• Title/Summary/Keyword: 수술 후 장마비

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The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

Transcatheter Arterial Embolization in the Treatment of Massive Hemoptysis (대량 객혈 환자에서 동맥 색전술의 치료 효과)

  • Choi, Wan-Young;Choi, Jin-Won;Lim, Byung-Sung;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Seo, Heung-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.35-41
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    • 1992
  • Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.

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