Thawatchai Akaraviputh - Academia.edu (original) (raw)

Papers by Thawatchai Akaraviputh

Journal of Hepato-Biliary-Pancreatic Sciences, 2010

BackgroundWith the rapid and marked progress in gastrointestinal endoscopy, the education of doct... more BackgroundWith the rapid and marked progress in gastrointestinal endoscopy, the education of doctors in many new diagnostic and therapeutic procedures is of increasing importance. Telecommunications (telemedicine) is very useful and cost‐effective for doctors’ continuing exposure to advanced skills, including those needed for hepato‐pancreato‐biliary diseases. Nevertheless, telemedicine in endoscopy has not yet gained much popularity. We have successfully established a new system which solves the problems of conventional ones, namely poor streaming images and the need for special expensive teleconferencing equipment.MethodsThe digital video transport system, free software that transforms digital video signals directly into Internet Protocol without any analog conversion, was installed on a personal computer using a network with as much as 30 Mbps per channel, thereby providing more than 200 times greater information volume than the conventional system. Kyushu University Hospital in ...

World journal of gastrointestinal endoscopy, Jun 16, 2024

Journal of the Medical Association of Thailand, Feb 1, 2020

DOAJ (DOAJ: Directory of Open Access Journals), Mar 1, 2017

Background: Treatment for obstructive left-sided colorectal cancer (OLCC) typically consists of a... more Background: Treatment for obstructive left-sided colorectal cancer (OLCC) typically consists of a three-staged procedure. During the first stage, the obstruction is managed with diversion colostomy. Traditionally in the second stage, we perform open resection for the primary tumor. In this study, we evaluated the feasibility of laparoscopic resection of OLCC with diversion colostomy in terms of operative results and short-term outcomes. Methods: A total of 20 patients underwent laparoscopic resection for OLCC (study group), 48 patients underwent open resection for OLCC (control group 1), and 53 patients underwent laparoscopic resection for non-OLCC (control group 2). Afterwards, results from the procedures were obtained and clinical data were analyzed. Results: The operative time was significantly longer in the study group than in the control group 1 (153 minutes vs. 126 minutes, p ¼ 0.041), and the length of hospitalization was shorter in the study group than in the control group 1 (5.3 days vs. 7.6 days, p ¼ 0.032). Regarding the operative results and short-term outcomes, there were no significant differences between the study group and control group 2. Colostomy retraction was a specific morbidity which occurred in two patients of the study group. Conclusion: Laparoscopic resection of OLCC with diversion colostomy is feasible. Abdominal cavity adhesion is only limited. We strongly recommend that laparoscopic resection should be performed at least 2 weeks after diversion colostomy, and the plastic rod should be left in place during the pneumoperitoneum to reduce the risk of colostomy retraction.

Siriraj Medical Journal, Apr 1, 2023

Objective: The current standard of care for locally advanced rectal cancer is associated with mul... more Objective: The current standard of care for locally advanced rectal cancer is associated with multimodality therapy. Neoadjuvant chemoradiation significantly decreased the locoregional recurrence rate and improved survival. However, distant metastasis develops rather than local recurrence, which becomes the leading cause of death. This study aimed to evaluate the oncological outcomes of total neoadjuvant therapy (TNT) in locally advanced rectal cancer. Materials and Methods: This retrospective study recruited 18 patients diagnosed with locally advanced rectal adenocarcinoma (cT3-4 or cN1-2), treated with consolidation TNT. The primary endpoint was pathological complete response (pCR). The secondary endpoint included postoperative outcomes, local recurrences, and distant metastases. Results: The pathologic complete response was observed in 27.8% of consolidation therapy cases and 25% of induction therapy cases. Downstaging of the T-category was achieved in 10 (55.6%) patients, and downstaging of the N-category was achieved in 14 (77.8%) patients. Only one patient who achieved pCR developed distant metastasis, whereas all patients with pathological stage III developed distant metastasis. Conclusion: TNT is a promising approach for patients with locally advanced rectal cancer. This strategy improved complete pathologic response rates in TNT, and pCR was found to be associated with fewer local recurrences and greater disease-free survival.

World Journal of Gastroenterology, 2010

AIM: To characterize clinical features, surgery, outcome, and survival of malignant melanoma (MM)... more AIM: To characterize clinical features, surgery, outcome, and survival of malignant melanoma (MM) of the gastrointestinal (GI) tract in a surgical training center in Bangkok, Thailand. METHODS: A retrospective review was performed for all patients with MM of the GI tract treated at our institution between 1997 and 2007. RESULTS: Fourteen patients had GI involvement either in a metastatic form or as a primary melanoma. Thirteen patients with sufficient data were reviewed. The median age of the patients was 66 years (range: 32-87 years). Ten patients were female and three were male. Seven patients had primary melanomas of the anal canal, stomach and the sigmoid colon (5, 1 and 1 cases, respectively). Seven patients underwent curative resections: three abdominoperineal resections, two wide local excisions, one total gastrectomy and one sigmoidectomy. Six patients had distant metastatic lesions at the time of diagnosis, which made curative resection an inappropriate choice. Patients who underwent curative resection exhibited a longer mean survival time (29.7 mo, range: 10-96 mo) than did patients in the palliative group (4.8 mo, P = 0.0006). CONCLUSION: GI MM had an unfavorable prognosis, except in patients who underwent curative resection (53.8% of cases), who had a mean survival of 29.7 mo.

