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Articles by Y. J Jang
Total Records ( 4 ) for Y. J Jang
  Y. J Jang , N. K Yeo and J. H. Wang

Objectives  To introduce the cutting and suture technique of the caudal L-strut for the management of caudal septal deviation and to evaluate its efficacy and surgical outcomes.

Design  Retrospective study.

Setting  Tertiary care rhinology clinic.

Patients  Forty-five patients who underwent endonasal septoplasty using the cutting and suture technique of the caudal L-strut.

Interventions  After elevation of the mucoperichondrial flap, deviated portions of cartilage and bone were excised, leaving at least a 1.5-cm strip of L-strut. If caudal septal deviation persisted, the caudal strut was cut at the convex-most part, and the cut ends were slightly overlapped and sutured together.

Main Outcome Measures  Improvement in the treatment of nasal obstruction using a visual analog scale and a questionnaire for subjective satisfaction were evaluated 2 to 6 months after septoplasty. To evaluate outcomes objectively, endoscopic photographs of the nasal cavity before and after surgery were evaluated by 2 independent surgeons.

Results  Significant improvement in the treatment of nasal obstruction was achieved, with mean visual analog scale scores of 7.93 preoperatively and 3.63 postoperatively (P < .001). Subjective satisfaction was rated as much improved in 68% of patients, improved in 15%, and no change in 17%. Endoscopic examinations showed that 51% of patients had near-complete correction of the septum and that 47% had improved but a little persisting caudal deviation. One patient had no change in caudal septal deviation on endoscopic examination.

Conclusion  The cutting and suture technique of the caudal L-strut seems to be a useful technique that can be performed with relative ease and simplicity.

  N. K Yeo , J. H Wang , Y. S Chung , Y. J Jang and B. J. Lee

Objective  To analyze the incidence of prolonged epiphora after maxillectomy according to transected nasolacrimal duct management technique, type of tumor, radiotherapy, and timing of tube removal and performance of dacryocystorhinotomy.

Design  Retrospective medical record review.

Settings  University hospitals.

Patients  We studied 89 patients (90 cases) who underwent nasolacrimal duct transection during maxillectomy with preservation of orbital contents for the management of sinonasal tumors between July 1, 1996, and January 31, 2008.

Main Outcome Measures  The incidence of prolonged epiphora was analyzed according to 4 different transected nasolacrimal duct management techniques: simple transection without any additional procedure, silicone tube stenting, transcanalicular Silastic stenting, and marsupialization without stenting. We also analyzed the relationship between other factors (type of tumor, radiotherapy, and timing of tube removal) and the incidence of prolonged epiphora. Prolonged epiphora was defined as persistent if it lasted longer than 6 months.

Results  The overall incidence of prolonged epiphora was 15.6% (14 of 90 cases). The prolonged epiphora rates differed according to the management technique (no procedure, 27.3% [3 of 11 cases]; silicone tube, 7.0% [4 of 57 cases]; transcanalicular Silastic stenting, 66.7% [4 of 6 cases]; marsupialization, 18.8% [3 of 16 cases]; P = .002). The silicone tube technique showed the lowest rate (odds ratio = 0.20, P = .06). In contrast, the incidence of prolonged epiphora was not affected by the type of tumor, postoperative radiotherapy, or timing of tube removal.

Conclusion  Silicone tube stenting can be used as the effective and convenient transected nasolacrimal duct reconstructive technique to prevent prolonged epiphora.

  Y. J Jang , M. S Park , S. S Park , J. H Kim , H An , S. H Park , S. J Kim , C. S Kim and Y. J. Mok

Background  The results of gastric cancer treatment have improved during the past 2 decades. In addition to early diagnosis, surgeon experience and subspecialty may influence long-term outcomes. This study analyzed data accumulated during the past 20 years regarding the impact of surgical subspecialty on gastric cancer prognosis.

Design  A 20-year, retrospective study.

Setting  Korea University Guro Hospital, Seoul.

Patients  A total of 2797 patients admitted between 1984 and 2003 with surgically treated, pathologically confirmed, primary gastric adenocarcinoma.

Main Outcome Measure  Long-term survival.

Results  The incidence of total gastrectomy and the number of retrieved lymph nodes increased during the study period. In curative cases, 5-year survival improved from 66.1% to 76.6%, and this survival gain was restricted to stages I, III, and IV. A Cox proportional hazards regression model showed that age, sex, tumor location, type of resection, stage, and the interaction between period of study and surgical subspecialty were independent prognostic factors.

Conclusions  This large, long-term cohort study demonstrates that the management of gastric cancer has been largely successful, with favorable trends in prognostic factors. Successful outcomes are realized more often by gastric surgical specialists. Efforts must be made to improve the treatment of patients with stage II gastric cancer because the improvements in long-term results have plateaued.

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