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Ruangsin S, Sunpaweravong S, Laohawiriyakamol S. Achievement of benchmark outcomes by a young surgical attendant performing pancreatoduodenectomies. Langenbecks Arch Surg 2023; 408:404. [PMID: 37843626 DOI: 10.1007/s00423-023-03132-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE Pancreatoduodenectomy is a challenging procedure for young general surgeons, and no benchmark outcomes are currently available for young surgeons who have independently performed pancreatoduodenectomies after completing resident training. This study aimed to identify the competency of a young surgeon in performing pancreatoduodenectomies, while ensuring patient safety, from the first case following certification by a General Surgical Board. METHODS A retrospective review of data from the university hospital was performed to assess quality outcomes of a young surgical attendant who performed 150 open pancreatoduodenectomies between July 13, 2006, and July 13, 2020. Primary benchmark outcomes were hospital morbidity, mortality, postoperative pancreatic fistula, postoperative hospital stay, and disease-free survival. RESULTS All benchmark outcomes were achieved by the young surgeon. The 90-day mortality rate was 2.7%, and one patient expired in the hospital (0.7% in-hospital mortality). The overall morbidity rate was 34.7%. Postoperative pancreatic fistula grades B and C were observed in 5.3% and 0% of patients, respectively. The median postoperative hospital stay was 14 days. The 1- and 3-year disease-free survival were 71.3% and 51.4%, respectively. CONCLUSION Pancreatoduodenectomy requires good standards of care as it is associated with high morbidity and mortality. As only one surgeon could be included in this study, our benchmark outcomes must be compared with those of other institutions. CLINICAL TRIAL REGISTRATION The study was registered at Thai Clinical Trials Registry and approved by the United Nations (registration identification TCTR20220714002).
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Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, 15 Kanjanawanich Road, Hat Yai, 90110, Songkhla, Thailand.
| | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, 15 Kanjanawanich Road, Hat Yai, 90110, Songkhla, Thailand
| | - Supparerk Laohawiriyakamol
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, 15 Kanjanawanich Road, Hat Yai, 90110, Songkhla, Thailand
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Ruangsin S, Chansanti O. Intralesional Zinc Hyaluronate Injection to Prevent Keloid Recurrence After Surgical Excision: A Prospective, Randomized Pilot Study. Dermatol Surg 2023; 49:530-531. [PMID: 36946695 DOI: 10.1097/dss.0000000000003757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Laohawiriyakamol S, Chewatanakornkul S, Wanichsuwan W, Ruangsin S, Sunpaweravong S, Bejrananda T. Urogenital dysfunction after laparoscopic surgery for rectal or sigmoid colon cancer. Asian J Surg 2023; 46:492-500. [PMID: 35717291 DOI: 10.1016/j.asjsur.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/OBJECTIVE Urogenital dysfunction is a common complication after surgery for sigmoid colon or rectal cancers and may result from various causes. Herein, we evaluated urogenital dysfunction and the associated factors after laparoscopic surgery at different follow-up times. METHODS We conducted a prospective study on 91 patients who were diagnosed with sigmoid colon and rectal cancers and underwent laparoscopic surgery during 2014-2016. Voiding and male and female sexual dysfunctions following surgery were evaluated by the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Female Sexual Function Index-6 (FSFI-6), respectively. Urogenital function was compared at pre-surgery and 3 and 12 months postoperatively, and factors associated with urogenital dysfunction were identified. RESULTS The overall urinary function after surgery was better when compared to that at pre-surgery; however, there was deterioration in both male and female sexual functions. The mean preoperative IPSS, IIEF-5, and FSFI-6 scores were 9.35, 12.18, and 6.09, respectively. The mean differences among IPSS, IIEF-5, and FSFI-6 at 12 months postoperatively and pre-surgery were -3.08 (95% confidence interval [CI] -4.77 to -1.40), -2.57 (95% CI -4.33 to -0.80), and -2.58 (95% CI -4.73 to 0.42), respectively. Multivariate analysis demonstrated that age ≤60 years (odds ratio 4.22) and postoperative complications (odds ratio 2.77) were correlated with erectile dysfunction. CONCLUSION Voiding function improved after laparoscopic surgery in both sigmoid colon and rectal cancer patients. However, sexual function in both male and female patients was worse. Age ≤60 years and postoperative complications were strongly associated with male sexual dysfunction.