World Journal of Clinical Cases, Jan 16, 2023

Gastrointestinal Endoscopy, Jun 1, 2023

JSLS, 2021

Background and Objectives:Laparoscopic cholecystectomy with common bile duct exploration (LC with... more Background and Objectives:Laparoscopic cholecystectomy with common bile duct exploration (LC with LCBDE) remains the preferred technique for difficult common bile duct stone (CBDS) removal. The chopstick method uses commonly available instruments and may be cost-saving compared to other techniques. We studied the outcome of LCBDE using the chopstick technique to determine if it could be considered a first-choice method.Methods:Data from all patients that underwent LCBDE from January 1, 2012 to April 30, 2019 were retrospectively analyzed. A standard 4-port incision and CBDS permitted extraction with two laparoscopic instruments by chopstick technique via vertical choledochotomy. Demographic data, stone clearance rate, surgical outcomes, complications, and other associated factors were evaluated.Results:Thirty-two patients underwent LCBDE. The mean number of preoperative endoscopic retrograde cholangiopancreatography (ERCP) sessions was 2.4. In 65.5% of cases, the CBDS was completely removed by the chopstick technique, while 96.9% of stones were removed after using additional tools. The need for additional instruments was associated with increased age, increased numbers of stones, longer period from the latest ERCP session, and previous upper abdominal surgery. The conversion rate to open surgery was 28.1% and was significantly associated with a history of upper abdominal surgery.Conclusion:The chopstick technique is a good alternative and could be considered as a first-line technique in LCBDE to remove the CBDS in cases with 1 to 2 large suprapancreatic CBDS due to instrument availability, cost-effectiveness, and comparable surgical outcomes.

Endoscopy, Dec 1, 2010

A 60-year-old man was diagnosed with pancreatic head adenocarcinoma. He underwent pancreaticoduod... more A 60-year-old man was diagnosed with pancreatic head adenocarcinoma. He underwent pancreaticoduodenectomy (Whipple procedure). Four months later he developed obstructive jaundice, high fever, and chills. His total bilirubin level was 2.0 mg/dL (range 0.3-1.2 mg/dL) and alkaline phosphatase was 270 U/L (range 39-117 U/L). Computed tomography (CT) of the abdomen showed marked dilatation of the afferent limb and a suspected recurrent tumor in the pancreatic area (• " Fig. 1).

DOAJ (DOAJ: Directory of Open Access Journals), Feb 1, 2006

... Ph.D., Wijarn Pongpanich, MD, Thawatchai Akaraviputh, MD, Somchai Leelakusolvong, MD, Wiroon ... more ... Ph.D., Wijarn Pongpanich, MD, Thawatchai Akaraviputh, MD, Somchai Leelakusolvong, MD, Wiroon Boonnuch, MD, Varut Lohsiriwat, MD, Darin Lohsiriwat, MD ... Gastroenterology 1979;77:133-7. 8. McPherson GA, Benjamin IS, Hodgson HJ, Bowley NB, Allison DJ, Blumgart ...

Gastrointestinal Endoscopy

Siriraj Medical Journal

Objective: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach that aims to op... more Objective: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach that aims to optimize perioperative management, promote postoperative recovery, reduce postoperative complications, and improve long-term survival. The current study aimed to evaluate and compare the postoperative physical activity after gastrectomy between patients who underwent upper gastrointestinal surgery according to ERAS and those who underwent surgery based on the conventional care (CC) protocol. Materials and Methods: This prospective and retrospective review enrolled 60 patients (n = 31, ERAS group; n = 29, CC protocol group) diagnosed with adenocarcinoma of the stomach and esophagogastric junction who underwent curative surgical resection. Physical outcomes, including body weight, body mass index, body fat percentage, basal metabolic rate, muscle mass, gait speed, and handgrip strength at the preoperative and immediate postoperative periods and at 1, 3, and 6 months postoperatively, were com...

Surgery, Gastroenterology and Oncology

Background: Enhanced recovery after surgery (ERAS) protocol has been shown to reduce recovery per... more Background: Enhanced recovery after surgery (ERAS) protocol has been shown to reduce recovery period and postoperative complications. This prospective study aimed to evaluate the short-term outcomes of ERAS in patients who underwent upper gastrointestinal (UGI) surgery. Methods: Patients who underwent surgery for benign or malignant diseases of the esophagus, esophagogastric junction, or stomach during October 2018-December 2019 were included. Outcomes compared between ERAS and conventional care (CC) included length of hospital stay (LOS), postoperative complications, mortality, recovery, and hospitalization cost. Results: Eighty-eight (32 ERAS, 56 CC) patients were included. ERAS had shorter LOS (5.5 vs. 12.5 days, p<0.001), earlier time to toleration of oral soft diet (3 vs. 8 days, p<0.001), faster time to first defecation (71.6 vs. 114.5 hours, p<0.001), early ambulation (43.8 vs. 84.6 hours, p=0.010), and reduced hospitalization cost (197,140 vs. 256,315 Thai baht, p<0.032). C-reactive protein level on postoperative day 1 was significantly lower in ERAS patients (61.3 vs. 87.9 mg/L, p=0.027). BMI recovery occurred within 3 and 6 months in ERAS and CC, respectively. There was no significant difference in surgery-related or nonsurgery-related complications between groups. No mortality was observed. Conclusions: In a UGI surgical setting, ERAS accelerated recovery, reduced LOS, and lowered hospitalization cost.

