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| 1 | Efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy:A prospective,randomized study显示文摘AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption. | Thawatchai Akaraviputh Charay Leelouhapong Varut Lohsiriwat Somkiat Aroonpruksakul | 2009 | World Journal of Gastroenterology2009，15，16： | 78 |
| 2 | Hemorrhoids:From basic pathophysiology to clinical management显示文摘This review discusses the pathophysiology,epidemiology,risk factors,classification,clinical evaluation,and current non-operative and operative treatment of hemorrhoids.Hemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions.The most common symptom of hemorrhoids is rectal bleeding associated with bowel movement.The abnormal dilatation and distortion of the vascular channel,together with destructive changes in the supporting connective tissue within the anal cushion,is a paramount finding of hemorrhoids.It appears that the dysregulation of the vascular tone and vascular hyperplasia might play an important role in hemorrhoidal development,and could be a potential target for medical treatment.In most instances,hemorrhoids are treated conservatively,using many methods such as lifestyle modification,fiber supplement,suppositorydelivered anti-inflammatory drugs,and administration of venotonic drugs.Non-operative approaches include sclerotherapy and,preferably,rubber band ligation.An operation is indicated when non-operative approaches have failed or complications have occurred.Several surgical approaches for treating hemorrhoids have been introduced including hemorrhoidectomy and stapled hemorrhoidopexy,but postoperative pain is invariable.Some of the surgical treatments potentially cause appreciable morbidity such as anal stricture and incontinence.The applications and outcomes of each treatment are thoroughly discussed. | Varut Lohsiriwat | 2012 | World Journal of Gastroenterology2012，18，17： | 74 |
| 3 | Treatment of hemorrhoids: A coloproctologist's view显示文摘Hemorrhoids is recognized as one of the most common medical conditions in general population. It is clinically characterized by painless rectal bleeding during defecation with or without prolapsing anal tissue. Generally,hemorrhoids can be divided into two types: internal hemorrhoid and external hemorrhoid. External hemorrhoid usually requires no specific treatment unless it becomes acutely thrombosed or causes patients discomfort. Meanwhile,low-graded internal hemorrhoids can be effectively treated with medication and nonoperative measures(such as rubber band ligation and injection sclerotherapy). Surgery is indicated for highgraded internal hemorrhoids,or when non-operative approaches have failed,or complications have occurred. Although excisional hemorrhoidectomy remains the mainstay operation for advanced hemorrhoids and complicated hemorrhoids,several minimally invasive operations(including Ligasure hemorrhoidectomy,doppler-guided hemorrhoidal artery ligation and stapled hemorrhoidopexy) have been introduced into surgical practices in order to avoid post-hemorrhiodectomy pain. This article deals with some fundamental knowledge and current treatment of hemorrhoids in a view of a coloproctologist- which includes the management of hemorrhoids in complicated situations such as hemorrhoids in pregnancy,hemorrhoids in immunocompromised patients,hemorrhoids in patients with cirrhosis or portal hypertension,hemorrhoids in patients having antithrombotic agents,and acutely thrombosed or strangulated hemorrhoids. Future perspectives in the treatment of hemorrhoids are also discussed. | Varut Lohsiriwat | 2015 | World Journal of Gastroenterology2015，21，31： | 54 |
