• Title/Summary/Keyword: 난소 절제술

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Laparoscopic Ovariohysterectomy in Female Dogs (복강경을 이용한 암캐의 난소자궁절제술)

  • Kim, Young-Ki;Lee, Scott-S.;Park, Se-Jin;Lee, Seung-Yong;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.149-153
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    • 2011
  • In this report, laparoscopic ovariohysterectomy (LOHE) was performed on two, healthy, intact female dogs. Three ports, umbilical port for placing the laparoscope and the left and right paramedian instrument ports were placed into the abdominal cavity. First, in order to isolate the right ovary, the vascular pedicle was coagulated by activating the universal bipolar forceps. Then, the pedicle and suspensory ligament were transected by the bipolar electrocauterization scissors. In the same manner, the left ovary was isolated. The uterine body and the uterine arteries were coagulated bilaterally and transected just rostral to the cervix. The isolated ovaries and uterus were exteriorized through the left paramedian instrument port, which was extended by approximately 1 cm to allow for tissue removal. The skin and subcutaneous tissue were closed in a routine manner. Surgical times for LOHE in two dogs were 35, 40 min respectively. Total length of abdominal incision was shorter than 3 cm in two dogs. No clinical complications related to the LOHE were observed during 1.5 years after surgery. The LOHE is an alternative surgical technique that deserves further investigation.

A New Healthcare Policy in Korea Part 3: Ultrasound and MRI in Urogenital Disorders (새로운 건강보험 보장성 강화 대책 3부: 비뇨생식기 초음파 및 MRI 급여 확대)

  • Young Sup Shim;Kye Jin Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1083-1095
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    • 2020
  • Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.

Treatment Results of Ovarian Dysgerminoma (난소 미분화세포종의 치료 결과)

  • Chung, Eun-Ji;Suh, Chang-Ok;Seong, Jin-Sil;Keum, Ki-Chang;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.221-228
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    • 1996
  • Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the Patterns of failure in ovarian dysgerminoma retrospectively According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Materials and Methods : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY) Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy (group 2). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass (20) pelvic discomfort or pain (5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy/l-2weeks 1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease ($100\%$). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four Patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one Patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 Patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were $96.6\%$ (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation. So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). Conclusion : The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.

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Clinical Characteristics of Pleomorphic Carcinoma (다형성 암종의 임상적 고찰)

  • Lee, Deok-Heon;Park, Hoon;Park, Chang-Kwon;Kwon, Kun-Young;Park, Nam-Hee;Choi, Sae-Young;Lee, Kwang-Sook;Yoo, Young-Sun
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.397-403
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    • 2003
  • Background: The research sought to identify the clinical features of pleomorphic carcinoma of the lung generally known as a rare subtype in accordance with the lung cancer classification done in 1999 by WHO. Material and Method: 250 cases of surgically resected lung cancers were collected in this hospital from January 1992 to December 2001. This study included 42 cases of pleomorphic carcinoma diagnosed through light microscope and immunohistochemistry. Result: Out of 42 cases, males represented 31, and females 11, the age ranged from 26 to 77. Main clinical symptoms included coughing, hemoptysis, sputum. Diagnoses disclosed the stage as stage la in 3 cases (7%), Ib in 16 (38%), IIa in 1 (2%), IIb in 8 (19%), IIIa in 15 (35%), and IIIb in 1 (2%). Out of these, no lymph node metastasis was represented in 23 cases (54%), while N1 and N2 involving lymph node metastasis was shown 19 cases (46%). A total of 19 patients developed metastasis, comprising the brain in 5 cases (26%), bone in 4 (21%), muscle in 4 (21%), Lymph node in 2 (10%), and 1 liver, ovary, contralateral lung, and adrenal gland, respectively. The size of the tumor ranged from 1 cm to 11 cm, averaging 5.85 cm. Out of the 42 patients, the total two-year and five-year survival rates in accordance with the Kaplan-Meier method represented 26% and 13%, respectively, These figures compared to the corresponding 44% and 34% in cases other than pleomorphic carcinoma from the survey target of 256 cases, proved to be significantly low (p<0.002). No significant difference was found in the survival rates compared between age and tumor size, between stage I and above stage II, and between N0 and above N1. Patients who developed postoperative metastasis all died, and showed significantly low survival rates (p<0.002) compared to those patients without metastasis. Conclusion: With the new diagnosis method of f999 WHO's lung cancer classification applied, pleomorphic carcinoma showed a higher prevalence rate than under previous classifications, their postoperative survival rate was significantly low compared to histologic type of non small cell lung carcinomas.

Effects of Intraperitoneal Bupivacaine Instillation on Postoperative Pain Behavior after Laparoscopic Ovariohysterectomy in Dogs (개에서 복강경을 이용한 난소자궁절제술시 복강 내 Bupivacaine의 점적투여가 술 후 통증행동에 미치는 영향)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Suh, Euy-Hoon;Chang, Hong-Hee;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.33-39
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    • 2011
  • The present study was aimed to investigate the effect of intraperitoneal bupivacaine instillation on postoperative pain after laparoscopic ovariohysterectomy (LOHE) in dogs. Twelve female German shepherd dogs (17-30 kg) were divided into two groups. The treatment group received 4.4 mg/kg of instilled intraperitoneal bupivacaine diluted to 0.25% with an equivalent volume of saline after pneumoperitoneum, but the control group received 1.76 ml/kg of 0.9% saline. Two blind observers measured the extent of dog's pain and sedation by using dynamic interactive visual analogue scale (DIVAS) preoperatively and 0.5, 1, 2, 4, 6, and 12 h postoperatively. At each designated time, blood cortisol, glucose, and creatine kinase (CK) concentrations were also measured. Based on the repeated-measures ANOVA, there were significant differences in time-dependent postoperative changes in patterns of DIVAS-pain score between two groups. In addition, the treatment group had significantly lower DIVAS-pain scores at 1, 2, 4, and 6 h postoperatively compared to the control group. DIVAS-sedation score and biochemical measures including cortisol, glucose, and CK did not show any significant differences between two groups. No complications associated with bupivacaine administration were observed. Thus, instilled bupivacaine intraperitoneally may be an effective method on relieving behavioral expressions associated with postoperative pain after laparoscopic ovariohysterectomy in dogs.