• Title/Summary/Keyword: 수술중

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Surgical Experience of Paraclinoidal Aneurysms (상상돌기 주위 동맥류의 수술적 치험)

  • Kang, Hyung Gon;Jo, Chul Min;Huh, Jae Teack
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.203-210
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    • 2001
  • Objective : Paraclinoidal aneurysms termed that aneurysms arising from proximal internal carotid artery(ICA) between the site of emergence of the carotid artery from roof of the cavernous sinus and origin of the posterior communicating artery(PCoA). These aneurysms pose conceptual and technical surgical problems with regard to acquisition of proximal control and safe intracranial exposure. The efficiency of surgical technique according to the location of paraclinoidal aneurysm was studied for minimal exposure. Materials and Methods : Over the past four years, the authors treated surgically 171 cases of cerebral aneurysm, among them ten patients were paraclinoidal aneurysms with two patients unruptured aneurysms. Mean age was 47 years old, and all patients were female. Three patients were proximal posterior carotid artery wall aneurysms(one large, one giant), four patients carotid-ophthalmic artery aneurysms and three patients superior hypophyseal artery aneurysms. Results : There could be done clip in all cases, there were no deaths and no complication. And no patient developed sustained neurological deficits including visual function except hydrocephalus in one case. Four patients complained of visual disturbance but two patients had recovery after postoperation and two patient were not longer to bad. Conclusion : Our recent experience suggests that preoperative scrutiny of diagnostic angiography allows classification of all paraclinoidal aneurysms regardless of size and surgical technique which this classification has focused on operative approaches unique to each aneurysm projection was helpful to improve the operative outcome with good visual function and to shorten the operative time.

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Length of stay in PACU among surgical patients using data mining technique (데이터 마이닝을 활용한 외과수술환자의 회복실 체류시간 분석)

  • Yoo, Je-Bog;Jang, Hee Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.7
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    • pp.3400-3411
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    • 2013
  • The data mining is a new approach to extract useful information through effective analysis of huge data in numerous fields. This study was analyzed by decision making tree model using Clementine C&RT(Classification & Regression Tree, CART) as data mining technique. We utilized this data mining technique to analyze medical record of 1,500 people. Whole data were assorted by length of stay in PACU and divided into 3 groups. The result extracted by C5.0 decision tree method showed that important related factors for lengh of stay in PACU are type of operation, preoperative EKG abnormality, anesthetics, operative duration, age.

Recent Surgical Treatment of Moyamoya Disease (모야모야병에 대한 최근의 외과적 치료)

  • Kim, Dal Soo;Yoo, Do Sung;Huh, Pil Woo;Kim, Jae Keon;Cho, Kyoung Suok;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.800-804
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    • 2001
  • The authors reviewed the recent trend of surgical treatment for pediatric as well as adult onset moyamoya disease(MMD). Combined direct and indirect arterial anastomosis or multiple indirect arterial bypasss has been increasing for pediatric MMD and direct arterial bypass is recommended for adult MMD, especially in patients with hemorrhagic MMD. Besides perioperative complications related to the management of MMD and 1999 annual report by the Research Committee on Spontaneous Occlusion of the Circle of Willis(Moyamoya Disease) of the Ministry of Health and Welfare, Japan will be summarizd.

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Order selection method for clinical pathway development in acute appendectomy (맹장염 수술에서 임상경로 개발을 위한 처방 선택 방법)

  • Park, Cheol-Yong;Kim, Tae-Yoon
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.1
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    • pp.43-50
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    • 2010
  • In this study, we propose a new order selection method for clinical pathway development in acute appendectomy. This method is based on the lift concept which is popular in association rule discovery and, starting from the orders with more frequencies, sequentially removes the negatively associated orders which have lift values somewhat less than one. The orders in acute appendectomy we consider in this study are test and medical treatment items respectively, and since there are different order patterns before, during, and after operation, three different order selections are made for each. The selection results are somewhat different from those selected only by the order of more frequencies. Specifically, the selection results of two methods are different in 1 or 2 orders for medical treatment items and in maximum 5 orders for test items, respectively.

