Purpose: The purpose of this study was to analyze the educational quality of laparoscopic cholecystectomy (LC) videos accessible on YouTube, one of the most important sources of internet-based medical information.Methods: The keyword 'laparoscopic cholecystectomy' was used to search on YouTube and the first 100 videos were analyzed.Among them, 27 videos were excluded and 73 videos were included in the study.An arbitrary score system for video quality, devised from existing LC guidelines, were used to evaluate the quality of the videos.Video demographics were analyzed by the quality and source of the video.Correlation analysis was performed.Results: When analyzed by video quality, 11 (15.1%) were evaluated as 'good', 40 (54.8%) were 'moderate', and 22 (30.1%) were 'poor', and there were no differences in length, views per day, or number of likes, dislikes, and comments.When analyzed by source, 27 (37.0%)were uploaded by primary centers, 20 (27.4%) by secondary centers, 15 (20.5%) by tertiary centers, 5 (6.8%) by academic institutions, and 6 (8.2%) by commercial institutions.The mean score of the tertiary center group (6.0 ± 2.0) was significantly higher than the secondary center group (3.9 ± 1.4, P = 0.001).The video score had no correlation with views per day or number of likes.Conclusion: Many LC videos are accessible on YouTube with varying quality.Videos uploaded by tertiary centers showed the highest educational value.This discrepancy in video quality was not recognized by viewers.More videos with higher quality need to be uploaded, and an active filtering process is necessary.
Radical gastrectomy is essential for gastric cancer treatment. While guidelines advise dissecting at least 16 lymph nodes, some research suggests over 30 nodes might be beneficial. This study assessed ICG-guided robotic gastrectomy's effectiveness in thorough lymph node dissection. We analyzed data from 393 stage II or III gastric cancer patients treated at Seoul St. Mary's Hospital from 2016-2022. Patients were categorized into conventional laparoscopy (G1, n = 288), ICG-guided laparoscopy (G2, n = 61), and ICG-guided robotic surgery (G3, n = 44). Among 391 patients, 308 (78.4%) achieved proper lymphadenectomy. The ICG-robotic group (G3) showed the highest success rate at 90.9%. ICG-guided robotic surgery was a significant predictor for achieving proper lymphadenectomy, with an odds ratio of 3.151. In conclusion, ICG-robotic gastrectomy improves lymphadenectomy outcomes in selected gastric cancer cases, indicating a promising surgical approach for the future.
There is growing evidence for the use of acceptance-commitment therapy (ACT) for the treatment of obsessive-compulsive disorder (OCD). However, few fully implemented ACT have been conducted on the neural mechanisms underlying its effect on OCD. Thus, this study aimed to elucidate the neural correlates of ACT in patients with OCD using task-based and resting-state functional magnetic resonance imaging (fMRI).
127 Background: Although there are several traditional treatment modalities for stage IV gastric cancer including chemotherapy, radiation therapy, palliative surgery, or best supportive care, survival result is unsatisfactory. Recently, gastrectomy after chemotherapy which is called conversion surgery or adjuvant surgery was introduced. Methods: In total, 419 patients who were diagnosed stage IV gastric cancer from 2010 to 2015 in eight Catholic Medical Center affiliated hospitals were divided into four groups; 212 for chemotherapy only group (G1), 124 for chemotherapy after primary gastrectomy group (G2), 23 for gastrectomy after chemotherapy group (G3), and 60 for best supportive care group (G4). To compensate chemotherapy effects, cases of complete remission, partial response, and stable disease were selectively analyzed. To identify the factors that affected survival rate, the result of surgery and the intent of surgery of the G3 were analyzed. Results: Three-year survival rate of the G3 was significantly higher than that of the G1 (42.8% vs 12.0%, p = 0.001). In case of the patients with a response to chemotherapy, three-year survival rate showed similar result (G3 vs G1, 46.1% vs 18.4%, p = 0.011). In the G3, R0 resection and curative intent of resection showed better three-year survival rate (R0 vs R1 or R2, 61.1% vs 16.2%, p = 0.003, curative vs palliative, 62.3% vs 23.8%, p = 0.031). Conclusions: The present study showed that gastrectomy after chemotherapy might improve the survival rate for the patients with stage IV gastric cancer, especially who could undergo R0 resection.
Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical procedures were identified based on the hospital's surgical fee codes. Hematologic conditions were sorted into risk levels, and patient treatments were scrutinized. Among the 131 initially identified patients, 89 were included in the study. Out of these, 75 underwent surgical procedures, while 14 received non-surgical treatments. The surgical group displayed better preoperative laboratory outcomes. Clinical characteristics, hematologic disease risk, and severity of appendicitis appeared not to be related to surgical complications. Patients without surgical complications showed improvement in preoperative absolute neutrophil count (ANC) and platelet counts. Lower preoperative ANCs and platelet counts were associated with extended hospital stays. For patients with hematologic disorders diagnosed with appendicitis, thorough preoperative laboratory evaluations followed by minimally invasive appendectomy appear to be a safe route without heightening the risk of severe complications compared to non-surgical management.
Advances in medicine and changes in the medical environment can affect the diagnosis and treatment of diseases. The main purpose of the present study was to investigate whether the difference in accessibility to diagnosis and treatment facilities influenced the occurrence of appendectomy in Korea.We collected data on 183,531 appendectomy patients between 2003 and 2017 using the National Health Insurance Services claims. Retrospective analysis of relationship between the age-standardized rate (ASR) of appendectomy and clinical variables affecting medical accessibility was performed. Pearson's correlation analyses were used.The incidence of appendectomy decreased from 30,164 cases in 2003 to 7,355 cases in 2017. The rate of computerized tomography (CT) scans for diagnosis of appendicitis increased from 4.73% in 2003 to 86.96% in 2017. The ASR of appendectomy in uncomplicated and complicated appendicitis decreased from 48.71 in 2005 to 13.40 in 2010 and 8.37 in 2005 to 2.96 in 2009, respectively. The ASR of appendectomy was higher in the high-income group. The proportion and ASR of appendectomy in older age group increased steadily with years. The total admission days continued to decrease from 6.02 days in 2003 to 4.96 days in 2017.The incidence of appendectomy was seemingly associated with the rate of CT scan. In particular, the incidence of appendectomy in uncomplicated appendicitis was markedly reduced. Through enhanced accessibility to CT scans, accurate diagnosis and treatment of appendicitis can be facilitated.
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