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Jae Ho Park

Bio: Jae Ho Park is an academic researcher from Chungnam National University. The author has contributed to research in topics: Colonoscopy & Endoscopic mucosal resection. The author has an hindex of 4, co-authored 15 publications receiving 38 citations.

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Journal ArticleDOI
TL;DR: Preoperative tattooing with ICG is useful for Laparoscopic colectomy, especially in the N0 colon cancer group and LAR, and laparoscopic anterior resection (LAR) showed similar results, however, for left and right hemicolectomy both groups showed no difference in operation time or hospital stay.
Abstract: AIM To prove that tattooing using indocyanine green (ICG) is feasible in laparoscopic surgery for a colon tumor. METHODS From January 2012 to December 2016, all patients who underwent laparoscopic colonic surgery were retrospectively screened, and 1010 patients with colorectal neoplasms were included. Their lesions were tattooed with ICG the day before the operation. The tattooed group (TG) included 114 patients, and the non-tattooed group (NTG) was selected by propensity score matching of subjects based on age, sex, tumor staging, and operation method (n = 228). In total, 342 patients were enrolled. Between the groups, the changes in [Delta (Δ), preoperative-postoperative] the hemoglobin and albumin levels, operation time, hospital stay, oral ingestion period, transfusion, and perioperative complications were compared. RESULTS Preoperative TG had a shorter operation time (174.76 ± 51.6 min vs 192.63 ± 59.9 min, P < 0.01), hospital stay (9.55 ± 3.36 d vs 11.42 ± 8.23 d, P < 0.01), and post-operative oral ingestion period (1.58 ± 0.96 d vs 2.81 ± 1.90 d, P < 0.01). The Δ hemoglobin (0.78 ± 0.76 g/dL vs 2.2 ± 1.18 g/dL, P < 0.01) and Δ albumin (0.41 ± 0.44 g/dL vs 1.08 ± 0.39 g/dL, P < 0.01) levels were lower in the TG. On comparison of patients in the "N0" and "N1 or N2" groups, the N0 colon cancer group had a better operation time, length of hospital stay, oral ingestion period, Δ hemoglobin, and Δ albumin results than those of the N1 or N2 group. The operation methods affected the results, and laparoscopic anterior resection (LAR) showed similar results. However, for left and right hemicolectomy, both groups showed no difference in operation time or hospital stay. CONCLUSION Preoperative tattooing with ICG is useful for laparoscopic colectomy, especially in the N0 colon cancer group and LAR.

14 citations

Journal ArticleDOI
TL;DR: The use of this scoring system seemed to improve the outcomes of non-variceal UGIB patients in this study, through proper management and intervention, and high-risk patients could be screened using this new scoring system to predict 30-day mortality.
Abstract: Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure. A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items. The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806–0.856; P < 0.001), PNED (AUROC, 0.865; 95%CI, 0.841–0.886; P < 0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774–0.827; P < 0.001), and GBS (AUROC, 0.765; 95%CI, 0.736–0.793; P < 0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 h during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed. This is a preliminary report of a new bleeding score which may predict 30-day mortality better than the other scoring systems. High-risk patients could be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seemed to improve the outcomes of non-variceal UGIB patients in this study, through proper management and intervention.

13 citations

Journal ArticleDOI
TL;DR: Three modified EMRs are superior to cEMR and are equally effective for achieving HCR of rectal NETs, although EMR-P required the longest procedure time.
Abstract: Small rectal neuroendocrine tumors (NETs) confined to the submucosa are endoscopically resectable. Because most rectal NETs are submucosal tumors, conventional endoscopic mucosal resection (cEMR) may not result in a complete resection. This study investigated whether modified EMRs, namely endoscopic submucosal resection with ligation (ESMR-L), EMR with precutting (EMR-P), and strip biopsy are superior to cEMR for achieving histologically complete resection (HCR) of rectal NETs. Medical records of 215 patients who were treated with endoscopic resections for rectal NETs between January 2011 and July 2019 were retrospectively enrolled. Of the patients, 110, 33, 29, and 43 underwent cEMR, ESMR-L, EMR-P, and strip biopsy, respectively. For each method, HCR and en bloc resection rates, procedure times, and complication rates were measured. HCR was achieved with cEMR, EMR-P, ESMR-L, and strip biopsies for 74.5%, 90.9%, 93.1%, and 90.7% of cases, respectively. The HCR rate for cEMR was inferior to those of the modified EMRs (p = 0.045 for cEMR vs. EMR-P; p = 0.031 for cEMR vs. ESMR-L; p = 0.027 for cEMR vs. strip biopsy). Among the three modified EMRs, there was no significant difference in achieving HCR (p = 1.000). En bloc resection (p = 0.096) and complication rates (p = 0.071) were not significantly different among the four EMR methods, although EMR-P required the longest procedure time (p = 0.000). All three modified EMRs are superior to cEMR and are equally effective for achieving HCR of rectal NETs.

