Jin Yong Shin

Inje University, Kŭmhae, South Gyeongsang, South Korea

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Publications (12)6.13 Total impact

  • Jong Kwon Park, Sung Jin Oh, Jin Yong Shin
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    ABSTRACT: Rupture of the iliac artery during percutaneous angioplasty is a life-threatening condition that requires prompt diagnosis and treatment to rescue the patient. Recently, percutaneous angioplasty has become an outpatient procedure, but there is no reliable guideline for observation time in the hospital after percutaneous angioplasty. We describe a 67-year-old man with bilateral lesions in the iliac artery who experienced a delayed rupture of the iliac artery 2 days after percutaneous balloon angioplasty and placement of a self-expandable stent. The patient was successfully treated by endovascular intervention with a stent graft. In our department, percutaneous angioplasty is not performed in an outpatient clinic, and all patients are admitted to the hospital and observed for at least 3 days after percutaneous angioplasty. Because our patient was in the hospital when the iliac artery ruptured, prompt diagnosis and treatment were possible. Moreover, because appropriately sized stent grafts were prepared in the hospital, timely endovascular treatment could be performed, and the patient recovered successfully. From this case, we conclude that observing patients for a sufficient time in the hospital and preparing appropriately sized stent grafts are 2 important factors for the safety of patients who undergo percutaneous angioplasty.
    Annals of Vascular Surgery 10/2013; · 0.99 Impact Factor
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    ABSTRACT: The aim of this study was to analyze the oncologic outcomes and the risk factors for recurrence after a tumor-specific mesorectal excision (TSME) of resectable rectal cancer in a single institution. A total of 782 patients who underwent a TSME for resectable rectal cancer between February 1995 and December 2005 were enrolled retrospectively. Oncologic outcomes included 5-year cancer-specific survival and its affecting factors, as well as risk factors for local and systemic recurrence. The 5-year cancer-specific survival rate was 77.53% with a mean follow-up period of 61 ± 31 months. The overall local and systemic recurrence rates were 9.2% and 21.1%, respectively. The risk factors for local recurrence were pN stage (P = 0.015), positive distal resection margin, and positive circumferential resection margin (P < 0.001). The risk factors for systemic recurrence were pN stage (P < 0.001) and preoperative carcinoembryonic antigen level (P = 0.005). The prognostic factors for cancer-specific survival were pT stage (P < 0.001), pN stage (P < 0.001), positive distal resection margin (P = 0.005), and positive circumferential resection margin (P = 0.016). The oncologic outcomes in our institution after a TSME for patients with resectable rectal cancer were similar to those reported in other recent studies, and we established the risk factors that could be crucial for the planning of treatment and follow-up.
    Journal of the Korean Society of Coloproctology 04/2012; 28(2):100-7.
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    Sung Jin Oh, Jin Yong Shin
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    ABSTRACT: Currently, circumferential resection margins (CRM) are used as a clinical endpoint in studies on the prognosis of rectal cancer. Although the concept of a circumferential resection margin in extraperitoneal rectal cancer differs from that in intraperitoneal rectal cancer due to differences in anatomical and biologic behaviors, previous reports have provided information on CRM involvement in all types of rectal cancer including intraperitoneal lesions. Therefore, the aim of this study was to analyze risk factors of CRM involvement in extraperitoneal rectal cancer. From January 2005 to December 2008, 306 patients with extraperitoneal rectal cancer were enrolled in a prospectively collected database. Multivariate logistic regression analysis was used to identify predictors of CRM involvement. The overall rate of CRM involvement was found to be 16.0%. Multivariate analysis showed that male sex, larger tumor size (≥4 cm), stage higher than T3, nodal metastasis, tumor perforation and non-sphincter preserving proctectomy (NSPP) were risk factors for CRM involvement. Male sex, larger tumor size (≥4 cm), advanced T stage, nodal metastasis, tumor perforation, and NSPP are significant risk factors of CRM involvement in extraperitoneal rectal cancer. Given that postoperative chemoradiotherapy is recommended for patients with a positive CRM, further oncologic studies are warranted to ascertain which patients with these risk factors would require adjuvant therapy.
    Journal of the Korean Surgical Society. 03/2012; 82(3):165-71.
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    Jin Yong Shin
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    ABSTRACT: Although robotic surgery was invented to overcome the technical limitations of laparoscopic surgery, the role of a robotic (procto)colectomy (RC) for the treatment of colorectal cancer compared to that of a laparoscopic (procto)colectomy (LC) was not well defined during the initial adoption periods of both procedures. This study aimed to evaluate the efficacy and the safety of a RC for the treatment of colorectal cancer by comparing the authors' initial experiences with both a RC and a LC. The first 30 patients treated by using a RC for colorectal cancer from July 2010 to March 2011 were compared with the first 30 patients treated by using a LC for colorectal cancer from December 2006 to June 2007 by the same surgeon. Perioperative variables and short-term outcomes were analyzed. In addition, the 30 RC and the 30 LC cases involved were divided into rectal cancer (n = 17 and n = 