직장암 환자의 술 전 병기 결정에 있어서 전산화 단층 촬영의 의의

신용덕,백승언,신연명,오경승 대한대장항문학회 1995 Annals of Coloproctolgy Vol.11 No.3

상행 결장의 게실염을 동반한 S상 결장암 1예

이승현,안병권,백승언 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.1

The coexistence of colon cancer and colonic diverticulum has been reported. It is suggested to share similar epidemiologic features and risk factors between diverticular disease and colorectal neoplasia. An 51-year-old man patient was admitted for evaluation. He had no subjective symptoms. He had a mass-like lesion of ascending colon on CT. Multiple outpouching diverticuli with pus-like discharge of ascending colon were identified on colonofiberscope. A sigmoid polyp was also noted incidentally. Biopsy confirmed the diagnosis of adenocarcinoma. Thereafter, the patient underwent right hemicolectomy with sigmoidectomy.

직장암 절제 수술 후에 발생하는 문합부 누출의 위험 인자

이승현,안병권,배승언 고신대학교 의과대학 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Background: Anastomotic leakages are one of the most serious complications after rectal cancer resection. The aim of this study was to identify the relevant risk factors of anastomotic leakage after low anterior resection for rectal cancer. Methods: We reviewed retrospectively the medical records of 251 patients, who underwent low anterior resection for rectal cancers between January, 2001 and December, 2004. All patients underwent a tumor-specific mesorectal excision. We excluded the patients underwent emergent surgery, protective stoma formation and used pelvic drainage. Results: The mean distance of the tumor from the anal verge was 8.0 cm (3-16 cm). Lower anterior resection was performed in 214 patients and ultra-low anterior resection in 37 patients. Fifteen patients had preoperativechemoradiation for rectal cancer. The anastomotic leakage was identified in 10 patients (4.0%). Seven patients with anastomotic leakage underwent corrective surgery.Other postoperative complications included 5 rectovaginal fistula (2.0%) and 4 intra-abdominal abscess (1.6%). The incidences of anastomotic leakage were significantly different according to preoperative chemoradiation (13.3% vs. 3.4%, p=0.05) and rectal obstruction (33.3% vs. 3.3%, p=0.00). Conclusions: In patients with history of preoperative chemoradiation and rectal obstruction, the careful management for anastomotic leakage is necessary

복강경 대장절제술의 초기 경험

이승현,안병권,백승언 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.1

Background : Laparoscopic colon resection has many benefits, such as decreased incidence of pulmonary complication, faster return of the bowel function, decreased narcotic requirements, shorter hospital stay, and faster recovery time. However it has long learning curve because of complex mesenteric blood supply, multiple quadrant location and bowel anastomosis. The aim of this study was to identify the clinical outcome for laparoscopic colorectal surgery as initial experience. Methods : From Jan. 2002 to Dec. 2006, we reviewed 16 patients who had underwent laparoscopic colon resection at Kosin University Gospel Hospital. We studied the clinical outcome, such as operative time, passage of flatus, retrieved lymph node, complications, hospital stay. Results : Of the 16 patients, 6 cases were male, 10 cases were female. The median age was 50.1 years(26-69). The primary diseases were cancer in 15 cases (93.7%), and benign in 1 case. The operative procedure were right hemicolectomy in 3 cases (18.8%), left hemicolectmy in 1 cases (6.3%), anterior resection in 6 cases (37.5%), low anterior resection in 4 cases (25.0%) and total colectomy in 1 case (6.3%). The mean operative time was 227.8 minutes (150-370). The flatus passage was 2.6 days (1-6). The mean number of retrieved lymph node was 12.2 (3-27). The postoperative complication was wound infection in 2 cases. The mean hospital stay was 11.1 days. Conclusions : The laparoscopic colorectal surgery seems to be safe. To evaluate the benefit compare to open colorectal surgery, we need further study.