9 citations

Journal ArticleDOI
TL;DR: The results suggest that careful decision of the margin is needed when performing endoscopic resection of early gastric SRC, as subepithelial spread occurs frequently and can reach up to 6 mm.
Abstract: Introduction: Although signet ring cell carcinoma (SRC) is a poorly differentiated cancer subtype, recent studies suggest that endoscopic resection can be applied in small, mucosal early gastric SRC. However, other studies report frequent positive lines at the lateral resection margin after endoscopic treatment. Subepithelial spread beneath normal mucosa can exist in SRC, and such lesions may be the cause of positive margins after endoscopic resection. Thus, we conducted a retrospective study in order to evaluate the significance of subepithelial spread in early gastric SRC. Method: Medical records of early gastric SRC patients who underwent surgery or endoscopic resection from January 2011 to December 2016 at a single tertiary hospital (Daejeon, South Korea) were reviewed to examine subepithelial spread and clinical datum. Two expert pathologists reviewed all pathologic specimens, and only patients showing a pure SRC component were included. Results: Eighty-six patients were initially enrolled, and subepithelial spread existed in 62 patients (72.1%). The mean distance of subepithelial spread was 1,132.1 µm, and the maximal distance was 6,000 μm. Only discoloration was significantly associated with the presence of a subepithelial spread ( p < 0.05, χ2 test, and logistic regression test). Distance of subepithelial spread did not correlate with total lesion size. Conclusion: Subepithelial spread of early gastric SRC occurs frequently and can reach up to 6 mm. Lesion discoloration may be associated with the presence of subepithelial spread. Our results suggest that careful decision of the margin is needed when performing endoscopic resection of early gastric SRC.

8 citations

Journal ArticleDOI
TL;DR: A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition, but during the insertion procedure, needle puncture had to be attempted twice before successful PEGtube placement was achieved.
Abstract: Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure. (Korean J Gastroenterol 2018;72:308-312)

7 citations


Cited by
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01 Jan 2005
TL;DR: It is suggested that SEMS insertion is better than surgical GJ for palliation of patients with GOO in terms of clin ical success, morbidity, and mortality.
Abstract: Background: The treatment of gastroduodenal outflow obstruction(GOO) caused by malignant diseases represents a significant challenge. Open surgical gastrojeju nostomy (GJ)has been the treatment of choice, but it has high morbidity and mort ality rates. More recently, endoscopic placement of self-expanding metallic ste nts (SEMS) has been proposed and the results of small, preliminary studies are e ncouraging. This study compared technical and clinical success, morbidity, morta lity,and hospital stay in patients undergoing endoscopic and surgical treatment of GOO. Methods: Medical records of 60 consecutive patients with GOO seen betwee n April 1997 and November 2002 were retrospectively reviewed. Because of extreme ly short life expectancy, 13 patients were treated by insertion of a double-lum en nasogastric-jejunal tube. The remaining 47 patients (28 men, 19 women; mean age 73.5 years,range 48-92 years) with unresectable pancreatic (33), gastric(7) , metastatic lymph nodal (4), papillary (2), and biliary (1) tumors were treated by placement of a SEMS(24) or open surgical GJ (23). Results: The technical suc cess rates were similar, but clinical success was lower in the GJ group (92%vs. 56%, p= 0.0067). The SEMS group had a shorter length of hospital stay (3.0 [1. 4] days vs. 24.1 [10.3], p 0.001). Thirty-day mortality was 30%in the GJ gro up, and 0%in the SEMS group(p = 0.004). Morbidity was higher in the GJ compared with the SEMS group (61%vs. 17%, p= 0.0021). Mean survival was longer in the SEMS group (96.1 [9.6] days vs. 70.2 [36.2] days,p = 0.0165 for a single test of hypothesis; Bonferroni correction for a multiple testing removes this significa nce), consequently,out-of-hospital survival was longer for the SEMS group (93. 2[9.3] days vs. 46.0 [31.5] days, p 0.001). None of the endoscopic procedures required the assistance of an anesthesiologist or the use of an operating room. Conclusions: The results of this retrospective study suggest that SEMS insertion is better than surgical GJ for palliation of patients with GOO in terms of clin ical success, morbidity, and mortality. Technical success rates were similar. SE MS placement should be proposed as the first-line treatment for relief of GOO. However, a randomized,comparative, prospective study of SEMS vs. laparoscopic GJ is needed.