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Affiliation(s)
- Supparerk Laohawiriyakamol
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
| | - Siripong Chewatanakornkul
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Worawit Wanichsuwan
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
| | - Tanan Bejrananda
- Urologic Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand
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Wongwaiyut K, Ruangsin S, Laohawiriyakamol S, Leelakiatpaiboon S, Sangthawan D, Sunpaweravong P, Sunpaweravong S. Pretreatment Esophageal Wall Thickness Associated with Response to Chemoradiotherapy in Locally Advanced Esophageal Cancer. J Gastrointest Cancer 2019; 51:947-951. [PMID: 31758468 DOI: 10.1007/s12029-019-00337-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE A multimodality approach using concurrent chemoradiotherapy (CRT) followed by esophagectomy has been the standard treatment in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Computed tomography (CT) is widely utilized to evaluate esophageal cancer before and after CRT. This study evaluated the utility of pretreatment maximal esophageal wall thickness on CT scans to predict treatment outcomes after CRT in patients with locally advanced ESCC. METHODS Eighty-one patients with T3 locally advanced ESCC, whom were treated completely with CRT with and without surgery, and had available CT scans before and after CRT at a university hospital between 2005 and 2015, were retrospectively reviewed. RESULT Twenty patients (24.7%) had esophagectomy after neoadjuvant CRT and sixty-one patients (75.3%) had definitive CRT. The maximal esophageal wall thicknesses were measured retrospectively and correlated with the response and survival after treatment. A total of 40% of neoadjuvant CRT patients achieved a pCR. There was a significant difference in pretreatment maximal esophageal wall thickness between the pCR and non-pCR groups (mean 11.9 ± 5.3 mm versus 16.9 ± 3 mm; p = 0.01). Pretreatment maximal esophageal wall thickness < 10 mm was significantly related to better overall survival than ≥ 10 mm (median survival 79 months versus 15 months; HR 3.21, 95%CI 1.14-9; p = 0.02). The neoadjuvant CRT group had significantly better survival than the definitive CRT group (median survival 51 months versus 14.5 months; HR 0.46; 95%CI 0.25-0.85; p = 0.01). CONCLUSION In our study, pretreatment esophageal wall thickness of T3 locally advanced ESCC is a useful indicator for predicting survival and pCR after treatment.
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Affiliation(s)
- Kraipop Wongwaiyut
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
| | - Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
| | | | - Siriporn Leelakiatpaiboon
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
| | - Duangjai Sangthawan
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
| | - Patrapim Sunpaweravong
- Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand
| | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand.