| 4 | Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery显示文摘AIM:To determine the relationship between pre-operative hypoalbuminemia and the development of complications following rectal cancer surgery, as well as postoperative bowel function and hospital stay. METHODS:The medical records of 244 patients undergoing elective oncological resection for rectal adenocarcinoma at Siriraj Hospital during 2003 and 2006 were reviewed. The patients had pre-operative serum albumin assessment. Albumin less than 35 g/L was recognized as hypoalbuminemia. Postoperative outcomes, including mortality, complications, time to first bowel movement, time to first defecation, time to resumption of normal diet and length of hospital stay, were analyzed. RESULTS:The patients were 139 males (57%) and 105 females (43%) with mean age of 62 years. Fifty-six patients (23%) had hypoalbuminemia. Hypoalbuminemic patients had a significantly larger tumor size and lower body mass index compared with non-hypoalbuminemic patients (5.5 vs 4.3 cm;P < 0.001 and 21.9 vs 23.2 kg/m2;P = 0.02, respectively). Thirty day postoperative mortality was 1.2%. Overall complication rate was 25%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (37.5% vs 21.3%;P = 0.014). In univariate analysis, hypoalbuminemia and ASA status were two risk factors for postoperative complications. In multivariate analysis, hypoalbuminemia was the only significant risk factor (odds ratio 2.22,95% CI 1.17-4.23;P < 0.015). Hospitalization in hypoalbuminemic patients was significantly longer than that in non-hypoalbuminemic patients (13 vs 10 d, P = 0.034), but the parameters of postoperative bowel function were not significantly different between the two groups. CONCLUSION:Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following rectal cancer surgery. | Varut Lohsiriwat Darin Lohsiriwat Wiroon Boonnuch Vitoon Chinswangwatanakul Thawatchai Akaraviputh Narong Lert-akayamanee | 2008 | World Journal of Gastroenterology2008，14，8： | 24 |
| 5 | Colonoscopic perforation:Incidence,risk factors,management and outcome显示文摘This review discusses the incidence,risk factors,management and outcome of colonoscopic perforation(CP).The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic interventions.The perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple comorbidities.Management of CP is mainly based on patients' clinical grounds and their underlying colorectal diseases.Current therapeutic approaches include conservative management(bowel rest plus the administration of broadspectrum antibiotics),endoscopic management,and operative management(open or laparoscopic approach).The applications of each treatment are discussed.Overall outcomes of patients with CP are also addressed. | Varut Lohsiriwat | 2010 | World Journal of Gastroenterology2010，16，4： | 20 |
| 6 | Enhanced recovery after surgery vs conventional care in emergency colorectal surgery显示文摘AIM:To investigate the feasibility and beneficial effects of enhanced recovery after surgery(ERAS) programme in the setting of emergency colorectal surgery.METHODS:Between January 2011 and October 2013,patients undergoing emergency resection for obstructing colorectal cancer at the Faculty of Medicine Siriraj Hospital,Bangkok,Thailand using ERAS programme were compared with those using conventional care(1:2 ratio). They were matched for their age,gender,ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity score,and type of surgery. Primary outcomes were length of hospital stay and postoperative morbidity. Secondary outcomes included gastrointestinal recovery,30-d readmission,and time interval from surgery to chemotherapy.RESULTS:Twenty patients treated with ERAS programme were compared with 40 patients receiving conventional postoperative care.Median of hospital stay was shorter in the ERAS group:5.5 d(range:3-16)vs 7.5 d(range:5-25),P=0.009.The ERAS group had a non-significant reduction in the incidence of postoperative complication(25%vs 48%,P=0.094).No 30-d mortality and readmission occurred.Patients with ERAS programme had a shorter time to first flatus(1.6 d vs 2.8 d,P<0.001)and time to resumption of normal diet(3.5 d vs 5.5 d,P=0.002).Time interval between operation and initiation of adjuvant chemotherapy was significantly shorter in the ERAS group(37 d vs 49 d,P=0.009).CONCLUSION:The ERAS programme in the setting of emergency colorectal surgery was safe and feasible.It achieved significantly shorter hospitalisation and faster recovery of bowel function. | Varut Lohsiriwat | 2014 | World Journal of Gastroenterology2014，20，38： | 16 |
