• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.65-72
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• 2011

Purpose: We evaluated the complications of allograft reconstruction after a bone tumor resection, and reviewed literatures to overcome such complications. Materials and Methods: We retrospectively reviewed clinical records and radiographs of fifteen patients in whom reconstruction with allograft after bone tumor resection. Results: Eight patients were men and seven were women with a mean age of 27.1 years (1-56 years) and a mean follow-up period of 89.5 months (33-165 months). All postoperative complications related to the allograft were recorded. Twenty patients (80.0%) obtained a radiologic bony union at a mean of 8.35 months (4-12 months). The mean Musculoskeletal Tumor Society score was 73.5% (46.6-93.0%). Nine patients (60.0%) experienced one event and 3 (20.0%) patients experienced multiple events during the follow-up period. Recorded events were infection (3), fracture (2), nonunion (2), limb length discrepancy (2) and varus deformity (2). The mean event free survival period was 60.8 months (6-144 months). The mean allograft survival period was 80.2 months and the 5 year survival rate of the allografts was 83.0%. Conclusion: In order to overcome complications, the combination of an allograft and vascularized fibular graft is highly recommended. In the near future, the tissue engineering technique, the application of the stem cell and PRP, could reduce the complication of allograft such as resorption and nonunion.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.55-60
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• 2008

Background: Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure. The aim of our study was to investigate whether preoperative and postoperative BNP levels could predict postoperative complications and outcomes in patients after coronary artery bypass graft (CABG). Material and Method: Data was collected prospectively on 30 patients (M/F=19/11, age $60.0{\pm}9.6$ years) undergoing conventional CABG during a 1-year period beginning on January 1, 2005. Patients underwent off-pump CABG, and combined surgery was excluded. The BNP assay was performed preoperatively, immediate postoperatively at the intensive care unit (ICU), and 1, 3, 5, and 7days postoperatively. Result: Preoperative BNP levels significantly correlated with preoperative echocardiographic ejection fraction and an ICU stay of 5 days or more (r=-0.4, p=0.028; r=0.39, p=0.031, respectively). A preoperative BNP cut-off value above 263 pg/mL demonstrated high specificity (90.5%) for predicting postoperative complications using the receiver operating characteristics curves. Preoperative and postoperative (7 days) BNP levels were different depending on the abscence (mean BNP=$99{\pm}23\;pg/mL$ vs. $296{\pm}74\;pg/mL$, p<0.05) and presence (mean BNP=$212{\pm}29\;pg/mL$ vs. $408{\pm}23\;pg/mL$, p<0.01). Conclusion: Preoperative BNP levels >263 pg/mL predict postoperative complications in patients receiving CABG.

• Journal of Gastric Cancer
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• v.7 no.3
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• pp.152-159
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• 2007

Purpose: Recently, the use of laparoscopic assisted gastrectomy for early gastric cancer has been on the increase and the procedure has been quickly adopted by clincians. However, there are few reports regarding the safety and risk of this type of surgery. The aim of this study is to evaluate the morbidity and to verify the safety of laparoscopic assisted gastrectomy for early gastric cancer. Materials and Methods: A total of 376 patients that had undergone laparoscopic assisted gastrectomy for early gastric cancer between April 2004 and December 2006 were reviewed retrospectively. The clinicopathological characteristics, operative complications, and factors related to complications were evaluated. Results: The overall operative morbidity and mortality rates were 10.6% and 0%, intraoperative morbidity was 1.1% (4 of 376 patients) and post operative morbidity was 9.6% (36 of 376 patients). Most complications required no surgery except for an intestinal obstruction in two cases. Multivariate analysis of risk factors related to operative morbidity determined that age was an independent factor associated with morbidity (P=0.021). Conclusion: The complication rate of laparoscopic assisted gastrectomy is low and most complications can be managed by conservative methods rather than with surgery. There were no specific predicting factors for complications except old age. Laparoscopy is a technically feasible and acceptable surgical modality for early gastric cancer.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.58-62
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• 2008

Posterior cruciate ligament reconstructions are dangerous procedure in terms of neurovascular complication. But deep vein thrombosis and associated compartment syndrome after posterior cruciate ligament reconstruction has not been reported, yet. We have experienced a patient who developed a deep vein thrombosis and compartment syndrome after revision posterior cruciate ligament reconstructive surgery, and report the importance of diagnosis and management with the discussions.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.941-947
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• 2000

Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.843-847
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• 2001