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Yanasoot A, Yolsuriyanwong K, Ruangsin S, Laohawiriyakamol S, Sunpaweravong S. Costs and benefits of different methods of esophagectomy for esophageal cancer. Asian Cardiovasc Thorac Ann 2017; 25:513-517. [PMID: 28871799 DOI: 10.1177/0218492317731389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background A minimally invasive approach to esophagectomy is being used increasingly, but concerns remain regarding the feasibility, safety, cost, and outcomes. We performed an analysis of the costs and benefits of minimally invasive, hybrid, and open esophagectomy approaches for esophageal cancer surgery. Methods The data of 83 consecutive patients who underwent a McKeown's esophagectomy at Prince of Songkla University Hospital between January 2008 and December 2014 were analyzed. Open esophagectomy was performed in 54 patients, minimally invasive esophagectomy in 13, and hybrid esophagectomy in 16. There were no differences in patient characteristics among the 3 groups Minimally invasive esophagectomy was undertaken via a thoracoscopic-laparoscopic approach, hybrid esophagectomy via a thoracoscopic-laparotomy approach, and open esophagectomy by a thoracotomy-laparotomy approach. Results Minimally invasive esophagectomy required a longer operative time than hybrid or open esophagectomy ( p = 0.02), but these patients reported less postoperative pain ( p = 0.01). There were no significant differences in blood loss, intensive care unit stay, hospital stay, or postoperative complications among the 3 groups. Minimally invasive esophagectomy incurred higher operative and surgical material costs than hybrid or open esophagectomy ( p = 0.01), but there were no significant differences in inpatient care and total hospital costs. Conclusion Minimally invasive esophagectomy resulted in the least postoperative pain but the greatest operative cost and longest operative time. Open esophagectomy was associated with the lowest operative cost and shortest operative time but the most postoperative pain. Hybrid esophagectomy had a shorter learning curve while sharing the advantages of minimally invasive esophagectomy.
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Affiliation(s)
- Alongkorn Yanasoot
- Department of Surgery, Faculty of Medicine, 26686 Prince of Songkla University, Songkla, Thailand
| | - Kamtorn Yolsuriyanwong
- Department of Surgery, Faculty of Medicine, 26686 Prince of Songkla University, Songkla, Thailand
| | - Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, 26686 Prince of Songkla University, Songkla, Thailand
| | | | - Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, 26686 Prince of Songkla University, Songkla, Thailand
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Ruangsin S, Laohawiriyakamol S, Sunpaweravong S, Mahattanobon S. The efficacy of cefazolin in reducing surgical site infection in laparoscopic cholecystectomy: a prospective randomized double-blind controlled trial. Surg Endosc 2014; 29:874-81. [DOI: 10.1007/s00464-014-3745-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 07/08/2014] [Indexed: 11/30/2022]
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Sunpaweravong S, Puttawibul P, Ruangsin S, Laohawiriyakamol S, Sunpaweravong P, Sangthawan D, Pradutkanchana J, Raungkhajorn P, Geater A. Randomized Study of Antiinflammatory and Immune-Modulatory Effects of Enteral Immunonutrition During Concurrent Chemoradiotherapy for Esophageal Cancer. Nutr Cancer 2013; 66:1-5. [DOI: 10.1080/01635581.2014.847473] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sunpaweravong S, Ruangsin S, Laohawiriyakamol S, Mahattanobon S, Geater A. Prediction of major postoperative complications and survival for locally advanced esophageal carcinoma patients. Asian J Surg 2012; 35:104-9. [PMID: 22884266 DOI: 10.1016/j.asjsur.2012.04.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 06/21/2011] [Accepted: 04/17/2012] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Predicting the major complications after esophagectomy is important and may help in preselecting patients who are most likely to benefit from surgery, especially in locally advanced esophageal cancer patients who have poor prognosis. OBJECTIVE To identify the factors associated with the development of pneumonia and anastomotic leakage complications, and the survival characteristics in locally advanced esophageal cancer patients. METHODS A consecutive series of 232 locally advanced esophageal cancer patients (183 men and 49 women, median age 63 years) who underwent esophagectomy at Prince of Songkla University Hospital between 1998 and 2007 was analyzed. RESULTS There were nine (3.8%) 30-day mortalities. Pneumonia occurred in 53 patients (22.8%) and anastomotic leakage in 37 patients (15.9%). Multivariate analyses showed that low body mass index was related to leakage (p = 0.015), while soft-diet dysphagia (p = 0.009), forced expiratory volume in 1 second <75% (p = 0.0005), type of surgery (McKeown technique) (p = 0.019), and long operative time (p = 0.006) were related to pneumonia. The median survival rate was 13.0 months. Stage 2b patients had longer survival than stages 3 and 4a patients (p = 0.0001). CONCLUSION Patient body mass index, dysphagia, spirometry, type of surgical technique, and operative time can help predict the likelihood of pulmonary or leak complications after esophagectomy. TNM (Tumor, Node, Metastasis) staging can help predict the overall survival after resection in locally advanced cases.