| 7 | Opioid-sparing effect of selective cyclooxygenase-2 inhibitors on surgical outcomes after open colorectal surgery within an enhanced recovery after surgery protocol显示文摘AIM: To evaluate the opioid-sparing effect of selective cyclooxygenase-2(COX-2) inhibitors on short-term surgical outcomes after open colorectal surgery.METHODS: Patients undergoing open colorectal resection within an enhanced recovery after surgery protocol from 2011 to 2015 were reviewed. Patients with combined general anesthesia and epidural anesthesia, and those with acute colonic obstruction or perforation were excluded. Patients receiving selective COX-2 inhibitor were compared with well-matched individuals without such a drug. Outcome measures included numeric pain score and morphine milligram equivalent(MME) consumption on postoperative day(POD) 1-3, gastrointestinal recovery(time to tolerate solid diet and time to defecate), complications and length of postoperative stay.RESULTS: There were 75 patients in each group. Pain score on POD 1-3 was not significantly different between two groups. However, MME consumption and MME consumption per kilogram body weight on POD 1-3 was significantly less in patients receiving a selective COX-2 inhibitor(P < 0.001). Median MME consumption per kilogram body weight on POD 1-3 was 0.09, 0.06 and nil, respectively in patients receiving a selective COX-2 inhibitor and 0.22, 0.25 and 0.07, respectively in the comparative group(P < 0.001), representing at least 59% opioidreduction. Patients prescribing a selective COX-2 inhibitor had a shorter median time to resumption of solid diet [1(IQR 1-2) d vs 2(IQR 2-3) d; P < 0.001] and time to first defecation [2(IQR 2-3) d vs 3(IQR 3-4) d; P < 0.001]. There was no significant difference in overall postoperative complications between two groups. However, median postoperative stay was significantly 1-d shorter in patients prescribing a selective COX-2 inhibitor [4(IQR 3-5) d vs 5(IQR 4-6) d; P < 0.001]. CONCLUSION: Perioperative administration of oral selective COX-2 inhibitors significantly decreased intravenous opioid consumption, shortened time to gastrointestinal recovery and reduced hospital stay after open colorectal surgery. | Varut Lohsiriwat | 2016 | World Journal of Gastrointestinal Oncology2016，8，7： | 7 |
| 8 | Colonoscopic perforation:A report from World Gastroenterology Organization endoscopy training center in Thailand显示文摘瞄准:决定 colonoscopic 穿孔(CP ) 的发生,并且从在泰国训练中心的世界肠胃病学组织(WGO ) 内视镜检查法与 CP 评估病人的临床的调查结果,管理和结果。方法:所有 colonoscopies 和 sigmoidoscopies 在内视镜的单位表现在 1999 和 2007 之间,药 Siriraj 医院的教师, Mahidol 大学,曼谷被考察。CP,病人的特征,内视镜的信息, intra 起作用的调查结果,管理和结果的发生被分析。结果:结肠(13699 colonoscopies 和 3658 灵活 sigmoidoscopies ) 的 17357 内视镜的过程的一个总数在 9 年的经期上在 Siriraj 医院里被执行。十五个病人(0.09%) 有 CP:14 从结肠镜检查并且 1 从乙状结肠镜检查。穿孔的最普通的地点在 S 字形的冒号(80%) ,由横向的冒号(13%) 列在后面。穿孔被直接损伤从柄或内诊镜的尖端引起(n = 12, 80%) 并且内视镜的 polypectomy (n = 3, 20%) 。有 CP 的所有病人经历了外科的管理:主要修理(27%) 和肠切除术(73%) 。死亡率是 13% ,手术后的复杂并发症率是 53% 。结论:CP 是稀罕却严肃的复杂并发症追随者结肠镜检查和乙状结肠镜检查,与病态和死亡的高率。CP 的发生是 0.09% 。外科仍然是 CP 管理的支柱。 | Varut Lohsiriwat Sasithorn Sujarittanakarn Thawatchai Akaraviputh Narong Lertakyamanee Darin Lohsiriwat Udom Kachinthorn | 2008 | World Journal of Gastroenterology2008，14，43： | 6 |
