• Title/Summary/Keyword: 수술중

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The Treatment Choice for Patients with Papillary Thyroid Carcinoma (유두상 갑상선암의 치료 방법 선택에 대한 고찰)

  • Park Cheong-Soo;Choi Jin-Sup;Park Byeong-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.175-182
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    • 1993
  • 유두상 갑상선암의 대부분은 서서히 진행하는 양호한 임상경과를 보이나, 일부는 저등급 혹은 미분화 갑상선암으로 전환되는 생물학적 특성을 보인다. 저자는 유두상 갑상선암 환자 358예를 적용된 치료방법과 치료결과를 분석하여 논란이 되고 있는 치료방법들 중에서 적절한 치료방법을 찾고자 본 연구를 시도하였다.% 568예중 동측엽절제술 및 협부 절제술 혹은 갑상선 아전 절제술 220예, 갑상선 전 절제술 혹은 근전절제술 143예, 종양적출술 5예였고, 이중 115예는 여러가지 형태의 경부 곽청술이 추가되었고, 150예는 수술후 방사성 동위원소 치료까지 추가되었다. 또 전 환자에서 TSH 억제를 위한 갑상선 호르몬 투여를 하였다. 추적 기간은 5년에서 12년까지 평균 8.5년이었다. Cady와 Rossia AMES Scoring system에 따라 저위험군과 고위험군으로 나누어 재발율과 사망율을 산출한 결과 저위험군 255예중 재발율 11.0%, 사망율 0.4%, 고위험군 65예중 재발율 36.9%, 사망율 20.0%을 보여 고위험군에서 현격히 불량한 예후를 나타내었다. 따라서 저자들은 유두상 갑상선암의 치료방법 선택은 일률적인 치료방법 보다는 환자 개인의 임상적 특성, 병기 등을 고려하여 저위험군에서는 소극적 수술을, 고위험군에서는 적극적인 수술과 수술후 보조치료를 시행하는 것이 바람직하다고 사료되었다.

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Tongue Surgery of a Dairy Cow Showing a Consistent Intersucking Behavior (지속적인 인터서킹 행동장애를 보이는 경산우의 혀수술)

  • Yong, Hwan-Yul;Cho, Jong-Ki;Kim, Sung-Ki
    • Journal of Veterinary Clinics
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    • v.25 no.2
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    • pp.136-138
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    • 2008
  • On a dairy farm, a Holstein cow had consistently shown an intersucking behavior within the milking herd. It has been considered as one of several behavioral disorders primarily coming from feeding management failure during weaning period. Due to their behavior, injured teats of other milking cows could decrease milk production. Through tongue surgery, by producing a convex shape of the dorsum of the tongue after suturing the excised ventral region, the intersucking behavior was forcefully corrected and disappeared thereafter within the dairy herd without any complications.

Primary Intracardiac Hemangioma -1 case report- (원발성 심장 혈관종 -1례 보고-)

  • 임상현;장병철;이문형;조상호
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.735-738
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    • 1998
  • Intracardiac hemangiomas are very rare primary cardiac tumor and there have been at least 37 reports of surgically resected cardiac hemangiomas. Most cardiac hemangiomas are asymptomatic. In symptomatic patients, symptoms are related to the location of tumor and outflow tract obstruction or obstruction of inferior and/or superior vena cava. Sudden death may occur due to conduction disturbances. The principle of treatment is surgical resection, and the prognosis is dependent upon the size, location and multiplicity of the tumor. A 40 year old man was admitted due to chest contusion and was found to have an intracardiac mass during echocardiographic examination. The mass was successfully removed and pathologic examination showed benign hemangioma. The patient was recovered uneventfully in postoperative period and was followed up for 1 year without evidence of recurrence.

