Schwannoma is a benign and uncommon neoplasm arising from the neural crest cells. The most common tumor sites are the skin and subcutaneous tissue of the head and neck. Retroperitoneal schwannomas account for 1–3% of all schwannomas and are predominantly female. In particular, adrenal schwannoma is very rare, and due to its large size at the time of diagnosis, adrenal schwannoma is frequently misdiagnosed as adrenocortical carcinoma or pheochromocytoma. Adrenal schwannoma is difficult to distinguish it from other adrenal diseases based on imaging findings alone. In this report, we introduce the case of a huge left adrenal schwannoma.
Bowel perforation secondary to a levonorgestrel-releasing intrauterine device is exceptionally rare. We present the case of a woman who exhibited abnormal findings during a colonoscopy examination. Despite undergoing an intrauterine device (IUD) insertion procedure for contraception in 2000, attempts for its removal in 2007 were unsuccessful due to the inability to locate the IUD. In 2022, she presented with intermittent hematochezia and lower left abdominal pain. Subsequent colonoscopy and abdominal computed tomography confirmed the presence of the IUD penetrating the uterine wall and entering the colon. Laparoscopic anterior resection was performed, and the patient’s postoperative recovery was uneventful, indicating the viability of laparoscopic treatment as a valuable option.
The number of older adult patients with colorectal cancer (CRC) is steadily increasing with the increasing aging population. However, healthcare professionals continue to approach treatment in older adult patients while considering the potential coexistence of complications relative to their age. There is a tendency to define and limit treatment options for managing “older adult patients” at relatively younger ages. Given the progression of aging societies and aging of patients with CRC, the impact of age on post-surgical outcomes should be analyzed to guide treatment decisions and ensure the highest quality of care for this population. This study aimed to compare outcomes in patients aged approximately 80 years who have undergone surgery after being diagnosed with CRC at the National Pusan University Hospital. This retrospective observational study included 502 patients who underwent surgery after being diagnosed with CRC at Pusan National University Hospital from January 2018 to December 2022. All surgeries were performed by a single surgeon. Older adult patients underwent open surgery more frequently. No significant differences in surgical outcomes or hospital stay were found between the two groups. Moreover, no notable differences were observed in overall complications, including major surgery-related complications such as anastomotic leakage, bleeding, and infection, between the two groups. However, pneumonia was significantly more common in the older patient group (P = .016). Among patients requiring emergency surgery, the older adult group demonstrated a significantly higher proportion of emergency surgeries and complications associated with regular surgeries compared with the younger group. In older adult patients, the risk of postoperative complications should not be determined solely based on age; a comprehensive assessment is necessary. However, in the case of emergency surgery, older adult patients may be relatively vulnerable compared with younger patients.
Background/Objectives: The study aims to provide a comprehensive understanding of personalized treatment for patients with inguinal hernias at our hospital, focusing on complications, recurrence rates, and hospitalization duration to optimize treatment outcomes. Methods: Our center performs inguinal hernia surgery using an algorithm tailored to individual clinical conditions, developed in collaboration with the anesthesiology department. We retrospectively reviewed outcomes of open, totally extraperitoneal (TEP), and transabdominal preperitoneal (TAPP) approaches, with all procedures performed by a single surgeon. Results: A total of 229 patients (213 males; age range, 24–92 years; median age, 69 years) underwent inguinal hernia repair at Busan National University Hospital between January 2018 and April 2024. Patients in the open group had higher age and comorbidity burden (age/ASA American Society of Anesthesiologists physical status classification: open 74/3.5 vs. TAPP 70/2.0 vs. TEP 68/2.0; p = 0.036/< 0.001). There were no statistically significant differences in intraoperative complications (p = 1.000); however, the conversion rate was slightly higher in the TEP group (TEP 2 vs. TAPP 1). Length of hospital stay was longest in the TAPP group (open 3.77 days vs. TAPP 3.98 days vs. TEP 3.27 days; p = 0.817), while postoperative complication rates did not differ significantly among groups (overall complications: open 15.4% vs. TAPP 6.2% vs. TEP 4.3%; p = 0.100). Conclusions: Laparoscopic surgery is recommended when general anesthesia is feasible, with TEP preferred for patients without previous surgeries and TAPP for those with preperitoneal space (PPS) access challenges due to previous surgeries or radiation therapy. Open surgery is suitable for patients unable to undergo general anesthesia. Anesthesia and surgical approaches should be based on patient preferences and individual clinical conditions.