https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/438 2026-07-03T22:21:23Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/212516 Title: Efficacy of neoadjuvant FOLFIRINOX in resectable pancreatic cancer (NeoFOL-R): study protocol for an international, multicenter, prospective, randomized controlled trial Authors: Jung, Hye-Sol; Choi, Julian; Park, Se Jun; Han, Youngmin; Cho, Young Jae; Yoon, Jeesun; Oh, Do-Youn; Yoon, Yoo-Seok; Kim, Jin Won;  Lim, Chang-Sup; Park, Jin Hyun; Choi, In Sil; Hong, Tae Ho; Kim, Hyung Sun; Jeung, Hei-Cheul; Ahn, Keun Soo; Kim, Jin Young; Yu, Young-Dong; Kim, Ju Won; Hwang, Ho Kyoung; Lee, Choong-Kun; Choi, Hye Jin; Jung, Yun Kyung; Park, Kwonoh; Yoon, Jai Hoon; Han, In Woong; Hong, Jung Yong; Seo, Hyung Il; Do Yang, Jae; Jeon, So-Yeon; Yang, Seok Jeong; Chon, Hong Jae; Kwon, Wooil; Park, Joon Seong; Shan, Yan-Shen; Lee, Myung Ah; Jang, Jin-Young Abstract: Background Recent randomized controlled trials (RCTs) regarding the outcomes of neoadjuvant chemotherapy for patients with resectable pancreatic cancer (PC) reported inconsistent results. As the survival rate of FOLFIRINOX was found to be superior to that of gemcitabine, interest in the efficacy of neoadjuvant chemotherapy with FOLFIRINOX for resectable PC is growing. In this study, we aimed to investigate the efficacy of neoadjuvant FOLFIRINOX in patients with resectable PC. Methods This international (South Korea, Australia, and Taiwan), multicenter, phase 3, RCT will include 609 patients with resectable pancreatic ductal adenocarcinoma and ECOG performance 0-1. Resectable PC is defined as no arterial contact and no tumour contact with the superior mesenteric vein/portal vein or <= 180 degrees contact without vein contour irregularity. Neoadjuvant FOLFIRINOX consisted of oxaliplatin (85 mg/m(2)), administered intravenously over 2 h, followed by leucovorin (400 mg/m(2)) over 2 h and irinotecan (180 mg/m(2)) over 90 min, administered concurrently. Subsequently, an intravenous bolus infusion of 5-FU (400 mg/m(2)) and a continuous infusion of 5-FU (2400 mg/m(2)) over 46 h, repeated every 2 weeks for 6 cycles. Adjuvant therapy with modified FOLFIRINOX (mFOLFIRINOX) included oxaliplatin (85 mg/m(2)), irinotecan (150 mg/m(2)), leucovorin (400 mg/m(2)), and fluorouracil (2400 mg/m(2)) over 46 h and repeated every 2 weeks, with six cycles in the neoadjuvant group and 12 cycles in the upfront surgery group. The primary endpoint is a two-year survival rate by intention-to-treat. Secondary outcomes are overall survival, disease-free survival, resection rate, R0 resection rate, lymph node negative rate, recurrence rate, response rate. When calculating with a significance level of 5% and a statistical power of 80%, 171 events (deaths) are needed. Considering the 5-year participant enrollment period and a minimum of a 2-year follow-up period, 518 patients were required to observe 171 events. A total of 609 patients were required when the dropout rate was calculated as 15%. Discussion The NeoFOL-R trial investigates the efficacy of perioperative versus adjuvant FOLFIRINOX for patients with resectable PC. The study is ongoing, starting in February 2024 in South Korea, Australia, and Taiwan. Trial registration NCT 05529940. Registered in September 2022. KCT0008360 (Korean Clinical Trial Database). Registered in April 2022. 2026-12-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/217783 Title: Impact of expanded pediatric surgery add-on payments on claimed surgical fees: a multi-institutional data analysis Authors: Son, Joonhyuk; Lee, Sanghoon; Park, Sungjoo; Kim, Wontae; Seo, Jeong-Meen; Oh, Chaeyoun Abstract: Purpose: Pediatric surgery in Korea has historically been undervalued under the national fee system. Since 2021, the government has progressively expanded surgical add-on reimbursement for pediatric surgeries, yet their real-world impact remains unclear. Methods: We retrospectively analyzed pediatric surgeries (<19 years) performed at 4 tertiary institutions from 2020 to 2025. Surgeries were divided into 4 periods based on major policy changes. Variables included the number of surgeries, claimed surgical fees, patient age and weight, and eligibility for add-on reimbursement. Trends over time and variations among hospitals were examined. Results: A total of 1,959 surgeries were analyzed. Surgical volume did not significantly change across periods (P = 0.342). In contrast, total claimed surgical fees increased 1.66-fold in Period 2, 3.26-fold in Period 3, and 3.42-fold in Period 4 compared with Period 