https://he02.tci-thaijo.org/index.php/agstjournal <pre class="tw-data-text tw-text-large XcVN5d tw-ta" dir="ltr" data-placeholder="Translation"><span lang="en">The Association of General Surgeons of Thailand under the Royal of Patronage of HM the King (AGST) is an organization that aims to promote the academic and surgical roles at the national and international levels. As well as promoting relations within the network for both internal and external cooperation. Focusing on creating academic works and presenting to all sectors to be informed. AGST</span><span lang="en"> work development to be in line with the vision and mission. Which focuses on providing Thai surgeons with excellent academic excellence in surgery at international level. A providing academic services to public is another important activity that the AGST operates. Therefore, the Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King academic articles are published to the general public to create presentation potential academic works, research, and disseminating knowledge in surgical education to professional groups. Journal of AGST to be the center of transmission exchange knowledge and medical technology at the national level as according to the national strategic plan. AGST also provides an opportunity for all surgeons, medical physicians, public health technical officers and general interested persons from inside and outside AGST to submit academic works Own articles and research. </span><span lang="en">The journal of AGST promote and develop academic knowledge in searching for empiricalevidence to support the mission to create the capacity for academic presentations, research, and disseminate knowledge in surgery to nearby professional groups. To be a center for publishing articles about general surgery and publishing them to the public.</span></pre> <pre id="tw-target-text" class="tw-data-text tw-text-large XcVN5d tw-ta" dir="ltr" data-placeholder="Translation"><span lang="en">&nbsp;</span></pre> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> <p>&nbsp;</p> สมาคมศัลยแพทย์ทั่วไปแห่งประเทศไทยในพระบรมราชูปถัมภ์ en-US Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 1686-879X https://he02.tci-thaijo.org/index.php/agstjournal/article/view/267851 <p>Pseudo-epitheliomatous hyperplasia (PEH) is a acanthosis characterized by hyperplastic process of the epidermis. The histological formation is abnormal and reactive epithelial proliferation that most common associated with underlying infectious, inflammatory, neoplastic conditions and chronic cutaneous wounds. Radical surgical excision is still the recommended first option and usually need wound coverage reconstruction. Alternative effective treatment may be in the future.</p> Surajit Awsakulsutthi Copyright (c) 2024 Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 2024-03-15 2024-03-15 9 1 1 5 https://he02.tci-thaijo.org/index.php/agstjournal/article/view/268167 <p><strong>Background</strong>: Gallstone disease, including symptomatic gallstones, chronic and acute cholecystitis is prevalent worldwide. Laparoscopic cholecystectomy (LC) has emerged as the treatment of choice for these conditions. However, the cost of LC remains a concern due to various factors, including the expenses associated with instrumentation. This study seeks to assess the feasibility, utility and outcomes of laparoscopic cholecystectomy performed with the PP-Ports Trocar, an innovative and cost-effective alternative, compared to conventional commercial trocars.</p> <p><strong>Objective</strong>: To evaluate the feasibility and utility of PP-Ports Trocar in laparoscopic cholecystectomy.