직장암에서 수술 전 방사선-화학요법 후 발생한 후기 합병증

이승현,이철민,안병권,백승언 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.1

OBJECTIVES: To compare the late complications after operations for rectal cancers with and without preoperative chemoradiation. METHODS: From January 2003 to December 2005, 55 patients underwent operation after preoperative chemoradiation for adenocarcinoma of the rectum. All of them received the full scheduled dose of radiation with concurrent chemotherapy. The interval between preoperative chemoradiation and surgery was 4-6 weeks. 47 patients who had tumors below 8 cm from the anal verge were enrolled into the study group (CRT group). During same period, we selected 153 patients who had adenocarcinoma of the rectum below 8cm from the anal verge, underwent surgery alone without postoperative radiotherapy non-CRT group). We compared the early and the late postoperative complications between the CRT group and the non-CRT group. RESULTS: Of the late complications, the incidence of anastomotic stricture was significantly higher in the CRT group (P = 0.018). The incidence of anal stricture was higher in the CRT group (P = 0.164). In the CRT group, 3 cases (17.6%) had failed to preserve the anal function due to moderate or severe anal stricture. Of the 3 cases, protective ileostomy was persistent in 2 cases, colostomy was performed in one case. Otherwise, the late complications of the CRT group were intestinal obstruction in 2 cases (4.3%), lymph edema in 2 cases (4.3%). CONCLUSION: In CRT group, failure of anal function preservation due to anastomotic stricture or anal stricture was more common and serious than non-CRT group. We emphasize the need for careful management for postoperative anal stricture after preoperative chemoradiation.

후직장의 위장관 간질 종양 1예

최영일,이승현,안병권,백승언 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

The retrorectal gastrointestinal stromal tumor is very rare. An 24-year-old woman patient was admitted for huge pelvic mass with constipation, lower abdominal discomfort. The pelvic mass was palpable on posterior rectal wall on digital rectal examination. On exploration, tumor excision was performed. Gross finding shows 14x11x10.5 cm sized grayish tan and irregular mass. The cut surface is solid, bright yellow to grayish yellow with foci of hemorrhage and calcification. The tumor show spindle shaped cells and mitosis. It showed positive staining for c-kit. The tumor was diagnosed as gastrointestinal stromal tumor in rectrorectal space.

비악성 담도계 질환의 재수술

백승언(Sung Uhn Baek),최경현(Kyung Hyun Choi),이승도(Sung Do Lee),서재관(Jae Kwan Seo),박영훈(Young Hoon Park) 대한외과학회 1986 Annals of Surgical Treatment and Research(ASRT) Vol.30 No.6

신장이식 200예의 임상 분석

백승언(Sung Uhn Baek),이승도(Sung Do Lee),서재관(Jae Kwan Seo),양상호(Sang Ho Yang),이시래(Si Rhae Lee),유현열(Hyun Yul Rhew) 대한외과학회 1991 Annals of Surgical Treatment and Research(ASRT) Vol.41 No.2

Flow Cytometry를 이용한 DNA분석과 고형종양의 예후

백승언,신연명,이승도 고신대학교 의학부 1992 高神大學校 醫學部 論文集 Vol.8 No.2

Flow cytometric DNA content analysis is a rapid, quantitative method of determining the DNA ploidy status and proliferative index of a given tumor. Aneuploidy is present in 60-70% of solid tumors and has been recognized as a marker of malignancy and unfavorable prognosis. Also, high S-phase fraction has been recognized as an expression of biological aggressiveness and poor prognosis. This method has been applied widely to many kinds of malignant tumors to evaluate it's prognostic significance and possibility of clinical application. But the results are still contriversial according to the exminers and kinds of tumors. To evaluate prognostic significance of this method in gastric carcinoma we examined DNA ploidy and survival time of 235 gastric cancer patients who underwent opertions at the Departement of Surgery, Kosin Medical College between January 1979 and June 1981, and the results were compared with other prognostic factors such as TNM atage, histologic grade, Lauren's classification and patients' age along with a collective review of recent literatures.

Snuffbox 동정맥루

백승언 고신대학교 의학부 1992 高神大學校 醫學部 論文集 Vol.8 No.1

37 cases of snuffbox arteriovenous fistulas were performed at Kosin medical college between March 1991 and September 1992. The procedure which was first reported by Mehigan in 1982. was modified by author. The advantages of this procedure were technically easier with minimal dissection, more distally located and offers another chance of Brescia-Cimino fistula. The patency rate was 89.7% as a first procedure. So it is advisable as a first choice of internal arteriovenous fistula.