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P S Paik

Publications and source records attributed to P S Paik.

3 recordsLinked to original sources

Abdominal incision tumor implantation following pneumoperitoneum laparoscopic procedure vs. standard open incision in a syngeneic rat model.

INTRODUCTION: A recent hamster model study suggests that the abdominal wall wound implantation rate increases following laparoscopic colon cancer surgery compared with the traditional open technique. However, results of that study were confounded by several factors, including a midline incision in the laparoscopy group, an unclear definition of wound implantation, significant age variations in study subjects, and cell line use with low viability. The aim of this study was to compare the abdominal incision implantation rates following a pneumoperitoneum-laparoscopic-type procedure with a standard open incision using a syngeneic host/colon cancer rat model. METHODS: Viable DHD/K12 rat colon carcinoma cells (2 x 10(5) cells/rat) were injected intraperitoneally via 18G angiocath into anesthetized, immunocompetent BD-IX rats (syngeneic host rats). Rats were then randomly divided into open incision and laparoscopy groups. At three weeks post-operatively, tumor growth at the injection, incision, and port sites was measured. RESULTS: Following standard midline incision, 50 percent of rats (26/50 rats) developed wound implantations, whereas only 25 percent of rats (14/57 rats) developed at least one trocar site wound implantation after laparoscopy with pneumoperitoneum. Fourteen percent of trocar sites (16/114 port sites) developed wound implantations. No tumor growth was noted on the peritoneal surfaces other than in the incisional sites. CONCLUSION: Laparoscopic-type procedure with pneumoperitoneum did not increase wound implantation in a syngeneic host/colon carcinoma rat model compared with the standard open incision technique.

Abdominal Muscles↗

Laparoscopic colectomy.

Laparoscopic treatments for benign colonic disease and as palliative operations for advanced malignant disease have gained widespread acceptance as safe, efficacious, and beneficial treatment options. There are also strong indications that laparoscopic treatment for malignant colorectal disease is a viable alternative in selective patients. Further studies with substantial follow-up to determine the adequacy of resection and the comparability of cure rates are needed to assess any changes in the long-term staging and survival patterns of these treatments.

Colectomy↗

Intra-abdominal abscesses following laparoscopic and open appendectomies.

Recent findings in a small number of studies have suggested a trend toward increased infectious complications following laparoscopic appendectomy. The purpose of the present review was to evaluate the incidence of postappendectomy intra-abdominal abscess formation following laparoscopic and open appendectomies. Using the surgical database of the Los Angeles County-University of Southern California Medical Center, we reviewed the records of all appendectomies performed at the center between March 1993 and September 1995. Incidental appendectomies as well as appendectomies in pediatric patients under the age of 18 years were excluded. A total of 2497 appendectomies were identified; indications for these procedures included acute appendicitis in 1422 cases (57%), gangrenous appendicitis in 289 (12%), and perforated appendicitis in 786 (31%). The intraoperative diagnosis made by the surgeon was used for classification. A two-tailed P value of <0.05 was considered significant. There was no significant difference in the rate of abscess formation between the groups undergoing open and laparoscopic appendectomies for acute and gangrenous appendicitis. In patients with perforated appendicitis, a total of 26 postappendectomy intra-abdominal abscesses occurred following 786 appendectomies for an overall abscess formation rate of 3.3%. Eighteen abscesses occurred following 683 open appendectomies (2.6%), six abscesses occurred following 67 laparoscopic appendectomies (9.0%), and the remaining two abscesses occurred following 36 converted cases (5.6%). For perforated appendicitis, however, there was a statistically significant increase in the rate of abscess formation following laparoscopic appendectomy compared to conventional open appendectomy (9.0% vs. 2.6%, P = 0.015). There was no significant difference in the rate of abscess formation between open vs. converted cases or between laparoscopic vs. converted cases. A comparison of the length of the postoperative hospital stay showed no significant difference between open and laparoscopic appendectomy for perforated appendicitis (6.1 days vs. 5.9 days). Laparoscopic appendectomy for perforated appendicitis is associated with a higher rate of postoperative intra-abdominal abscess formation without the benefit of a shortened hospital stay. Given these findings, laparoscopic appendectomy is not recommended in patients with perforated appendicitis.

Abdominal Abscess↗