59 citations

09 Jun 2012
TL;DR: The results show that ESMR-L and ESD might be superior to conventional EMR for the treatment of small rectal carcinoid tumors.
Abstract: BACKGROUND Despite a growing understanding of the clinical effectiveness of endoscopic treatment for small rectal carcinoid tumors, there is still controversy concerning the best endoscopic treatment for resecting rectal carcinoid tumors easily and effectively. OBJECTIVES The objective of the present study was to compare the therapeutic efficacy and safety of endoscopic submucosal resection with a ligation device (ESMR-L) with endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. In addition, a conventional snare-based endoscopic mucosal resection (EMR) was included in the study and compared with both ESMR-L and ESD. METHODS A retrospective analysis was performed in 115 patients who underwent endoscopic resection of a rectal carcinoid tumor between January 2005 and June 2011. These patients were classified into three groups according to the type of endoscopic procedure: EMR group (n=33), ESMR-L group (n=40) and ESD group (n=44). RESULTS The complete resection rate of the EMR group was significantly lower than those of the ESMR-L and ESD groups (77.4 vs. 100 and 97.7%, P=0.002 and P=0.007). Tumor-free vertical margins were significantly greater in the ESMR-L and ESD groups than in the EMR group (ESMR-L and ESD vs. EMR group, P=0.013 and P=0.041). The curative resection rate of rectal carcinoid tumors in the EMR group was 77.4%, which was significantly lower than that of the ESMR-L (95%, 38/40) and EDS groups (97.7%, 43/44) (77.4% vs. 95%, P=0.036 and 77.4% vs. 97.7%, P=0.007). CONCLUSIONS Our results show that ESMR-L and ESD might be superior to conventional EMR for the treatment of small rectal carcinoid tumors.

44 citations

Journal ArticleDOI
TL;DR: In this paper, a review of multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography is presented, and the optimal protocol for fluorescence-guided colorectal surgery is discussed.
Abstract: Indocyanine green (ICG) could be applied for multiple functions such as fluorescent tumor localization, fluorescence lymph node mapping (FLNM), and intraoperative angiography in colorectal cancer surgery. With the near-infrared (NIR) systems, colonoscopic ICG tattooing can be used to define the early colorectal cancer that cannot be easily distinguished through the serosal surface. The lymphatic pathways can be visualized under the NIR system when ICG is injected through the submucosal or subserosal layer around the tumor. Intraoperative ICG angiography can be applied to find a favorable perfusion segment before the colon transection. Although all fluorescence functions are considered essential steps in image-guided surgery, it is difficult to perform multifunctional ICG applications in a single surgical procedure at once because complex protocols could interfere with each other. Therefore, we review the multifunctional ICG applications for fluorescent tumor localization, FLNM, and ICG angiography. We also discuss the optimal protocol for fluorescence-guided colorectal surgery.

26 citations

01 Jan 2006
TL;DR: Endoscopic resection using a ligation device is a useful and safe method for resection of small rectal carcinoid tumors.
Abstract: 瞄准:比 10 公里小的直肠的良性肿瘤肿瘤能是有用内视镜检查法的本地切除的 resected。以便完全移开直肠的良性肿瘤肿瘤,我们在这飞行员控制与一台结扎设备评估了内视镜的粘膜切除术使随机化的学习。方法:十五个病人从 1993 ~ 2002 在我们的医院里与直肠的良性肿瘤肿瘤(不到 10 公里) 被诊断。有 9 男性和 6 女性,与吝啬的年龄 61.5 年(范围, 34-77 年) 。病人没有良性肿瘤症候群症状的抱怨。十五个病人随机被划分成 2 个组:7 个良性肿瘤肿瘤被常规内视镜的切除术治疗,并且 8 个良性肿瘤肿瘤被内视镜的切除术用一台结扎设备治疗。结果:所有直肠的良性肿瘤肿瘤在中间被定位到远侧的直肠。从 3 公里改变到 10 公里和病人的背景特征的肿瘤的尺寸不在二个组是不同的。用一台结扎设备的良性肿瘤肿瘤的完全的移动的率(100% , 8/8 ) 比常规内视镜的切除术的显著地高(57.1% , 4/7 ) 。三个病人有深边缘,另外的治疗为被执行的肿瘤参与。没有复杂并发症用一台结扎设备发生了在期间或在内视镜的切除术以后。在两个组的所有病人在 3 年的观察时期期间是活着的。结论:用一台结扎设备的内视镜的切除术是为小直肠的良性肿瘤肿瘤的切除术的一个有用、安全的方法。

22 citations