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1.  Surgical issues in locally advanced rectal cancer treated by preoperative chemoradiotherapy 
The standard treatment for patients with locally advanced rectal cancer is preoperative chemoradiotherapy followed by total mesorectal excision. This approach is supported by randomized trials, but there are still many unanswered questions about the multimodal management of rectal cancer. In surgical terms, these include the optimal time interval between completion of chemoradiotherapy and surgery; adequate distal resection margin and circumferential radial margin; sphincter preservation; laparoscopic surgery; and conservative management, including a 'wait and see' policy and local excision. This review considers these controversial issues in preoperative chemoradiotherapy.
PMCID: PMC3539104  PMID: 23323229
Rectal cancer; Chemoradiotherapy; Surgical procedures
2.  The current status and future perspectives of laparoscopic surgery for gastric cancer 
Gastric cancer is most common cancer in Korea. Surgery is still the main axis of treatment. Due to early detection of gastric cancer, the innovation of surgical instruments and technological advances, gastric cancer treatment is now shifting to a new era. One of the most astonishing changes is that minimally invasive surgery (MIS) is becoming more dominant treatment for early gastric cancer. These MIS are represented by endoscopic resection, laparoscopic surgery, robotic surgery, single-port surgery and natural orifice transluminal endoscopic surgery. Among them, laparoscopic gastrectomy is most actively performed in the field of surgery. Laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) has already gained popularity in terms of the short-term outcomes including patient's quality of life. We only have to wait for the long-term oncologic results of Korean Laparoscopic Gastrointestinal Surgery Study Group. Upcoming top issues following oncologic safety of LADG are function-preserving surgery for EGC, application of laparoscopy to advanced gastric cancer and sentinel lymph node navigation surgery. In the aspect of technique, laparoscopic surgery at present could reproduce almost the whole open procedures. However, the other fields mentioned above need more evidences and experiences. All these new ideas and attempts provide technical advances, which will minimize surgical insults and maximize the surgical outcomes and the quality of life of patients.
PMCID: PMC3204545  PMID: 22066116
Gastric cancer; Future perspective; Laparoscopy; Sentinel lymph node navigation surgery; Minimally invasive surgery
3.  The effective distribution system for the concentration of patients to extra-large hospitals 
In Korean society, extra-large hospitals are congested with the majority of patients. Because of the congestions, the urgent patients need to wait anywhere from as short as a month to around three months. These concentrations of the patients on the extra-large hospitals causes not only the economic problem in terms of loss of opportunity cost and resources of other medium and large hospitals but also the fear and the consequential stress of the patients and the families of the patients who are waiting for the surgeries. The phenomenon of the concentrations derived due to the insufficient information to the medical consumers. If the information on medical treatment services such as surgery schedule is provided before the selection of hospital, we expect that the selection of hospital for the patients and their family will differ, resulting in redistribution of concentration phenomenon. In this paper, we propose and verify the effective distribution system for the concentration on the extra-large hospitals.
Web simulation survey was conducted. A total 100 respondents were divided into 4 groups of 25 respondents and the different information was provided to each group.
Through multiple comparisons among groups, only group which was provided with both information about 'the difference of surgical results' and 'the waiting time for surgery', had difference in significance.
By providing two sets of information to patients, reckless selection of extra-large hospitals can be spread to more appropriate hospitals and therefore achieve effective distribution of the population concentration on extra-large hospital.
PMCID: PMC3204691  PMID: 22066063
Hospital distribution systems; Patient self-determination act; Decision theory; Appointments and schedules

Results 1-3 (3)