| 9 | Enhanced recovery after surgery in emergency colorectal surgery:Review of literature and current practices显示文摘Enhanced recovery after surgery(ERAS), a multidisciplinary program designed to minimize stress response to surgery and promote the recovery of organ function, has become a standard of perioperative care for elective colorectal surgery. In an elective setting, ERAS program has consistently been shown to decrease postoperative complication, reduce length of hospital stay, shorten convalescence, and lower healthcare cost. Recently, there is emerging evidence that ERAS program can be safely and effectively applied to patients with emergency colorectal conditions such as acute colonic obstruction and intraabdominal infection. This review comprehensively covers the concept and application of ERAS program for emergency colorectal surgery. The outcomes of ERAS program for this emergency surgery are summarized as follows:(1) The ERAS program was associated with a lower rate of overall complication and shorter length of hospital stay – without increased risks of readmission,reoperation and death after emergency colorectal surgery; and(2) Compliance with an ERAS program in emergency setting appeared to be lower than that in an elective basis. Moreover, scientific evidence of each ERAS item used in emergency colorectal operation is shown. Perspectives of ERAS pathway in emergency colorectal surgery are addressed. Finally, evidence-based ERAS protocol for emergency colorectal surgery is presented. | Varut Lohsiriwat Romyen Jitmungngan | 2019 | World Journal of Gastrointestinal Surgery2019，11，2： | 6 |
| 10 | Surgery for gastrointestinal malignant melanoma:Experience from surgical training center显示文摘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 andone 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. | Thawatchai Akaraviputh Satida Arunakul Varut Lohsiriwat Cherdsak Iramaneerat Atthaphorn Trakarnsanga | 2010 | World Journal of Gastroenterology2010，16，6： | 5 |
| 11 | Percutaneous endoscopic gastrostomy tube replacement:A simple procedure?显示文摘Replacement of gastrostomy tube in patients under-going percutaneous endoscopic gastrostomy (PEG) is generally considered as a safe and simple procedure. However, it could be associated with serious complications, such as gastrocutaneous tract disruption and intraperitoneal tube placement, which may lead to chemical peritonitis and even death. When PEG tube needs a replacement (e.g., occlusion or breakage of the tube), clinicians must realize that the gastrocutaneous tract of PEG is more friable than that of surgical gastrostomy because there is no suture fixation between gastric wall and abdominal wall in PEG. In general, the tract of PEG begins to mature in 1-2 wk after placement and it is well formed in 4-6 wk. However, this process could take a longer period of time in some patients. Accordingly, this article describes three major principles of a safe PEG tube replacement: (1) good control of the replacement tube along the well-formed gastrocutaneous tract; (2) minimal insertion force during the replacement, and, most importantly; and (3) reliable methods for the confirmation of intragastric tube insertion. In addition, the management of patients with suspected intraperitoneal tube placement (e.g., patients having abdominal pain or signs of peritonitis immediately after PEG tube replacement or shortly after tube feeding was resumed) is discussed. If prompt investigation confirms the intraperitoneal tube placement, surgical intervention is usually required. This article also highlights the fact that each institute should have an optimal protocol for PEG tube replacement to prevent, or to minimize, such serious complications. Meanwhile, clinicians should be aware of these potential complications, particularly if there are any difficulties during the gastrostomy tube replacement. | Varut Lohsiriwat | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，1： | 4 |
| 12 | Approach to Hemorrhoids显示文摘 | Varut Lohsiriwat | 2013 | Current Gastroenterology Reports2013，，7： | 3 |
