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Purpose Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients. Methods We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups. Results The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013). Conclusion The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

PurposeThe aim of this study was to evaluate whether the perioperative carcinoembryonic antigen (CEA) ratio could be used as a determinant for adjuvant therapy after curative surgery in stage II colorectal cancer.MethodsData for 119 patients with stage II colorectal cancer who underwent radical surgery between 2010 and 2013 were collected. The perioperative CEA ratio was defined as the postoperative/preoperative serum CEA level, and the patients were grouped according to their perioperative CEA ratios: high ratio (≥0.5) and low ratio (

PurposeThe aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate.MethodsWe retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study. We examined clinical factors, including age, sex, body mass index, pain, body temperature, white blood cell count, C-reactive protein, nil per os (NPO) time, hospital duration, computed tomography (CT) findings, location of diverticulitis, operation performed, and presence of comorbidity (e.g., hypertension and diabetes mellitus).ResultsIn the multivariate analysis, the statistically significant factor related with hospital duration was the presence of perforation on the CT scan (P < 0.001). Longer NPO time was related with pain score (>7) (P = 0.011). Operations were mainly performed in patients with left-sided colonic diverticulitis (P = 0.012).ConclusionWe suggest a perforation finding on the CT scan, a severe pain score at least above 7 on a numeric rating pain scale, and a left-sided lesion are absolute indications for in-hospital management.

Purpose: Guideline of stage II colon cancer chemotherapy is controversial issue. This study aims to assist in making proper guideline of stage II colorectal cancer chemotherapy. Methods: We retrospectively analyzed the medical records of 137 patients who had colorectal cancer surgery and chemotherapy at Sanggye Paik Hospital, Surgical Department from 2008 to February 2013. We analyzed disease-free survival rate (DFS), characteristics and relationship of stage II (II), stage II with lymphatic invasion (IIL), stage III with N1 (lymph mode involvement number under 3). Results: We found new metastasis in 23 patients (liver 11, lung 5, peritoneum 6, bone 1). There is no difference in DFS between II and IIL (P=0.064). But recurrence more frequently appeared with lymatic invasion group. There is no difference in DFS between IIL and III (P=0.083). But cancer stage had not effect to recurrence (P=0.153). In IIL patients, statistically difference did not be shown between oral and intravenous chemotherapy group (P=0.500). But chemotherapy completion group had higher DFS (P=0.001). Conclusion: Between II and IIL, DFS did not have difference but low P-value. In consideration of correlation analysis result and DFS between IIL and III, we think their prognosis is not same and completion of chemotherapy influence on good outcome in stage II with lymphatic invasion colon cancer.