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Recurrent Primary Signet Ring Cell Cancer of the Colon at Anastomosis Site after Curative Resection
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Yu Jin Suh, Jae Myung Cha, Joung Il Lee, Kwang Ro Joo, Sung Won Jung, Hyun Phil Shin, Soo Woong Kim
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Intest Res 2010;8(1):58-62. Published online June 30, 2010
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DOI: https://doi.org/10.5217/ir.2010.8.1.58
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- A primary signet ring cell cancer (SRCC) is a rare form of an adenocarcinoma of the large intestine. The prognosis of SRCC of the colon has been reported to be worse than classic adenocarcinoma of the colon; however, there is no difference in the post-operative surveillance for SRCC. We report a case of SRCC of the colon with negative resection margins that recurred at the anastomosis site 26 months after curative resection. A 55-year-old male presented to the hospital with abdominal pain. The initial colonoscopy and abdominal computed tomography revealed SRCC of the proximal ascending colon. He underwent extensive curative surgical resection and adjuvant chemotherapy for 8 months. However, 26 months post-operatively, the cancer recurred at the anastomosis site without peritoneal dissemination. Physicians should be aware that SRCC may have different recurrence patterns compared with classic adenocarcinoma, and may need more vigorous surveillance, even after curative surgery. (Intest Res 2010;8:58-62)
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A case of Small Bowel Obstruction due to Jejunal Adenocarcinoma Diagnosed by Double-balloon Enteroscopy
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Su Jin Hong, Jun Yong Bae, Moon Sung Lee, Sung Won Jung, Sang Gyune Kim, Bong Min Ko, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim
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Intest Res 2004;2(2):124-128. Published online December 22, 2004
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High Dose Midazolam versus Propofol plus Midazolam in Conscious Sedation during Colonoscopy
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Sung Won Jung, Sang Kyune Kim, Moon Sung Lee, Bong Min Ko, Su Jin Hong, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim
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Intest Res 2004;2(2):107-112. Published online December 22, 2004
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Abstract
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- Background/Aims
Colonoscopy under sedation has grown in popularity recently. Midazolam and propofol are generally used for conscious sedation during colonoscopy. In comparison of midazolma, propofol is shorter-acting hypnotic agent and has shorter plasma half-life and it was reported that combined use of propofol with benzodiazepines, barbiturates or opioids enhanced sedative effect by drug interaction. We investigated the effect of high dose midazolam and combined use of midazolam and propofol in conscious sedation during colonoscopy. Methods: We injected midazolam intravenously in 61 patients for sedation before colonoscopy. We divided patients into two groups; one group was injected with additional midazolam (31 patients, high dose midazolam group) and the other was injected with additional propofol (30 patients, combined group). We compared followings in both groups; 1) decrease of systolic and diastolic blood pressure, heart rate, respiration rate per minute, and oxygen saturation rate 2) recovery time 3) degree of amnesia 4) content of patient 5) adverse effects. Results: There is no significant difference between two groups in sex and mean age. In both groups, significant difference was not observed in decrease of systolic and diastolic blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate (p>0.05). Recovery time was shorter in combined group than in high dose midazolam group (p<0.05). Content of patients was higher in combined group (p<0.05), Fatal adverse effect was not found in both groups. Conclusions: Combine use of midazolam and propofol is more effective sedative method than use of high dose midazolam because of shorter recovery time and increased content of patients without increasing adverse effect. (Intestinal Research 2004;2:107-112)
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Clinical Study for Gastrointestinal Carcinoid Tumor; Aspect of Endoscopic, Endosonographic Findings and Endoscopic Treatment
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Bong Min Ko, Chang Beom Ryu, Moon Sung Lee, Kye Won Kwon, Sang Gyune Kim, Sung Won Jung, Su Jin Hong, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim
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Intest Res 2004;2(2):89-95. Published online December 22, 2004
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Abstract
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- Background/Aims
Because screening for colonic cancer includes colonoscopy, more of carcinoid tumors may be diagnosed at an earlier stage. Metastatic disease is rare in lesions smaller than 1cm and common in lesions larger than 2cm. Small lesions are managed with local excision or endoscopic resection. Endoscopic resection, a major advance in endoscopy, provides an endoscopic option for management of carcinoid tumor of the GI tract. We study to evaluate the efficacy and safety of high-frequency probe EUS-assisted endoscopic resection in the management of carcinoid tumor of the GI tract, to evaluate of clinical usefulness of cap aspiration method in comparison with snare polypectomy. Methods: For 31 patients, snare polypectomy and cap aspiration lumpectomy were performed between February 2001 and September 2004 after evaluating by endosonography. Results: EUS examination confirmed that all of the rectal carcinoid tumor were hypoechic mass confined to the second or third layer of the rectum. The rate of complete removal of carcinoid tumors with aspiration lumpectomy was significantly higher than with snare polypectomy (p<0.05). Conclusions: EUS can provide precise information about size, layer of origin, and echogenicity of the carcinoid tumor. It is useful in the diagnosis of carcinoid of the rectum and can have an important role in the choice of therapy. Endoscopic resection with cap is a useful and safe method for resection of small carcinoid tumor of the rectum according to endoscopic shape and EUS findings. (Intestinal Research 2004;2:89-94)
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Endoscopic Mucosal Resection of Early Colon Cancer: Additional Therapy and Clinical Outcomes
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Sang Gyune Kim, Chang Beom Ryu, Moon Sung Lee, Bong Min Ko, Sung Won Jung, Su Jin Hong, Young Seok Kim, Jin Oh Kim, Kye Won Kwon, Chan Sup Shim, Boo Sung Kim
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Intest Res 2004;2(2):65-70. Published online December 22, 2004
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- Background/Aims
The prevalence of early colon cancer is increasing and endoscopic removal of it has been widely accepted. After endoscopic resection, a number of remnant or recurrent tumors were managed successfully through salvage endoscopic mucosal resection (EMR) or argon plasma coagulation (APC). This study evaluated the outcomes of EMR for early colon cancer and efficacy of additional therapy in preventing recurrence. Methods: During the period from March 2001 to April 2004, a total of 50 early colon cancers were resected and analyzed retrospectively. EMR was performed either piecemeal by snare and cap aspiration or en bloc by conventional EMR and submucosal dissection. The patients were followed up at 3, 6, 12, 24 months and median follow up period was 21.8 months. By using the magnifying endoscopy, If the endoscopists judged the tumors incompletely excised or recurred. APC and EMR as additional therapy were done. Results: 50 early colon cancers comprised 44 mucosal cancers and 6 submucosal cancers in which en bloc resection was 34 (68%) and piecemeal resection was 16 (32%). Apart from the 13 cases which is unable to decide its lateral margin free because of piecemeal resection, Complete resection rate was 26/37(70.3%). The 20 cases receiving additional therapy consisted of en bloc resection 8 cases and piecemeal resection 12 cases. Recurrence rate of previous additional therapy was 1/20(5%) and had no significant difference with no additional therapy. Conclusions: For endoscopic treatment of early colon cancer En bloc resection is much better than piecemeal resection. Because of its high complete resection rate. But, in case of suggestive incomplete resection, recurrence rate will be decreased through the additional therapy. The long term results of additional therapy after EMR for Early colon cancer seem to be required for more study. (Intestinal Research 2004;2:65-70)
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