| 13 | Role of endoscopy in caustic injury of the esophagus显示文摘Caustic injury of the esophagus is a problematic condition challenging endoscopists worldwide. Althoughthe caustic agents and motives are different among countries and age groups, endoscopy still plays an invaluable role in diagnosis and treatment. Endoscopy can determine the severity of caustic ingestion which is of great importance in choosing appropriate treatment. However, some aspects of endoscopy in diagnosis of caustic injury remain controversial. Whether or not all patients need endoscopy, when to perform endoscopy and how to assess the severity are just some examples of these controversies. Due to lack of randomized controlled trials, many findings and suggestions are inconclusive. Computerized tomography scan of the chest and abdomen gains popularity in assessing the severity of caustic injury and avoiding unnecessary surgery. If esophageal stricture eventually develops, endoscopic dilatation is a mainstay. Maneuvers such as steroid injection and esophageal stent may be used in a refractory stricture. Nevertheless, some patients have to undergo surgery in spite of vigorous attempts with esophageal dilatation. To date, caustic injury remains a difficult situation. This article reviews all aspects of caustic injury of the esophagus focusing on endoscopic role. Pre-endoscopic management, endoscopy and its technique in acute and late phase of caustic injury including the endoscopic management of refractory stricture, and the treatment outcomes following each endoscopic intervention are thoroughly discussed. Finally, the role of endoscopy in the long term follow-up of patients with esophageal caustic injury is addressed. | Asada Methasate Varut Lohsiriwat | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，10： | 3 |
| 14 | Pattern and distribution of colonic diverticulosis:Analysis of 2877 barium enemas in Thailand显示文摘AIM:To determine the pattern and distribution of colonic diverticulosis in Thai adults.METHODS:A review of the computerized radiology database for double contrast barium enema(DCBE)in Thai adults was performed at the Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok,Thailand.Incomplete studies and DCBE examinations performed in non-Thai individuals were excluded.The pattern and distribution of colonic diverticulosis detected during DCBE studies from June 2009 to October 2011 were determined.The occurrence of solitary cecal diverticulum,rectal diverticulum and giant diverticulum were reported.Factors influencing the presence of colonic diverticulosis were evaluated.RESULTS:A total of 2877 suitable DCBE examinations were retrospectively reviewed.The mean age of patients was 59.8±14.7 years.Of these patients,1778(61.8%)were female and 700(24.3%)were asymptomatic.Colonic diverticulosis was identified in 820patients(28.5%).Right-sided diverticulosis(641 cases;22.3%)was more frequently reported than left-sided diverticulosis(383 cases;13.3%).Pancolonic diverticulosis was found in 98 cases(3.4%).The occurrence of solitary cecal diverticulum,rectal diverticulum and giant diverticulum were 1.5%(42 cases),0.4%(12 cases),and 0.03%(1 case),respectively.There was no significant difference in the overall occurrence of colonic diverticulosis between male and female patients(28.3%vs 28.6%,P=0.85).DCBE examinations performed in patients with some gastrointestinal symptoms revealed the frequent occurrence of colonic diverticulosis compared with those performed in asymptomatic individuals(29.5%vs 25.3%,P=0.03).Change in bowel habit was strongly associated with the presence of diverticulosis(a relative risk of 1.39;P=0.005).The presence of diverticulosis was not correlated with age in symptomatic patients or asymptomatic individuals(P>0.05).CONCLUSION:Colonic diverticulosis was identified in28.5%of DCBE examinations in Thai adults.There was no association between the presence of diverticulosis and gender or age. | Varut Lohsiriwat Wanwarang Suthikeeree | 2013 | World Journal of Gastroenterology2013，19，46： | 3 |