Objective: Duodenal diverticulum is not uncommon but most are asymptomatic. Surgery is recommende... more Objective: Duodenal diverticulum is not uncommon but most are asymptomatic. Surgery is recommended only for the patients with symptoms. Although laparoscopic diverticulectomy can be done, it is often with significant difficulties due to inherent limitations of the laparoscopic technique and posterior location of the lesion. The advent of the robotic surgical technology with superior imaging and instrumentation may provide an alternative minimally invasive approach for this situation. We herein report our case series utilizing the daVinci Surgical System (dVSS) for duodenal diverticulectomy. Methods: We retrospectively reviewed our robotic database for all duodenal procedures performed at a single institution (the Valley Hospital: VH). Only patients who underwent laparobotic duodenal diverticulectomy (LRDD) were included and their recorded videos reviewed. Data analyzed were patients' demographic, perioperative outcomes, and technical details. We used the daVinci Si (Intuitive Surgical Inc. Sunny Vale, Calif.) for all cases. Results: 4 female patients underwent LRDD. All presented with abdominal pain. Diagnosis was made by CT scans or MRI with or without EGD. 3 patients had diverticula located in the second part of the duodenum (75%). Concomitant procedures (choledochoduodenostomy and CBD exploration) were performed in two patients. Mean operative time was 142.5 min. There was one complication but no mortality. Average length of stay was 4 days. Conclusion: LRDD is feasible, efficient, and safe. The dVSS provides the surgeon improved visualization and enhanced dexterity to perform complex procedure.

BMC Surgery, 2021

Background The SARS-CoV2 virus has been identified in abdominal cavity of the COVID-19 patients. ... more Background The SARS-CoV2 virus has been identified in abdominal cavity of the COVID-19 patients. Therefore, the potential viral transmission from any surgical created smoke in these patients is of concern especially in laparoscopic surgery. This study aimed to compare the amount of surgical smoke and surgical field contamination between laparoscopic and open surgery in fresh cadavers. Methods Cholecystectomy in 12 cadavers was performed and they were divided into 4 groups: laparoscopic approach with or without smoke evacuator, and open approach with or without smoke evacuator. The increased particle counts in surgical smoke of each group were analyzed. In the model of appendectomy, surgical field contamination under ultraviolet light and visual contamination scale between laparoscopic and open approach were compared. Results Open cholecystectomy significantly produced a greater amount of overall particle sizes, particle sizes < 5 μm and particle sizes ≥ 5 μm than laparoscopic cho...

Objective: The use of prophylactic antibiotics in colorectal surgery is well established. Type of... more Objective: The use of prophylactic antibiotics in colorectal surgery is well established. Type of antibiotics, however, varies significantly among surgeons. The aim of this study was to determine whether mono-antimicrobial regimen is as effective as poly-antimicrobial regimen in the prevention of surgical wound infections following elective colorectal cancer surgery. Materials and Methods: The medical records of 56 patients with colorectal cancer undergoing elective oncological resection from January 2004 to September 2006 at Siriraj Hospital, Bangkok, were retrospectively reviewed. Patients were divided into two groups according to the regimen of prophylactic intravenous anti-biotics; group A: monotherapy (cefminox-Meicelin ®) and group B: polytherapy (ceftriaxone plus metronidazole). The duration of antibiotics administration was up to 24 hours in colonic surgery and up to 3 days in rectal surgery. Patient characteristics and rate of wound infection within 30 days after the operat...

Journal of laparoendoscopic & advanced surgical techniques. Part A, 2016

The aim of the present study was to compare the outcomes of secondary laparoscopic CBD exploratio... more The aim of the present study was to compare the outcomes of secondary laparoscopic CBD exploration (LCBDE) following failed endoscopic retrograde cholangiopancreatography (ERCP) and primary laparoscopic common bile duct (CBD) exploration. One hundred eighty-five patients undergoing LCBDE were divided into Group I consisting of patients undergoing a primary LCBDE (n = 102) and Group II consisting of patients undergoing LCBDE after failure of ERCP to clear the CBD stones (n = 83). Primary outcome measure was successful laparoscopic CBD clearance. The secondary outcome measures were degree of difficulty, operative time, complications, hospital stay, and the cost of treatment. Success rate was similar in both groups (85.3% versus 80.7%). Mean operative time, degree of difficulty, hospital stay, and cost of procedure were significantly higher in Group II (P value <.05). It may be prudent to consider ERCP failure patients for primary LCBDE than risk the complications of ERCP if they ar...