Biomedical subjects

Y F Juang

Publications and source records attributed to Y F Juang.

4 recordsLinked to original sources

PubMed1994

Management of the perineal wounds following excision of the rectum for malignancy.

In a retrospective study, 103 patients undergoing abdominoperineal resection or total proctocolectomy due to rectal adenocarcinoma or familial polyposis with malignant change in the rectum were included. The methods for treating the pelvic and perineal wounds were divided into four categories: (1) suture of the pelvic peritoneum with open drainage, (2) suture of the pelvic peritoneum and perineum with simple drainage, (3) suture of the pelvic peritoneum and perineum with suction drainage, and (4) suture of the perineum with omental pedicle graft. The parameters analyzed were incidence of perineal wound infection, primary healing of the perineum, extraperineal complications and mean hospital stay. The infective rate of the group 1 was significantly higher than for the other groups. The incidence of primary wound healing for groups 2, 3, 4 was 73%, 78%, 81% respectively compared with group 1 of 20% at one month. There was no significant difference between the various groups regarding extraperineal complications. There was no significant difference in hospital stay among groups 2, 3, 4, but they were significantly shorter than for group 1. Primary closure of the pelvic peritoneum and perineal wound with simple drainage is now adopted by us due to its low infection rate, short hospital stay and easy performance.

Adult↗

PubMed1990

Clinicopathologic characteristics in colorectal adenocarcinoma and their relationship to survival.

In January 1981 at the surgical department of the Kaohsiung Medical College Hospital, we began a longterm clinicopathological study of colorectal adenocarcinoma according to "The General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus" issued by the Japanese Research Society for Cancer of the Colon and Rectum. The aim was to evaluate this type of tumor's staging system as a guide to prognosis, and to determine the effects of several clinicopathological characteristics on survival. The data presented are based on the findings in the first 327 patients whose tumors were resectable. The clinicopathological variables included in this study were: age, sex, duration of symptoms, tumor location, the proportion of the bowel wall circumference involved, numbers of lymph nodes involved, depth of the cancer invasion, gross type, histological type and microscopic stage. The microscopic stage was found to be related strongly to survival. Other variables associated with significantly poorer five-year survival were: age under 40 years, duration of preoperative symptoms shorter than 6 months, a tumor occupying more than two-thirds of the bowel wall circumference, greater number of lymph nodes involved, more poorly differentiated cancer, the cancer invading into adjacent organs and ulceroinfiltrative tumor in univariate analysis. The overall five-year survival rate was 53.4% in this series.

Adenocarcinoma↗

PubMed1990

[Colon and rectal trauma].

From July 1982 to June 1989, 64 patients with trauma involving a colon and rectum operated on at the Kaohsiung Medical College Hospital were retrospectively reviewed. Their ages ranged from 14 to 90 years (mean 43.6 +/- 17.6 years); 48 were male, 16 female. Thirty-four (53.1%) had penetrating injuries, 30 (46.9%) had blunt injuries. Twenty-six (86.7%) blunt injuries and 7 (20.6%) penetrating injuries involved various associated injuries. There was a significantly greater number of associated organ injury in cases of blunt trauma. The most common organ injured concomitantly was the small intestine. The severity of injury and general condition were quantified for each patient using the intraoperative grading system proposed by Flint et al, and revealed that it was independent of the colorectal site, but related to the mode of trauma. After an assessment of the grade of injury, 42 patients underwent colostomies, 14 primary closures, 2 resections and anastomoses and 6 exteriorized repairs In the primary closure group, there was no mortality but 2 suture leakages which reoperated to colostomies. In three patients (50%) of the exteriorized repair group with fecal leakage developed at the repair site, the exteriorized loops were coverted into colostomies without complication. The most common complications were wound infection and abdominal abscess. The mortality (14.1%) and morbidity (45.3%) were not related to the location of the injured bowel but were influenced by the grade of colorectal trauma, associated organ injury and the mode of trauma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1989

Surgical treatment of bleeding and perforated peptic ulcer diseases.

From 1977 to 1988, 556 patients underwent emergency surgery for complicated peptic ulcers. Among them, 409 patients were for treated perforations and 147 for hemorrhages. In the perforated ulcer category, the morbidity rate was 12.5% and mortality rate 6.8%. For bleeding ulcers, the morbidity rate was 27.2% and mortality rate 14.9%. Several risk factors, such as age, interval of time between perforation and surgery, blood loss, associated disease, and shock were found to have created a higher operative risk. A definitive surgery including vagotomy and drainage, vagotomy and antrectomy, partial gastrectomy and highly selective vagotomy could be safely performed with an acceptable mortality for properly selected cases. Follow-up results also indicated better scores in this group of patients. We concluded that a definitive ulcer operation is safe, acceptable and curative for low risk patients with perforated or bleeding ulcers.

Adult↗