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Intramural Hematoma of the Descending Thoracic Aorta Misdiagnosed as Aortic Rupture - A case report- (대동맥 파열로 오인된 흉부 하행 대동맥의 벽내 혈종 치험 1예)

  • 조원민;민병주;이인성;신재승
    • Journal of Chest Surgery
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    • v.37 no.10
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    • pp.872-875
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    • 2004
  • The treatment modalities of the intramural hematoma (IMH) remain controversial. Nowadays, the IMH of the descending thoracic aorta is generally classified in the medical treatment category. We describe a patient with IMH of the descending thoracic aorta who received the medical treatment. During the follow-up, we speculated that the IMH had been aggravated leading to an aortic rupture including hemothorax. Therefore, we performed an emergency operation. Contrary to our expectations, operative findings showed a well-organized aortic wall and serous pleural effusion. The exact diagnosis was IMH of the descending thoracic aorta with penetrating atherosclerotic ulcer (PAU). This case reminded us of the importance of accurate diagnosis and proper treatment.

VATS Resection for a Posterior Mediastinal Extramedullary Hematopoietic Mass: Resection of Extramedullary Hematopoiesis (후종격동 종괴로 발견된 골수외 조혈 종괴의 비디오 흉강경 수술을 이용한 절제 1예)

  • Chang, Jee-Won;Maeng, Young-Hee
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.542-545
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    • 2010
  • Extramedullary hematopoiesis is a common compensatory mechanism of chronic anemia, but an asymptomatic posterior mediastinal mass is rarely diagnosed as an extramedullary hematopoiesis after surgical resection. The differential from neurogenic tumors is important, but fine needle aspiration biopsy is not recommended because of the difficulty of approach and risk of bleeding. Although diagnosis and treatment can involve resection via thoracotomy, video-assisted thoracic surgery may also be a useful strategy. We performed video-assisted thoracic surgery on a 59-year-old man for posterior mediastinal extramedullary hematopoiesis, with no evidence of recurrence or related hematologic diseases.

Mediastinal Cavernous Hemangioma (상대정맥에 발생한 해면상 혈관종 -1례 보고-)

  • 김동원;이재영;배철영;신원선;맹대현;곽영태;이신영
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.69-72
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    • 1998
  • Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4$\times$5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

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Open Heart Surgery in Patient with Incidentally Detected Cold Agglutinin - A case report - (수술 중 발견된 한랭응집소를 가진 환자의 개심술 - 1례 보고 -)

  • 윤영남;이삼윤;유경종
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.797-799
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    • 2001
  • Open heart surgery with hypothermia in patients with cold agglutinin can cause severe complications by hemolysis and hemagglutination of red blood cells. A 41 year-old male patient with mitral stenosis was admitted due to fever and cough. After antibiotics treatment, he was scheduled to undergo mitral valve replacement. In the operation room, we found agglutination of blood cardioplegia during lowering temperature of cardioplegia. And then, the cardioplegia was changed to warm cardioplegia and the operation was performed under normothermia due to the suspicion of the cold reactive protein. The operation was performed uneventfully. Postoperatively, cold agglutinin was confirmed by immunochemistry of the patient\`s serum.

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The Clamshell Incision for the Complete Repair in Pulmonary Atresia with Ventricular Septal Defect, and Major Aortopulmonary Collaterals (주대동맥폐동맥간 부행혈관이 동반된 폐동맥 형성부전 환아에서의 Clamshell 절개를 통한 완전교정술 -1례 보고-)

  • 차대원;박표원;전태국;강이석;이흥재
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.823-826
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    • 1999
  • A 6-month old girl who had pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals underwent one-stage complete repair with unifocalization through a bilateral thoracosternotomy(clamshell incision). There were no serious postoperative compli cations, and the postoperative echocardio-graphy showed no residual ventricular septal defect or significant pulmonary artery stenosis. In this condition, great surgical variability exists regarding the sources of pulmonary blood flow. Recent clinical work has focused on a one-stage complete repair. The potential advantages of the clamshell incision are apparent in terms of mediastinal approach, postoperative results, and safety.

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Cavernous Hemangioma of the Esophagus - One Case Report - (식도 해면상 혈관종 - 1례 보고 -)

  • 목형균;신호승;홍기우
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.851-854
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    • 1999
  • Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.

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Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.