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Affiliation(s)
- Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand.
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Ruangsin S, Wanasuwannakul T, Pattaravit N, Asim W. Effectiveness of a preoperative single dose intravenous dexamethasone in reducing the prevalence of postoperative sore throat after endotracheal intubation. J Med Assoc Thai 2012; 95:657-660. [PMID: 22994024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two-different doses of prophylactic dexamethasone intravenous administration in reducing the prevalence of postoperative sore throat following general endotracheal anesthesia. MATERIAL AND METHOD All patients (105 cases) of different procedures of elective surgery scheduled to have general anesthesia performed with endotracheal intubations were included. The subjects randomized into three pre-operative intravenous substance/drug administrations, group I (35 cases) with normal saline 2 ml, group II (35 cases) with dexamethasone 4 mg, and group III (35 cases) with dexamethasone 8 mg, respectively. The prevalence of sore throat and its severity was assessed, using visual analogue scale (VAS), scores of O to 10; 0 = no pain, and 10 = most severe pain. RESULTS Among three groups, the duration of surgery, and intubation-induced trauma had no statistical significance. The prevalence of sore throat at 1-hour/24-hour postoperative was 48.6/48.6%, 54.3/28.6%, and 54.3/42.9% in group I, II, and III respectively, and without statistical significance. CONCLUSION The intravenous dexamethasone had no significant effectiveness against postoperatively sore throat after endotracheal intubation.
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Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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Ruangsin S, Wanasuwannakul T. Variation of prophylactic antibiotic in laparoscopic cholecystectomy: Songklanagarind Hospital perspective. J Med Assoc Thai 2012; 95:48-51. [PMID: 22379741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Evaluate the effectiveness of variation of prophylactic antibiotic in laparoscopic cholecystectomy. MATERIAL AND METHOD A retrospective data review was undertaken of patients who received a laparoscopic cholecystectomy between January 1, 2005 and December 31, 2008 in Songklanagarind Hospital. The prevalence of surgical site infection (SSI), the variation of antibiotic prescription, and associated factors with SSI were reviewed and analyzed. RESULTS Four hundred thirty nine patients received a successful laparoscopic cholecystectomy. The prophylactic antibiotic was utilized in 328 patients (74.7%). Cefazolin was the most common antibiotic used. Only 3 patients (0.9%) received the antibiotic according to the recommendation of center for disease control and prevention (CDC). The SSI was accounted in 41 patients (9.3%); 29 had the prophylactic antibiotic, while 12 did not. There was no statistically significant difference in the prevalence of SSI between the two groups (p = 0.54). Factor significantly associated with SSI was the operative time more than three hours (p = 0.03). CONCLUSION Various patterns of prophylactic antibiotic were encountered. The practice variation seemed to be ineffective in the prevention of SSI. The selectively risk factors should be considered in the antibiotic prophylaxis.