| 15 | Learning curve of enhanced recovery after surgery program in open colorectal surgery显示文摘BACKGROUND Enhanced recovery after surgery(ERAS) reduces hospitalization and complication following colorectal surgery. Whether the experience of multidisciplinary ERAS team affects patients' outcomes is unknown.AIM To evaluate and establish a learning curve of ERAS program for open colorectal surgery.METHODS This was a review of prospectively collected database of 380 'unselected'patients undergoing elective 'open' colectomy and/or proctectomy under ERAS protocol from 2011(commencing ERAS application) to 2017 in a university hospital. Patients were divided into 5 chronological groups(76 cases per quintile). Surgical outcomes and ERAS compliance among quintiles were compared. Learning curves were calculated based on criteria of optimal recovery:defined as absence of major postoperative complications, discharge by postoperative day 5, and no 30-d readmission.RESULTS Hospitalization more than 5 d occurred in 22.6%(n = 86), major complication was present in 2.9%(n = 11) and 30-d readmission rate was 2.4%(n = 9) accounting for unsuccessful recovery of 25%(n = 95). Conversely, the overall rate of optimal recovery was 75%. The optimal recovery significantly increased from 57.9% in 1 st quintile to 72.4%-85.5% in the following quintiles(P < 0.001). Average compliance with ERAS protocol gradually increased over the time-from 68.6% in 1 st quintile to 75.5% in 5 th quintile(P < 0.001). The application of preoperative counseling,nutrition support, goal-directed fluid therapy, O-ring wound protector and scheduled mobilization significantly increased over the study period.CONCLUSION A number of 76 colorectal operations are required for a multidisciplinary team to achieve a significantly higher rate of optimal recovery and high compliance with ERAS program for open colorectal surgery. | Varut Lohsiriwat | 2019 | World Journal of Gastrointestinal Surgery2019，11，3： | 2 |
| 16 | Image Comparative Assessment Using Iterative Reconstructions: Clinical Comparison of Low-Dose Abdominal/Pelvic Computed Tomography Between Adaptive Statistical, Model-Based Iterative Reconstructions and Traditional Filtered Back Projection in 65 Patients显示文摘 | Varut Vardhanabhuti Richard D. Riordan Grant R. Mitchell Christopher Hyde Carl A. Roobottom | 2014 | Investigative Radiology2014，，4： | 2 |
| 17 | Rectovaginal fistula after low anterior resection:Prevention and management显示文摘Rectovaginal fistula after low anterior resection for rectal malignancy is one of the most challenging postoperative complications because it is difficult to treat and may complicate plans of adjuvant therapy.This problematic complication could lead to multiple operations,stoma formation,sexual dysfunction,fecal incontinence and psychosocial ramifications.This review comprehensively covers an overview of its incidence,risk factors,presentation and evaluation,management(ranging from conservative measures,endoscopic treatment and local tissue repair to radical resection and redo anastomosis)and treatment outcomes of rectovaginal fistula after low anterior resection.Notably,these therapeutic options and outcomes are influenced by several factors,including the size and location of the fistula,tumor clearance,cancer staging,quality of colorectal anastomosis and surrounding tissue,presence of diverting stoma,previous attempted repair,and the surgeon’s experience.Also,strategies to prevent rectovaginal fistula after low anterior resection are presented with illustrations.Finally,a decision-making algorithm for managing this complication is proposed. | Varut Lohsiriwat Romyen Jitmungngan | 2021 | World Journal of Gastrointestinal Surgery2021，13，8： | 2 |
| 18 | Surgical Outcomes of Lichtenstein Tension-Free Hernioplasty for Acutely Incarcerated Inguinal Hernia显示文摘 | Varut Lohsiriwat Wasupong Sridermma Thawatchai Akaraviputh Wiroon Boonnuch Vitoon Chinsawangwatthanakol Asada Methasate Narong Lert-akyamanee Darin Lohsiriwat | 2007 | Surgery Today2007，，3： | 1 |
| 19 | Efficacy of Pre-incisional Bupivacaine Infiltration on Postoperative Pain Relief after Appendectomy: Prospective Double-blind Randomized Trial显示文摘 | Varut Lohsiriwat Narong Lert-akyamanee Winchai Rushatamukayanunt | 2004 | World Journal of Surgery2004，，： | 1 |
| 20 | Anorectal emergencies显示文摘Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis(Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. | Varut Lohsiriwat | 2016 | World Journal of Gastroenterology2016，22，26： | 1 |
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