</p> <p><strong>Method</strong>: A retrospective analysis of electronic medical records from September 2023 to February 2024 was conducted. Patients who underwent LC using PP-Ports Trocar were compared with those using commercial trocars at Mae Fah Luang University Medical Center Hospital. Demographic data, surgical time, blood loss, hospital stay, and postoperative complications were analyzed.</p> <p><strong>Results</strong>: Twenty patients were included in the study, evenly distributed among two groups based on trocar type. No surgical complications were observed. <strong>PP-Ports </strong>Trocar demonstrated comparable outcomes to commercial trocars in terms of surgical time, blood loss, hospital stay and postoperative complications.</p> <p><strong>Conclusion</strong>: PP-Ports Trocar presents a promising alternative for laparoscopic cholecystectomy, offering cost-effective instrumentation without compromising surgical outcomes. Its adoption could potentially alleviate financial burdens associated with surgical procedures.</p> Phichai Phongmanjit Copyright (c) 2024 Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 2024-05-08 2024-05-08 9 1 6 12 https://he02.tci-thaijo.org/index.php/agstjournal/article/view/268693 <p><strong><em>Introduction:</em></strong><em> Anaplastic thyroid carcinoma (ATC) is an extremely aggressive cancer with a very poor prognosis. The lungs, pleura, adrenal glands, and liver are the most common sites of metastasis; metastasis to the digestive tract is rare.</em></p> <p><strong><em>Case presentation: </em></strong><em>The patient was a 63-year-old man with ATC </em><em>was treated with </em><em>pembrolizumab and lenvatinib. Concomitant venous thromboembolism was being treated with direct oral anticoagulants. He developed peritonitis</em><em>, and</em><em> revealed perforation sites associated with an intestinal mass</em><em>.</em></p> <p><strong><em>Clinical discussion: </em></strong><em>ATC with small bowel metastasis is uncommon. However, physicians should be aware of this possibility, especially in patients planned targeted therapy. </em></p> <p><strong><em>Conclusion: </em></strong><em>Small bowel metastasis of ATC is rare and results in tumor-associated perforation. Small bowel metastasis should be investigated in patients with ATC who present with gastrointestinal hemorrhage. Evidence of small bowel metastasis influences the choice of anticoagulant and systemic cancer treatment in ATC patients.</em></p> Nawaphan Taengsakul Copyright (c) 2024 Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 2024-05-16 2024-05-16 9 1 13 21 https://he02.tci-thaijo.org/index.php/agstjournal/article/view/269103 <p>มาตรฐานเดิม ของการรักษาโรคไส้ติ่งอักเสบ คือการผ่าตัด Appendectomy &nbsp;ซึ่งปฏิบัติกันมากว่า 100 ปี จนกระทั่งหนึ่งทศวรรษหลังนี้ มีงานวิจัยที่ชี้ชัดว่า การรักษาภาวะไส้ติ่งอักเสบด้วยยาปฏิชีวนะ เป็นทางเลือกที่ปลอดภัยในการรักษา Uncomplicated Appendicitis &nbsp;&nbsp;อย่างไรก็ตาม งานวิจัยดังกล่าวบางชิ้นยังบอกว่าในการติดตามผลระยะยาว 5 ปี มีอุบัติการณ์ไส้ติ่งอักเสบกำเริบหลังการรักษาด้วยยาปฏิชีวนะได้สูงถึง 30 -50% อุบัติการณ์ที่สูงมากนี้ จึงเกิดคำถามว่าศัลยแพทย์ที่เกี่ยวข้อง ควรจะแนะนำให้ผู้ป่วยเข้ารับการผ่าตัดไส้ติ่งหลังการใช้ยาปฏิชีวนะอย่างเดียวแล้วได้ผลในระยะแรก ซึ่งในสถานการณ์ดังกล่าว ยังไม่มีแนวปฏิบัติหรือข้อแนะนำ เกี่ยวกับบทบาทและข้อบ่งชี้ของการทำ Elective (interval)Appendectomy แต่ก็มีงานวิจัยบางชิ้นที่พบว่าอัตราการผ่าตัดไส้ติ่งในเวลาต่อมาหลังจากคนไข้ดีขึ้นด้วยยาปฏิชีวนะสูงถึง 40% ในปีแรก, 46% ในปีที่2 และ 49% ที่ 3 และ 4 ปี หรือกล่าวได้ว่าครึ่งต่อครึ่งของคนไข้ที่ต้องผ่าตัดในที่สุด &nbsp;นักวิชาการบางคนบอกว่าในระยะยาวกว่านั้นเช่น 10 ปี คนไข้ก็จะยังมีความเสี่ยงต่อไส้ติ่งอักเสบกำเริบ ดังนั้นเมื่อนำข้อมูลมาผสมผสานที่พบว่า การผ่าตัด Elective Laparoscopic Appendectomy ซึ่งมีอัตราการตายเพิ่ม เพียง 0.09% น่าจะดีกว่าการรอและเฝ้าระวังโรค</p> <p>&nbsp;</p> Chumsak Pruksapong Copyright (c) 2024 Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King 2024-05-04 2024-05-04 9 1