Wing-Yui Lui

Interval Appendectomy after Conservative Treatment of an Appendiceal Mass

IntroductionThe purpose of this study was to clarify the role of interval appendectomy after conservative treatment of an appendiceal mass.MethodsFrom January 1998 to December 2003, patients with an appendiceal mass who received conservative treatment at the Taipei Veterans General Hospital were studied retrospectively. Data on demographics, rate of appendicitis recurrence, duration of hospital stay, and complication rate were collected and analyzed.ResultsA total of 165 patients were included (89 males, 76 females). The mean age was 53.6 years (range 7–89 years). The rate of appendicitis recurrence after conservative treatment was 25.5%; most recurred within 6 months after discharge (83.3%). The benefit of preventing recurrence is less than 16% if interval appendectomy is performed 6 weeks after discharge and less than 10% if it is done 12 weeks later. The complication rate of appendectomy performed before or after recurrence was 10% in both groups. The duration of the second hospital stay for patients who underwent interval appendectomy before or after recurrence was 4.43 ± 3.32 vs. 6.75 ± 5.73 days (P = 0.023). Of the 165 patients, 17 (10.3%) had their diagnosis changed after survey or surgery, and 5 (3.03%) were found to have colon cancer upon follow-up.ConclusionsPatients who recovered from conservative treatment of an appendiceal mass should undergo colonoscopy or barium enema to detect any underlying diseases and to rule out coexistent colorectal cancer. Routine interval appendectomy benefits less than 20% of patients.

Distribution of the superficial temporal artery in the Chinese adult.

The superficial temporal artery is important in head and neck surgery. Ethnologic variation may affect surgical procedure. In this study, we evaluated the variations of the artery in Chinese adults. We measured its bifurcating location, the diameter of its vessels, and its relationship to nearby structures. A total of 26 cadavers with 52 superficial temporal arteries were examined in 3 consecutive years. The superficial temporal artery ran 1.14 cm anteriorly to the bony external auditory canal. The average diameters of the superficial temporal artery, frontal branch, and parietal branch were 2.14, 1.61, and 1.68 mm, respectively. In 45 of 52 cases (86.5 percent), bifurcation of the artery occurred well above the zygomatic arch. The present study thus demonstrated that the superficial temporal artery in the Chinese adult differs from that in the Caucasian and has provided a detailed anatomic distribution analysis of the superficial temporal artery in Chinese adults, which should benefit the clinician in dealing with operation procedures related to this artery.

Variations of the cystic artery in Chinese adults.

The origin and course of the cystic artery related to the Calot triangle were studied in 72 autopsies. The cystic artery arises from many possible origins; the right hepatic artery is the most common origin (76.6%). The Calot triangle (hepatocystic triangle), which is an important imaginary referent area for biliary surgery, is bounded by the common hepatic duct (CHD), the cystic duct, and the cystic artery. Of all the cystic arteries, 86.1% coursed through the Calot triangle, and 100% of the cystic arteries originating from the right hepatic artery coursed through the Calot triangle. However, only 54% of the cystic arteries that originated from the left, bifurcation, proper, and common hepatic arteries ran through the triangle. None of the cystic arteries that originated from the gastroduodenal, celiac, superior mesentery, or superior pancreaticoduodenal arteries passed through the triangle. Furthermore, 72.7% of the cystic arteries that originated from the right hepatic artery ran beneath the CHD as they entered the Calot triangle; the others ran anterior to the CHD. Of the cystic arteries that arose from locations other than the right hepatic artery, 29.4% ran posterior to the CHD, and 11.8% ran anterior to the CHD. The current study provides detailed information about anatomic variance in Chinese adults that may help avoid injury during open or laparoscopic cholecystectomies.

Applied anatomy of the genital branch of the genitofemoral nerve in open inguinal herniorrhaphy

OBJECTIVE To record the anatomical variations and clinical importance of the genital branch of the genitofemoral nerve in the inguinal canal. DESIGN Neuropathology study. SETTING General hospital, Taiwan. SUBJECTS 58 cadavers. INTERVENTIONS 116 dissections findings of the genitofemoral nerve in the inguinal canal. MAIN OUTCOME MEASURES Anatomical variations. RESULTS All the genital branches passed through the ventral aspect of the internal ring. Almost all these branches entered the ring and continued within the spermatic cord between the fibres of the cremaster and the internal spermatic fascia. In 59% the nerve was related to the inferior fibres and in 38% it was in relation to the lateral or medial fibres. In only 3% did the genital branch run outside the spermatic cord. CONCLUSION To avoid damage to the genital branch of the genitofemoral nerve, suturing should be done over the dorsal aspect of the internal ring. The cremaster should be incised longitudinal rather than transversely and the genital branch of the genitofemoral nerve should be identified before repair of the posterior wall.

Watchful Waiting Versus Interval Appendectomy for Patients Who Recovered from Acute Appendicitis with Tumor Formation: A Cost-effectiveness Analysis

Background: Interval appendectomy after conservative treatment of appendicitis with tumor formation remains controversial. The purpose of this study was to evaluate the efficacy of interval appendectomy based on a cost‐effectiveness analysis. Methods: This was a retrospective study including appendicitis patients with tumor formation who received conservative treatment at first admission to Taipei Veterans General Hospital between January 1998 and December 2003. Demographic data, rate of recurrent appendicitis, and medical costs were analyzed. Results: Of the 165 patients, 1 died after an acute myocardial infarction. The rate of recurrence of appendicitis after conservative treatment was 25.5%. The median cost of follow‐up after conservative treatment was NT

Surgical anatomy of the external branch of the superior laryngeal nerve in Chinese adults and its clinical applications

24,344. The median cost of interval appendectomy was NT

Acute Appendicitis in Patients with Acquired Immunodeficiency Syndrome

47,746. The median cost of appendectomy after recurrent appendicitis was NT

Distribution of the Superficial Veins in Cubital Fossa in Chinese Adults

62,135. Routine interval appendectomy in all 164 patients would have cost NT

The anatomical variations of the palmar cutaneous branch of the median nerve in Chinese adults

7,830,344. The follow‐up protocol with appendectomy after recurrence cost NT

Pretreatment with magnolol attenuates ischemia-reperfusion injury in rat small intestine

5,655,220. An additional NT