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Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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Ruangsin S, Jaroonrach V, Petpichetchian C, Puttawibul P, Sunpaweravong S, Chewatanagongun S. Establishment the cost-effectiveness through set criteria of laparoscopic cholecystectomy. J Med Assoc Thai 2010; 93:789-793. [PMID: 20649057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To assess the set criteria of laparoscopic cholecystectomy (LC) in reducing the length of hospital stay (LOHS), and total treatment expenditure. MATERIAL AND METHOD The measurement outcomes were prospectively analyzed through the medical record, and self questionnaire of the patients. RESULTS During the 1-year trial, a total of 122 patients were scheduled for LC. Among these, 85 cases had met the set criteria of low risk clients of both preoperative indicator of a) American Society of Anesthesiologists (ASA) class 1 or 2, and postoperative indicators of b) no surgical drainage, and c) no immediate complication, while 37 cases were excluded due to ASA class 3 or 4, and various reasons. Distributed by the duration of hospital stay, the patients were classified in to three groups; group A was overnight hospital stay, 15 of 85 subjects (17.6%), group B was short hospital stay (within 3 days), 51 of 85 subjects (60.0%), and group C was long hospital stay (more than 3 days), 19 of 85 subjects (22.4%). The mean length of hospital stay (LOHS) was 24 +/- 1.61 hours in group A, 55 +/- 11.16 in group B, and 108 +/- 21.59 in group C, while the average total expenditure was 531.22 +/- 111.09, 665.5 +/- 133.35 and 812.33 +/- 158.62, respectively. For the overnight hospital stay group, the LOHS and the total treatment expenditure was significantly lower the other groups (p < 0.001). The majority of the overnight hospital stay group had rated the patient satisfaction as excellent. CONCLUSION The set criteria of laparoscopic cholecystectomy (LC) are helpful and establish the cost-effectiveness in terms of reduction of LOHS and total treatment expenditure.
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Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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Sunpaweravong S, Chewatanakornkul S, Ruangsin S. Initial experience and result of thoracoscopic and laparoscopic esophagectomy. J Med Assoc Thai 2008; 91:1202-1205. [PMID: 18788691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Conventional esophagectomy requires either a laparotomy or a thoracotomy. Currently, the minimally invasive esophagectomy is an evolving alternative to the open technique. OBJECTIVE Assess and evaluate the early outcomes of the authors' experiences with the minimally invasive esophagectomy for esophageal cancer. MATERIAL AND METHOD Outcome data were collected prospectively from 28 consecutive patients, 22 men and six women with a mean age of 63 years and a range of 36-77 years. RESULTS Thoracoscopic esophageal mobilizations were successful in 17 patients. Four patients were converted to open thoracotomy. Laparoscopic gastric mobilizations were successful in eight patients and only one patient was converted to laparotomy. Mortality was one (3.5%), and perioperative morbidity was nine (32%), including pneumonia, pleural effusion, wound infection, anastomosic leakage, and hoarseness. CONCLUSION Minimally invasive esophagectomy is feasible and can be performed at the Prince of Songkla University Hospital. Optimal results require appropriate patient selection and surgeon experience.
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Affiliation(s)
- Somkiat Sunpaweravong
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
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Ruangsin S, Chowchuvech V. A randomized double-blind controlled trial comparing two forms of enema for flexible sigmoidoscopy. J Med Assoc Thai 2007; 90:2296-2300. [PMID: 18181310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To compare bowel preparation quality and patient tolerance of two common enema solutions for flexible sigmoidoscopy. MATERIAL AND METHOD Three hundred adults were randomized to receive a hypertonic sodium chloride or hypertonic sodium phosphate enema regime, each consisting of two enemas administered 60 and 30 min before the procedure. Patients completed surveys on preparation comfort. Patients and endoscopist were blinded to the preparation used During the procedure, the endoscopist took pictures of the mucosa and intraluminal content. All pictures were later evaluated by a single doctor who graded the quality of the preparation. RESULTS There were no serious complications during or following the procedures. The preparation quality was rated as excellent or good by 76.9% of the hypertonic sodium chloride group and 72.9% of the hypertonic sodium phosphate group (p = 0.423). The hypertonic sodium chloride enema was associated with more abdominal discomfort (p = 0.018). CONCLUSION Both enemas were safe for all patients with no statistical difference between the qualities of the two bowel preparations. Both preparations performed their bowel-cleaning function well and were suitable for the preparation of patients before flexible sigmoidoscopy. The less expensive hypertonic sodium chloride solution may be an option for hospitals where budgetary considerations are important.
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Affiliation(s)
- Sakchai Ruangsin
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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