. The patients were divided into 2 groups according to the number of examined LNs, termed the "insufficient" group (≤15 examined LNs) and the "sufficient" group (≥16 examined LNs). The survival curves of patients from both groups were compared according to the seventh edition of the TNM classification. Three hundred sixteen patients (3.2%) had ≤15 examined LNs for staging after they underwent standard, curative lymphadenectomy. Patients who had T1 tumor classification, N0 lymph node status, and stage I disease with an insufficient number of examined LNs after curative gastrectomy had a significantly worse prognosis than patients who had ≥16 examined LNs. Moreover, having an insufficient number of examined LNs was an independent prognostic factor for patients who had T1, N0, and stage I disease. Lymph node-negative cancers in which ≤15 LNs were examined, classified as N0 in the new TNM staging system, could not adequately predict patient survival after curative gastrectomy, especially in patients with early stage gastric cancer. Cancer 2012. © 2012 American Cancer Society.
    Cancer 10/2012; 118(19):4687-93. DOI:10.1002/cncr.27426 · 4.90 Impact Factor
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    ABSTRACT: Gastric cancer recurrence after curative surgery remains high. Although no preoperative marker of gastric cancer progression after radical gastrectomy exists, recent studies suggest that C-reactive protein (CRP) is associated with cancer progression. Our study evaluated the significance of preoperative high-sensitivity CRP (hs-CRP) levels as a marker of disease progression after radical gastrectomy. The preoperative hs-CRP levels of 1,221 gastric cancer patients who underwent radical gastrectomies were analyzed for clinicopathologic significance. Patients with previous gastric cancer treatment, another primary cancer, active infection, or postoperative mortality were excluded. hs-CRP levels were significantly associated with increased tumor depth (P = 0.028), nodal status (P = 0.012), and stage (P = 0.045). Seventeen percent of patients had elevated hs-CRP levels at the cutoff value of >3.00 mg/L, whereas 6.6% and 6.1% of patients had CEA and CA-19-9 levels about the cutoffs of ≥5.00 ng/ml and ≥35.0 U/L, respectively. Hs-CRP levels >3.00 mg/L were an independent risk factor for recurrence-free survival along with stage. Elevated preoperative hs-CRP levels in gastric cancer patients are clinically significant indicators of advanced stage and postoperative disease recurrence.
    Journal of Surgical Oncology 03/2012; 105(4):405-9. DOI:10.1002/jso.22129 · 2.84 Impact Factor
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    ABSTRACT: Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus.
    Journal of Gastric Cancer 12/2011; 11(4):230-3. DOI:10.5230/jgc.2011.11.4.230
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    ABSTRACT: Although many reports have indicated the feasibility of laparoscopic gastrectomy (LG) regarding short-term surgical outcomes, the role of LG remains controversial because studies of long-term outcomes of LG are insufficient. The purpose of this study was to evaluate the long-term oncologic outcomes of patients who have undergone LG. Between May 2003 and December 2009, 714 consecutive patients underwent LG for gastric cancer. After excluding operative mortality (n = 4) and a case of Krukenberg tumor that was not identified at the time of surgery (n = 1), a total of 709 patients were analyzed for long-term oncologic outcomes. Gastric cancer cases were analyzed according to the American Joint Committee on Cancer classification (seventh edition). Overall survival and relapse-free survival were estimated by using the Kaplan-Meier method. Median follow-up was 46.2 months. Postoperative recurrence was observed in 26 patients (3.7%). The instances of recurrence were as follows: seven peritoneal, six locoregional, five hematogenous, four distant lymph nodes, and four mixed recurrence. There were neither port-site nor wound site metastases. The 5-year relapse-free survival rates were: 95.8% in stage I, 83.4% in stage II, and 46.4% in stage III. Five-year overall survival rates were: 96.4% in stage I, 83.1% in stage II, and 50.2% in stage III. The independent risk factors for recurrence were T stage and N stage. For survival, age, T stage, and N stage were statistically independent prognostic factors Our single-center study of a large patient series revealed that LG for gastric cancer had acceptable long-term oncologic outcomes comparable to those of conventional open surgery.
    Surgical Endoscopy 07/2011; 26(1):130-6. DOI:10.1007/s00464-011-1838-3 · 3.31 Impact Factor
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    ABSTRACT: Prolonged liver retraction during radical gastrectomy for adequate exposure of the hepatogastric ligament may lead to hepatic trauma. The authors offer a new minimally traumatic liver retraction method using a simple liver suspension with a gauze suture and compare it with the modified liver-puncture method. This study retrospectively evaluated 92 patients who underwent the liver-suspension or liver-puncture method during gastric resections in 2010. Their clinical and operative characteristics were analyzed together with perioperative transaminases, and the two groups were compared. Patients with a history of liver disease, abnormal preoperative liver function test results, postoperative complications, or combined operations were excluded from the study. The liver-suspension method was performed using two 4 × 4-in. gauze pads threaded with a 2-0 Prolene suture, which were secured to the pars condensa with surgical clips and externally tied to suspend the liver toward the abdominal wall. Each liver retraction was completed without intraoperative complications. The patients in the liver-suspension group had more nonhepatic comorbidities than those in the liver-puncture group (P = 0.029). Other patient characteristics such as age, gender, and body mass index (BMI) did not differ between the two groups. No differences were found between the groups in terms of mean operative time (200.3 ± 66.9 vs 214.9 ± 74.4) or preoperative mean alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels. However, the patients in the liver-suspension group had significantly lower postoperative mean ALT levels (postoperative days 0, 1, 2, 3, and 5) and mean AST levels (postoperative days 0 and 1). Compared with the liver-puncture method, the authors' novel liver-suspension with suture-gauze technique is a safe and effective method for retracting the liver during laparoscopic and robotic upper abdominal surgeries.
    Surgical Endoscopy 06/2011; 25(12):3939-45. DOI:10.1007/s00464-011-1788-9 · 3.31 Impact Factor

Publication Stats

63 Citations
42.48 Total Impact Points

Institutions

  • 2013–2015
    • Eulji University
      Sŏul, Seoul, South Korea
  • 2011–2012
    • Yonsei University Hospital
      • Surgery
      Seoul, Seoul, South Korea
    • Yonsei University
      • Department of Surgery
      Sŏul, Seoul, South Korea