The Role of Adjuvant Postoperative External Beam Radiotherapy for Locoregional Control in Recurrent Advanced Papillary Thyroid Carcinoma : Preliminary Report in a Single Institute (재발된 진행 갑상선 유두암의 국소 및 부위 치료를 위한 수술후 보조 외부방사선의 역할)

  • Park, Sung Ho;Lee, Guk Haeng;Lee, Byeong Cheol;Lee, Myung Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.29-35
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    • 2015
  • 목적 : 국소 재발한 진행된 갑상선 유두암의 치료로 수술 후 외부방사선의 역할을 알아보고자 하였다. 대상 및 방법 : 원자력병원에서 2000년 1월부터 2012년 2월까지 사이버나이프 혹은 외부방사선 치료를 받은 수술과 방사선요오드 치료 후 국소 재발한 진행된 갑상선 유두암 환자 13 명을 대상으로 하였다. 경과관찰 기간 동안 국소 및 부위 재발이 발생환 환자는 6 명이었다. 몇몇의 위험인자를 찾기 위해서 Kaplan-Meier method와 log-rank test를 이용하여 성별, 종양단계, 방사선 치료 전 수술 횟수, 방사선요오드치료 횟수, 수술 후 잔존 암의 여부, 원격전이에 대해 단변량 분석하였다. 결과 : 방사선 치료 후 평균 추적관찰기관은 53.8개월(범위, 36 ~ 108개월)이고 그중 남자는 4 명이었다. 1년, 2년의 무진행 생존률은 각각 76.9와 53.8%였다. 단병량 분석은 성별과 잔존 암여부(p = 0.0475 and p = 0.0475, 각각)에 따라 무진행 생존률이 진행한 그룹과 진행하지 않은 그룹 사이에 유의한 차이가 있다는 것을 보여줬다. 결론 : 외부 방사선 치료 전에 잔존 암이 없었던 환자의 100%에서 국소 및 부위 재발이 일어나지 않았다. 외부방사선 치료는 수술과 방사선요오드 치료에 반응하지 않는 환자 중 수술 후 잔존 암이 없는 경우에 효과적인 치료 방법이 될 수 있다.

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Esophagectomy with Operating Mediastinoscope (종격동경을 이용한 식도절제수술 -1례-)

  • 윤용한;이두연;이성수
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1110-1115
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    • 1998
  • Esophagectomy has a high morbidity rate, mainly related to pulmonary complications. The respiratory morbidity of open esophagectomy is high, ranging from 6% to 10%. This high morbidity is partially responsible for the 6∼15% mortality rate of esophagectomy. Many techniques of esophagectomy without thoracotomy have been described since the initial report of Orringer and Sloan. Endoscopic microsurgical dissection of the esophagus was clinically introduced in 1989. Endoscopic microsurgical dissection of the esophagus was developed as a minimally invasive procedure that avoids thoracotomy and provides precise vision during the operation in order to reduce mediastinal trauma and to improve the peri- and post-operative situation. A 20 year-old women who accidentally swallowed about 150 cc of glacial acetic acid underwent an esophagectomy using the operating mediastinoscopy, cervical esophagogastric anastomosis, pyloromyotomy, and feeding jejunostomy tube placement for esophageal stricture. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day. Our clinical experience shows that endoscopic microsurgical dissection of esophagus is a safe and feasible method because it offers excellent optical control and enables the surgeon to operate in a minimally invasive manner.

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Ocular complications in patients with anti-adhesion barrier agent during arthroscopic shoulder surgery (견관절경 수술에서 사용된 유착방지제와 수술 후 안구 합병증의 연관성)

  • Heo, Hyun Joo;Lee, Ji Hye;Kim, Yu Yil;Baek, Seung Min;Jung, Da Wa
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.363-368
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    • 2020
  • Background: Intraoperative and postoperative ocular complications are rare. We retrospectively investigated the abnormal ocular findings in patients who underwent arthroscopic shoulder surgery. Methods: The records were investigated of patients who underwent shoulder arthroscopic surgery at our hospital between January 2018 and March 2019. Ocular complications were confirmed by review of medical records. We performed logistic regression analysis to defined the main factors associated with ocular complications. Results: The overall prevalence of postoperative ocular complications was 8.5% (18/211). A significant association was found between anti-adhesion barrier agent and ocular complications (p=0.020). Conclusions: Anti-adhesion barrier agent used during surgery may be the cause of postoperative ocular complication.