12, respectively), left-sided colon cancer (n = 7 and n = 12, respectively) and right-sided colon cancer (n = 6 and n = 6, respectively) for subgroup analyses. The mean operating times for RC and LC were significantly different at 371.8 and 275.5 minutes, respectively, but other perioperative parameters (rates of open conversion, numbers of retrieved lymph node, estimated blood losses, times to first flatus, maximal pain scores before discharge and postoperative hospital stays) were not significantly different in the two groups. Subgroup analyses showed that the mean operative times for a robotic proctectomy and a laparoscopic proctectomy were 396.5 and 298.8 minutes, respectively (P < 0.000). Postoperative complications occurred in five patients in the RC group and in six patients in the LC group (P = 0.739). Although the short-term outcomes of a RC during its initial use were better than those of a LC (with the exception of operating time), differences were not found to be significantly different. On the other hand, the longer operation time of a robotic proctectomy compared to that of a laparoscopic proctectomy during the early period may be problematic.
    Journal of the Korean Society of Coloproctology 02/2012; 28(1):19-26.
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    Jin Yong Shin
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    ABSTRACT: Postoperative small bowel obstruction is a common and serious complication following a proctectomy, and early postoperative small bowel obstruction (EPSBO) leads to longer hospital stays, delays chemotherapy in advanced cases, and may be a contributor to mortality. The goal of this study is to identify the risk factors of EPSBO after a proctectomy for rectal cancer, thereby seeking to reduce the incidence of EPSBO. Patients (735) who underwent a proctectomy for rectal cancer between March 2005 and February 2010 were entered into this study, and data were collected prospectively. Patients were judged to have EPSBO if, within the first 30 days, they presented symptoms such as nausea, vomiting and abdominal distention lasting for 2 days, and radiologic finding of small bowel obstruction after evidence of return of small bowel motility. The association between EPSBO and patients and surgery-related variables were studied by using univariate and multivariate analyses. EPSBO developed in 47 cases (6.4%) and was the most frequently occurring complication in the early perioperative period following a proctectomy. The frequency of EPSBO according to operative variables shows that EPSBO developed in 3.0% of the patients who underwent laparoscopic surgery (LS) compared with 8.4% of the patients who underwent open surgery (OS) (P = 0.004). OS (odds ratio [OR], 2.5) and a previous laparotomy (OR, 2.3) were independent risk factors for the development of EPSBO after a proctectomy for rectal cancer. EPSBO is more likely to occur in patients who undergo OS or who have had a previous laparotomy. LS may be considered as a surgical procedure that can reduce the risk of EPSBO in patients undergoing a proctectomy for rectal cancer.
    Journal of the Korean Society of Coloproctology 12/2011; 27(6):315-21.
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    Hong-Jo Choi, Jin Yong Shin
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    ABSTRACT: In patients with symptomatic incurable metastatic colorectal cancer (mCRC), the goal of resection of the primary lesion is to palliate cancer-related morbidity, including obstruction, bleeding, or perforation. In patients with asymptomatic primary tumors and incurable metastatic disease, however, the necessity of primary tumor resection is less clear. Although several retrospective analyses suggest survival benefit in patients who undergo resection of the primary tumor, applying this older evidence to modern patients is out of date for several reasons. Modern chemotherapy regimens incorporating the novel cytotoxic agents oxaliplatin and irinotecan, as well as the target agents bevacizumab and cetuximab, have improved median survival from less than 1 year with the only available single-agent 5-fluorouracil until the mid-1990s to over 2 years. In addition to significant prolongation of overall survival, combinations of novel chemotherapeutic and target agents have allowed improved local and distant tumor control, decreasing the likelihood of local tumor-related complications requiring surgical resection. Resection of an asymptomatic primary tumor risks surgical complications and may postpone the administration of chemotherapy that may offer both systemic and local control. In conclusion, the morbidity and the mortality of unnecessary surgery or surgery that does not improve quality of life or survival in patients with mCRC of a limited life expectancy should be carefully evaluated. With the availability of effective combinations of chemotherapy and target agents, systemic therapy for the treatment of life-threatening metastases would be a preferable treatment strategy for unresectable asymptomatic patients with mCRC.
    Journal of the Korean Society of Coloproctology 10/2011; 27(5):226-30.
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    Jin Yong Shin, Kwan Hee Hong
