Biomedical subjects

Suthep Udomsawaengsup

Publications and source records attributed to Suthep Udomsawaengsup.

4 recordsLinked to original sources

PubMed2006

Endoscopy and upper gastrointestinal contrast studies are complementary in evaluation of weight regain after bariatric surgery.

BACKGROUND: To assess the utility of upper endoscopy (EGD) and upper gastrointestinal (UGI) contrast studies in the evaluation of weight regain after previous bariatric surgery. METHODS: We retrospectively reviewed the findings of EGD and UGI studies for patients referred to our center for weight regain after bariatric surgery. All patients received a dietary assessment concomitant with the anatomic evaluations. RESULTS: From January 2003 and March 2006, 30 patients qualified for the study (25 women and 5 men, average age 49 years). Of the 30 patients, 16 had undergone gastroplasty and 14 open Roux-en-Y gastric bypass. Of the 30 patients, 27 (90%) had > or =1 abnormality detected on UGI study or EGD. Of these abnormalities, 10 were gastrogastric fistulas, 8 of which were detected with both UGI study and EGD; 11 dilated pouches were diagnosed by EGD but only 2 were also diagnosed on the UGI study. An enlarged stoma size was diagnosed in 7 patients (6 by EGD and 1 on the UGI study). Also, the UGI study diagnosed 1 Roux limb and 7 esophageal abnormalities not seen on EGD, and EGD diagnosed 4 esophageal and 3 gastric abnormalities not seen on the UGI study. On the basis of these findings and the dietary evaluation, 23 patients (77%) were offered a revisional procedure. CONCLUSION: EGD and UGI contrast studies are complementary in the evaluation of patients with weight regain after bariatric surgery. The combination of the 2 studies detected all the gastrogastric fistulas present. EGD provided more useful pouch and stomal information, and the UGI study detected esophageal or Roux limb abnormalities that frequently require additional evaluation.

Bariatric Surgery↗

PubMed2005

Round cell liposarcoma of scrotum with indolent course in young adult.

Myxoid/Round cell liposarcoma accounts for one-half of all liposarcomas and occurs as the second most common subtype. Both myxoid and round cell types share clinical, histological features and are accepted to represent a spectrum of lesions ranging from pure myxoid to near completely round cell liposarcoma. Round cell liposarcoma is highly metastatic and is classified as high grade and poorly differentiated myxoid sarcoma. Typical non-round cell myxoid liposarcoma is less metastatic and has more favorable prognosis. Karyotypic study of myxoid and round cell liposarcomas reveal a characteristic reciprocal translocation t (12;16)(q13;p11) resulting in the fusion of CHOP gene with TLS gene in more than 90% of cases. Most masses within the scrotal sac arise from the testis proper, and less likely from the extratesticular tissue. Liposarcoma represents approximately 20% of malignant extratesticular neoplasms, with the well differentiated subtype being the most common. Myxoid/round cell liposarcoma and round cell liposarcoma are rarely encounter in extratesticular soft tissue. We reported a rare case of round cell liposarcoma (high grade myxoid liposarcoma) of extratesticular tissue. To our knowledge, this is the first case of a large size (> 5cm) round cell liposarcoma arising from soft tissue within the scrotal sac of young adult with indolent course. Simple excision or enucleation are inadequate therapies and wide excision of the hemiscrotum including inguinal soft tissue and nodes is recommended. The role of retroperitoneal lymph node dissection and adjuvant chemotherapy remains controversial.

Adult↗

PubMed2005

The new laparoscopic proctocolectomy training (in soft cadaver).

OBJECTIVES: The purpose of the present study was to evaluate the quality of preservation (tissue plane, named vessels identification, consistency of colon and rectum), quality of performing procedures, difficulties and problems and finally the satisfaction of surgeons in laparoscopic proctocolectomy in soft cadaver. SETTING: Colorectal Division, Department of Surgery and Surgical Training Center Department of Anatomy, Faculty of Medicine, Chulalongkorn University. DESIGN: Prospective descriptive study MATERIAL AND METHOD: 10 soft cadavers were scheduled for laparoscopic proctocolectomy. The procedures (colon-rectum mobilization and named vessels identification) were performed by 14 experienced surgeons (8 colorectal surgeons) and assisted by surgical residents. The quality of preservation, successfulness and the satisfaction in performing the procedures were recorded using questionnaires for evaluation. RESULTS: The preservation was very good in every aspect especially tissue plane between colon, mesocolon and retroperitoneum which was clearly dissected, same asfasciapropria of rectum. The named vessels and the tissue consistency were very well preserved and tolerated to laparoscopic equipment handling. The surgeons were satisfied with the tissue handling and dissections. There were two difficulties, the first was air leakage but simply corrected with purse string suture and the second was unflavored smell which was not concerned. Laparoscopic proctocolectomy could be completely performed in soft cadaver. CONCLUSION: Laparoscopic proctocolectomy could be performed in soft cadavers with great satisfaction. Repeated practice is possible, so the surgeons can gain their experiences outside the operating theatre. This success may shorten the learning curve and may be the new era in cadaver-based training.

Attitude of Health Personnel↗

PubMed2004

Endoscopic transaxillary thyroid lobectomy: flexible vs rigid laparoscope.

BACKGROUND: The use of the endoscopic procedure for thyroid lobectomy in benign solitary thyroid nodule has been developed rapidly and increasingly refined in recent years. The early results are technically feasible, safe and mainly provide promising cosmetic results, some show a quicker recovery. The authors wanted to know if this procedure can be performed via rigid laparoscope which is simple, less expensive and widely available in many surgical centers. OBJECTIVES: The aims of this study were to evaluate operative time, blood loss, complication of flexible compared to 30 degrees rigid laparoscope in endoscopic transaxillary thyroid lobectomy for solitary thyroid nodule. METHOD: From February 2004 to June 2004, 13 cases of benign solitary thyroid nodule underwent the endoscopic transaxillary thyroid lobectomy. Flexible laparoscope techniques were performed in 9 cases and 30 degrees rigid laparoscope in the other 4 cases. Port site, number of ports and dissected method were the same in both procedures by the same surgeon. Operative time, blood loss, post-operative results were measured for evaluation. RESULTS: From 13 cases, 9 in the flexible laparoscope group and 4 in the rigid laparoscope group. All but one in the flexible group with torn internal jugular vein were successful. The mean operation time was 165.42 +/- 35.06 minutes, which was 175.63 +/- 35.70 minutes for flexible laparoscope group and 145 +/- 26.45 minutes for rigid laparoscope group. There was no recurrent laryngeal nerve injury and no subcutaneous emphysema. The patients were satisfied with the cosmetic results. CONCLUSION: On the basis of early experience with these 13 patients, the authors believe that endoscopic thyroidectomy using the rigid laparoscope has proved to be no different in the intra-operative results, so the authors do aimed to show that with the rigid laparoscope which is available in many surgical centers, less expensive and easy in maintenance will provide another surgical option for treatment of thyroid nodule, with maximized cosmetic effect.

Adult↗