Background: Replacement of the esophagus remains a challenge for surgeons involved in esophageal disease. From 1996 to 1999, a total of 27 patients with esophageal cancer underwent free jejunal transfer(12cases) or esophagogastrostomy(15cases). To determine the results such as leakage of anastomosis site, stenosis, reflux esophagitis and operation time, respiratory complications, etc. we reviewed the 4 years experiences. Material and method: Palliative bypass surgery or esophageal prosthesis and cancers of the pharyngoesophageal or esophagogastric junction were excluded in this study. Resection was usually peformed through right thoracotomy and anastomosis was made with EEA staplers in esophagogas-trstomy. In cases of jejunal free transfer, 6cases of proximal esophagojejunostomy were stapled anastomosed and remaining 6 cases and all distal site were hand-sewn anastomosed. All reconstruction was done through posteromediastinal route. Result: There were two mortalities from thoracic esophagogastrostomy and one from jeunal free transfer. Major and minor complications(anastomosis site leakage: 3 cases, graft failure: 2cases etc) occurred in 27 cases. In 15 thoracic esophagogastrostomy cases, 11 patients had mild to moderate reflux esophagitis and 5 patients incurred stricture of the anastomosis. Operation time was about 550$\pm$280 minutes in jejunal free transfer, and about 300$\pm$ 160 minutes in esophagogastromy patients. Conclusion: Post operative reflux esophagitis and dysphagia were more frequent in Ivor-Lewis operation group than jejunal free transfer group; however, respiratory complications and operation time were significantly longer in jejunal (roe transfer group(p<0.05). To minimize the incidence of postoperative reflux esophagitis and dysphagia, patient evaluation focused on jejunal free transfer surgery is better than esophagogastrostomy followed by adequate post operative care.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.988-990
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• 2000

흉강경을 이용한 교감신경다발 차단술은 다한증 치료에 아주 효과적이다. 술 후 유미흉과 같은 합병증은 발생은 적으나 아주 위험할 수 있다. 흉관 근접 부위의 좌측 2번째에서 4번째 흉부 교감신경다발 차단술 후 발생한 유미흉을 흉강경을 이용한 전기 응고법으로 치료하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.705-709
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• 2005

Background: To assess the outcome of pulmonary resection in the management of hemoptysis caused by benign inflammatory lung disease. Material and Method: A longitudinal cohort study of 45 consecutive patients who were presented with hemoptysis and were treated with pulmonary resection from January 1995 to May 2004. The predictive preoperative risk factors of morbidity and recurrence of hemoptysis were analyzed. The mean age of the patients was 47.1 years. The mean follow-up was $35\pm34$ months. Result: The overall hospital mortality rate was $4.4\%(2/45)$. Postoperative complications occurred in 8 patients $(18.6\%)$. Complications were more common in patients who received blood transfusion than non-transfused patients (p=0.002). Patients with tuberculous destroyed lung disease had more amount of preoperative hemoptysis (p=0.002), more probability of transfusion (p=0.001), more probability of undergoing pneumonectomy (p=0.039) and more probability of postoperative morbidity. Patients of undergoing pneumonectomy had more probability of reoperation due to postoperative bleeding (p=0.047). Hemoptysis recurred in five patients but three had been subsided and two sustained during follow-up. A latter two patients had been prescribed with antituberculosis medication due to relapse of tuberculosis. Conclusion: A tuberculous destroyed lung disease has a higher rate of postoperative morbidity than other inflammatory lung diseases. A pneumonectomy in patients of inflammatory lung disease should be performed with great caution especially because of postoperative bleeding. Future study with longer and larger follow-up might show the reasons of recurrence of hemoptysis.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.39-45
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• 2009

Purpose: To investigate the outcome of arthroscopic treatment for the complications of knee arthroplasty and to evaluate the effectiveness of arthroscopy. Materials and Methods: We analyzed 25 patients who underwent arthroscopy to treat complications of knee arthroplasty between May 1992 and June 2008. Nineteen cases out of 25 had total knee arthroplasty (TKA) and the remaining 6 cases had unicompartmental knee arthroplasty (UKA). Before arthroscopy, physical examinations and radiographic evaluations were carried out to find out the causes of complications. Joint fluid aspiration and hematologic evaluation were added when infection was suspected. Results: Among the diagnosis at the time of arthroscopy, there were 11 cases of infection, 6 cases of stiffness due to adhesion and fibrosis, and 2 cases of soft tissue impingement in the cases of TKA. Among the cases of UKA, one for each case of meniscal tear, subluxation of mobile insert, hemarthrosis, cement loose body, soft tissue impingement, and stiff knee was found. Nine out of 11 patients who had infection were treated successfully with arthroscopy but the remaining 2 cases underwent revision arthroplasty. Seven patients with arthrofibrosis had improved range of motion from $65^{\circ}$ preoperatively to $105^{\circ}$ postoperatively. The others also showed successful results after arthroscopy. Conclusion: Arthroscopy to treat complications after knee arthroplasty was a safe and effective method when appropriate selection of patients was made.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.56-59
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• 2012

Meniscal allograft transplantation (MAT) is an accepted treatment for the symptomatic postmeniscectomized knee in younger patients. However, the likelihood of a successful outcome is reduced by various complications. One of the complications after MAT is manifested as grafted meniscal tear. However, a bucket handle meniscal tear (BHMT) following MAT is an uncommon complication and furthermore a BHMT after revisional MAT (RMAT) is a extremely rare complication. We encountered a case of BHMT after RMAT in a lateral meniscus. Retrospectively reviewing the case, we could assume the cause, which would be helpful to prevent the complication in further MAT procedures.