• Title/Summary/Keyword: 수술중

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The Role of Neoadjuvant Chemotherapy for Advanced Stage Wilms Tumor (진행된 Wilms 종양에서 수술 전 항암화학요법의 의의)

  • Kang, Chang Kyu;Moon, Kwang Bin;Yoo, Keon Hee;Koo, Hong Hoe;Yoon, Hye Kyung;Park, Kwan Hyun
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1534-1539
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    • 2002

  • Purpose : This study was designed to exclude radiation in advanced(stage 3, 4) Wilms tumor (WT) by increasing the chance of complete surgical removal with preceding neoadjuvant chemotherapy, thereby reducing the incidence of late effects. Methods : Between December 1998 and July 2002, we conducted neoadjuvant chemotherapy after needle aspiration biopsy on patients who had advanced WT. If needle biopsy was accessible, we conducted neoadjuvant chemotherapy(vincristine, adriamycin, dactinomycin) for 12 weeks and then performed surgical removal, excluded radiation therapy and conducted postoperative chemotherapy (vincristine, dactinomycin${\pm}$adriamycin). In other cases, we firstly conducted the operation and then performed radiation and postoperative chemotherapy. Results : Of the 17 patients diagnosed as WT, 12 patients had an advanced stage of disease. In two of the 12 patients, initial surgical removal was conducted. The median age of patients was 21 months(5-103 months). Of the 10 the patients who received neoadjuvant chemotherapy, eight patients were stage 1, one patient was stage 2, and the other was stage 3 at operation. In nine patients except one with stage 3 disease, we could perform complete surgical resection and therefore could omit radiation. In four cases we could also exclude adriamycin after operation. All but one patient was alive, disease-free, for a median follow-up of 21 months(9-43 months). Conclusion : After neoadjuvant chemotherapy, we could increase the chance of complete tumor resection, exclude radiation and decrease the intensity of postoperative chemotherapy in selected cases. Long term follow-up is needed to determine whether our method would significantly decrease late effects.

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Lipomatous Tumors in Hand (수부에 발생한 지방종성 종양)

  • Lee, Kwang-Hyun;Lee, Bong-Gun;Bong, Hyun-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.131-139
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    • 2008

  • Purpose: Lipomatous tumor occurred in hand is very rare. There is a broad spectrum of lipomatous tumors including lipomas, variants of lipomas, lipomatosis, liposarcomas and so on. We report the clinical features of 11 cases of lipomatous tumor which occurred in hand. Materials and Methods: Between 1992 and 2008, 11 cases were histologically diagnosed as lipomatous tumor in hand. We reviewed all medical records and clinical photographs retrospectively and ascertained recurrence by telephone interview. Results: Eight cases were ordinary lipomas. Three cases were angiolipoma, fibrolipoma and atypical lipoma respectively. Four cases occurred in finger, two cases in thenar area, two cases in hypothenar area, one case in palm, two cases in wrist. All cases were situated on volar surface. All patients complained of palpable masses. One patient with subungal angiolipoma felt pain. There was no neurologic sign or vascular symptom preoperatively. In one case, postoperative complication (hypoesthesia in $5^{th}$ finger) was developed. There was no local recurrence. Conclusion: In our study, lipomatous tumors occurred in hand did not recur. Patients mainly complained of feeling of lump. Pain was uncommon symptom. Postoperative complication was rare if operation was performed carefully.

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Preoperative Evaluation (마취과적 수술전 평가)

  • Lee, Bong-Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.87-94
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    • 2008

  • Every anesthetic begins with preoperative evaluation. This meeting of patient and anesthesiologist allows for an exchange of information, an assessment of physical status, and the formulation of an anesthetic plan. The aim is to have the patient in the best possible condition, both mental and physical, prior to surgery. The preoperative visit is as important as any aspect of introperative management in providing a safe, effective anesthetic.

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