1. The proportion of surgeries eligible for add-on reimbursement rose to 76.6% in Period 4. The average claimed fee per case increased from 973,446 Korean won in Period 1 to 3,463,428 in Period 4. Patients <1,500 g demonstrated the largest increase (471%). Across hospitals, the magnitude of claimed fee increases varied, but all institutions showed substantial growth in claimed surgical fees. Conclusion: Stepwise expansion of pediatric surgical add-on reimbursement substantially increased claimed surgical fees across institutions without inflating surgical volume. These reforms improved financial reimbursement and may support future improvements in workforce sustainability, training, and care equity. Continuous policy monitoring will be essential to ensure long-term effectiveness and fiscal balance. 2026-06-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/210927 Title: A multicenter retrospective analysis by the Korean association of pediatric surgeons comparing laparoscopic and open surgical repair of congenital duodenal obstruction Authors: Park, Jinyoung; Ko, Dayoung; Koo, Eun-jung; Kwon, Hyunhee; Kim, Ki Hoon; Kim, Dae Yeon; Kim, Seong Chul; Kim, Soo-Hong; Kim, Wontae; Kim, Hae-Young; Kim, Hyun-Young; Nam, So Hyun; Namgoong, Jung-Man; Park, Junbeom; Park, Taejin; Bang, Min-Jung; Seo, Jeong-Meen; Sul, Ji-Young; Son, Joonhyuk; Sim, Joohyun; Ahn, Soo Min; Yang, Hee-Beom; Oh, Jung-Tak; Oh, Chaeyoun; Youn, Joong Kee; Lee, Sanghoon; Lee, Ju Yeon; Ihn, Kyong; Chang, Hye Kyung; Jeong, Yeon Jun; Jung, Eunyoung; Chung, Jae Hee; Cho, Min Jeng; Choe, Yun-Mee; Han, Seok Joo; Ho, In Geol; Hong, Jeong Abstract: Background: This multicenter retrospective study aimed to compare key perioperative outcomes such as operative time, time to full enteral feeding, hospital stay duration, postoperative complications, and mortality, between laparoscopic and open surgical repair of congenital duodenal obstruction (CDO) performed by members of the Korean Association of Pediatric Surgeons (KAPS). Methods: A national survey conducted between 2021 and 2023 provided data from 75 patients. Demographic characteristics, associated anomalies, anatomical types, surgical approach, and postoperative outcomes were compared between the laparoscopic (n = 36) and open (n = 39) groups. Results: Among the 75 patients (30 males, 45 females; male-to-female ratio 1:1.5), no significant differences were observed between groups in sex, birth weight, or gestational age. Surgical procedures included 66 duodenoduodenostomies, four duodenojejunostomies, two gastrojejunostomies, two web excisions with duodenoplasty, and one segmental duodenal resection. Laparoscopic repair was associated with longer operative times (p = 0.005). Time to full enteral feeding was comparable in both groups (p = 0.117). Hospital stay was significantly shorter in the laparoscopic group (p = 0.012). Postoperative complications and mortality did not differ between groups; no deaths occurred. Conclusion: Laparoscopic repair can be considered a safe and effective alternative to open surgery for selected patients with CDO, assuming adequate surgical expertise. 2026-05-01T00:00:00Z https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/210942 Title: Lateral laryngeal ultrasound for vocal cord evaluation in neck surgery: A mutually double-blind comparative study with laryngoscopy Authors: Woo, Jung-Woo; Lee, Jun Ho; Lee, Han Shin; Suh, Hyunsuk; Jung, Eun Jung Abstract: Background: Vocal cord dysfunction is a significant complication after thyroid surgery, typically evaluated with invasive laryngoscopy. This study assessed diagnostic accuracy and feasibility of lateral laryngeal ultrasound as a noninvasive alternative. Methods: In a prospective, double-blind study at Gyeongsang National University Changwon Hospital (February 2016 to June 2023), 718 patients underwent preoperative and postoperative vocal cord assessment using laryngoscopy and lateral laryngeal ultrasound. Both patients and assessors were blinded to the counterpart modality. Sensitivity, specificity, and visualization rates were analyzed. Results: Lateral laryngeal ultrasound visualized vocal cords in 99.6% of cases (715/718), with 100% sensitivity and 99.5% specificity for detecting vocal cord paralysis compared with laryngoscopy. No adverse effects were reported. Conclusions: Lateral laryngeal ultrasound is a reliable, noninvasive tool for perioperative vocal cord evaluation, offering a patient-friendly alternative that may reduce the need for laryngoscopy in thyroid surgery 2026-04-01T00:00:00Z