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    ABSTRACT: Although nodal metastasis is the most powerful prognostic factor in rectal cancer, marked heterogeneity exists within stage III rectal cancer. Recent studies of rectal cancer have shown a prognostic superiority of the lymph node ratio (LNR) compared with N stage. The purpose of this study was to investigate the prognostic value of the LNR in the era of the 7th edition of the TNM classification. We included 190 patients who underwent a curative resection for rectal cancer with nodal metastasis. The patients were divided into four groups on the basis of statistically calculated cut-off values as 0.21, 0.32, and 0.61. The LNR was an independent risk factor for overall survival (OS; P = 0.008) and for systemic recurrence-free survival (SRFS; P = 0.002). However, the LNR was not a predictive factor for local recurrence. When the N stage of the sixth TNM staging system was separately analyzed as a covariate, the LNR was also found to be a predictive factor for both OS and SRFS (P = 0.012 and P = 0.004, respectively). A LNR value of 0.21 offered the best cut off to separate patients into two prognostic groups. The defined cut-off values of the LNR were an independent risk factor for OS and distant metastasis-free survival in patients with rectal cancer, irrespective of the sixth or the seventh version of the TNM classification, and the LNR should be considered as a prognostic variable in any future staging system.
    Journal of the Korean Society of Coloproctology 10/2011; 27(5):252-9.
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    ABSTRACT: To associate the global gene expression of B7/CD28 family transcripts with pathologic features of colon cancer, we determined the B7/CD28 family transcripts in peripheral blood mononuclear cells (PBMCs) from normal subjects and patients with adenomatous polyps and colon cancer, and correlated the results with pathologic features of colon cancer. PBMCs from age-matched normal subjects and patients with adenomatous polyps and colon cancer were analyzed for peripheral blood transcripts (PBTs) of B7/CD28 family using real-time PCR. Differences in expression levels of B7/CD28 PBTs across all cancer stages and between colon cancer patients with or without microscopic lymphovascular invasion (LVI) were analyzed. The results showed a significant upregulation of PBTs of co-inhibitory molecules such as B7-H3 and PD-1 and a significant PBT downregulation of co-stimulatory molecules including CD28 and ICOS in colon cancer patients. Furthermore, the increase of B7-H3 PBT was strongly associated with tumor invasion (P = 0.025) and advanced TNM stages (P = 0.019), whereas the decline of co-stimulatory ligand B7-H2 PBT was related to regional lymph node metastasis (P = 0.028) and aggressive tumor invasion (P = 0.031). In addition, the ratios of PBT expression of CD28 family to B7 family such as CTLA-4 to B7-H2 and PD-1 to B7-H2 were significantly higher in colon cancer patients with microscopic LVI than in those without LVI (P = 0.001 and P = 0.016, respectively). Our results suggest that B7/CD28 family PBTs may serve as valuable markers reflecting the pathological features of colon cancer.
    Journal of Cancer Research and Clinical Oncology 02/2010; 136(9):1445-52. · 2.91 Impact Factor
  • Journal of The Korean Society of Coloproctology. 01/2009; 25(3).
  • Jin Yong Shin, Kwan Hee Hong
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    ABSTRACT: Currently, colectomies are the most frequently performed procedure to manage colorectal cancer. However, early postoperative small-bowel obstruction (EPSBO) is a common serious complication after colectomy. The purpose of our study was to assess the incidence of EPSBO after colectomy for colorectal cancer, and attempt to identify associated risk factors for EPSBO. Between 2005 and 2006, 504 patients who underwent a colectomy for colorectal cancer were prospectively monitored and entered into the study. Patients were assessed to have an EPSBO if, within the first 30 days, they presented with symptoms, such as nausea, vomiting, and abdominal distention, lasting for at least 2 days, with radiologic findings of small-bowel obstruction after evidence of small-bowel motility return. In this study, the following parameters were monitored prospectively: anti-adhesive, intraoperative adverse events (bleeding, bowel perforation), diversion stoma, repair of mesenteric defect, intra-abdominal drainage, local remnant tumor, status of bowel preparation, status of American Society of Anesthesiologists (ASA) grade, obesity, and history of previous abdominal surgery. The influence of these factors on the development of EPSBO after colectomies for colorectal cancer was analyzed. Cases were classified according to anastomotic level and extent of pelvic dissection into pelvic surgery group (PSG) and colonic surgery group (CSG). The influence of these factors on the development of EPSBO according to our classification also was analyzed. EPSBO developed in 41 cases (8.1%) and was the most frequently occurring complication during the early perioperative period. The frequency of EPSBO according to our classification of cases into PSG and CSG shows that EPSBO developed in 6.8% of PSG compared with 10.6% of CSG cases (p = 0.13). Local remnant tumor (odds ratio (OR) = 3.4) and poor ASA grading (OR = 3.5) were independent risk factors for the development of EPSBO after colectomies for colorectal cancer. In our subgroup analysis according to our classification based on anastomotic level and extent of pelvic dissection, local remnant tumor and poor ASA grading also independently increased the risk of developing EPSBO in PSG. It seems that pelvic surgeries do not have a higher rate of EPSBO compared with colonic surgeries. Local remnant tumor and poor systemic condition seems to be independent risk factors for EPSBO after colectomies for colorectal cancer, especially with pelvic surgery. These findings suggest that particular attention is needed to reduce the rate of EPSBO in patients who undergo colectomies for colorectal cancer.
    World Journal of Surgery 10/2008; 32(10):2287-92. · 2.23 Impact Factor
  • Journal of The Korean Society of Coloproctology. 01/2008; 24(4).
  • Source
    Journal of The Korean Society of Coloproctology. 01/2007; 23(1).

Publication Stats

22 Citations
6.13 Total Impact Points

Institutions

  • 2008–2013
    • Inje University
      • College of Medicine
      Kŭmhae, South Gyeongsang, South Korea
  • 2011–2012
    • Inje University Paik Hospital
      • Department of Surgery
      Goyang, Gyeonggi, South Korea