Thoracoscopic Sympathetic Nerve Reconstruction with using an Intercostal Nerve Graft after Thoracoscopic Sympathetic Clipping for Facial Hyperhidrosis (안면부 다한증에서 흉부교감신경차단수술 후 발생한 보상성 다한증에서 흉강경을 이용한 흉부교감신경 재건술)

  • Haam, Seok-Jin;Lee, Doo-Yun;Kang, Cheong-Hee;Paik, Hyo-Chae
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.807-810
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    • 2008
  • From October 2005 to August 2006, sympathetic nerve reconstruction with using the intercostal nerve was performed in 4 patients with severe compensatory hyperhidrosis following thoracoscopic sympathetic surgery for facial hyperhidrosis. The interval between the initial sympathetic clipping and the sympathetic nerve reconstruction was a median of 23.1 months. The compensatory sweating after sympathetic nerve reconstruction was improved for 2 patients, but it was not improved for 2 patients. Thoracoscopic sympathetic nerve reconstruction may be one of the useful treatment methods for the patients with severe compensatory hyperhidrosis after they under go sympathetic nerve surgery for hyperhidrosis.

Creation of an Axillary Arteriovenous Fistula in Patients with the Pulmonary Arteriovenous Fistula after a Bidirectional Cavopulmonary Shunt - 2 cases - (양방향 상행대정맥-폐동맥 단락술 후 폐동정맥루(Pulmonary Arteriovenous Fistula)가 발생한 환자에서 시행한 액와동정맥루 (Axillary Arteriovenous Fistula) 형성술 - 2예 보고 -)

  • 이창하;전양빈;이재웅;박철현;박국양;한미영;이성재;김성호
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.280-284
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    • 2003
  • Creation of an axillary arteriovenous fistula (AVF) was performed in two patients with high risks of Fontan operation after a cavopulmonary shunt. The patients complained of progressive cyanosis and decrease in exercise tolerance, and they showed pulmonary arteriovenous fistula on the pulmonary angiography. They were uneventfully transferred to the general ward on the first postoperative day and discharged 3 and 4 days after the operation respectively. There was no evidence of fistula-related volume loading and the other post-operative complications. An 8-month follow-up revealed improved symptoms such as, cyanosis and exercise intolerance, but not sufficient regression of pulmonary arteriovenous fistula on a lung perfusion scan and contrast echocardiography, which should be carefully checked hereafter.

Aortic Root Replacement Using Aortic Homograft in Acute Bacterial Endocarditis One Case Report (심내막염 환자의 동종대동맥편을 이용한 대동맥 근부 치환술 - 1례 보고 -)

  • Im, Chang-Yeong;Lee, Heon-Jae
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.819-822
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    • 1997
  • Aortic valve replacement with aortic allograft has been considered a treatment of choice for aortic valve disease secondary to bacterial endocarditis because of its good homodynamic performance and higher resistance to infection. The aortic root replacement technique might be superior to the subcoronary allograft implantation technique with regard to aortic regurgitation. A 46 yea,rs old male patient had acute aortic regurgitation with progressing heart failure secondary to acute bacterial endocarditis. The patient underwent emergent aortic root replacement using 20 mm aortic allograft. At operation, right coronary cusp perforation and heavy calcification of commissure between right and left coronary cusp were observed. The patient recovered well and postoperative echocardiography demonstrated no aortic regurgitation. Inflammatory signs were subsided after 8 weeks of antibiotics therapy. Medically uncontrolled acute bacterial endocarditis was treated successfully by aortic root replacement using aortic homograft.

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