• Title/Summary/Keyword: 식도 재건술

Search Result 114, Processing Time 0.024 seconds

Treatment of Acromioclavicular Joint Injury (견봉 쇄골인대 손상의 치료)

  • Noh, Kyu-Cheol;Lee, Jae-Won;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
    • /
    • v.15 no.1
    • /
    • pp.58-68
    • /
    • 2011
  • Acromioclavicular (AC) joint dislocations are common injuries in active individuals secondary to direct force on the lateral aspect of the adducted shoulder. Complete disruption of the acromioclavicular and coracoclavicular (CC) ligaments may occur, depending on the magnitude of the insulting force. Most of these injuries are successfully treated without surgery. However, for the treatment of cases in which surgical management is warranted, there are more than 100 surgical techniques available without a gold standard technique. We review the anatomy of the acromioclavicular joint, the diagnosis of disorders of this joint, and the different treatment options in this article.

  • PDF

Two Cases of Hydrometrocolpos in Neonate (질자궁수종 신생아 2례)

  • Park, Min Young;Son, Bo Ra;Kim, So Young;Kim, Young You;Kim, Hyun Hee;Lee, Won-Bae;Sung, In Kyung;Chun, Chung Sik;Lim, Su Aa
    • Clinical and Experimental Pediatrics
    • /
    • v.45 no.2
    • /
    • pp.278-283
    • /
    • 2002
  • Imperforated hymen, vaginal atresia or high transverse vaginal septum are caused by incomplete vaginal canalization. The infant may be present with distention of the vagina and the uterus with glandular secretions stimulated by maternal estrogens, known as hydrometrocolpos. We report two cases of hydrometrocolpos. In the first case, distal vaginal atresia with cystovaginal fistula was revealed by a contrast fluoroscope through the percutaneous catheterization. In the second case, urogenital sinus was detected by a fistulogram through a single orifice in the genital area. We decompressed the cystic mass by ultrasonogram guided aspiration, promptly at birth, then achieved the transient drainage of cystic fluids by percutaneous catheterization.

CLINICAL STUDY OF BLEPHAROPLASTY USED BY SUTURED METHOD (봉합법을 이용한 중검술의 임상적 연구)

  • Park, Kwang;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.18 no.3
    • /
    • pp.353-357
    • /
    • 1996
  • One of the most common cosmetic surgery, the blepharoplasty can be divided two method. there were incisional method and sutured method. Authors try to understand the anatomic difference between the oriental upper eyelids and apply the surgical techniques of constructing upper eyelid crease of oriental case effectively. And we discussed the postoperative complications of the blepharoplasty and proposed the solve of these problems. The sutured method of blepharoplasty was more simple technique than conventional incision method and had low occurrence of complications. Even though slight recurrence, suture method was more esthetic due to no scar formation.

  • PDF

Reconstruction of Hypopharynx and Cervical Esophagus : Choice of Flap (하인두 및 경부식도 결손의 재건 : 재건술의 선택)

  • Choi Eun-Chang;Lee Sei-Young;Chung Tae-Young;Kim Se-Heon;Kim Young-Ho;Ryu Dae-Hyun;Kim Choong-Bae
    • Korean Journal of Head & Neck Oncology
    • /
    • v.16 no.1
    • /
    • pp.26-32
    • /
    • 2000
  • Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

  • PDF

Repair of Tracheoesophageal Fistula under Laryngeal Microsurgery Approach: Case Report and Literature Review (기관식도 누공에 대한 후두미세수술 접근하 재건술: 증례 보고 및 문헌 검토)

  • Han, Mun Soo;Yum, Gunhwee;Oh, Kyung Ho;Kwon, Soon Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.31 no.2
    • /
    • pp.83-86
    • /
    • 2020
  • Patients with tracheoesophageal fistula show signs of aspiration, possibly leading to pneumonia, which could be fatal to bed-ridden patients. Tracheoesophageal fistula occurs as a complication of intubation, tracheostomy tube insertion and nasogastric tube insertion. Possible etiology is pressure and ischemic necrosis given by tracheostomy tube and nasogastric tube to trachea and esophagus; or in some cases, larynx and hypopharynx. Meanwhile, for repair of tracheoesophageal fistula, transcervical approach can be considered but takes relatively long operation time and is not appropriate for patients with underlying diseases. We report a case of tracheoesophageal fistula complicated several years after tracheostomy tube and nasogastric tube insertion who came to medical attention with signs of aspiration. Authors successfully performed repair of the fistula under laryngeal microsurgery approach without skin incision and dissection, and thereby report the experience with review of literature.

Free jejunal graft for cervical esophageal reconstruction (경부식도 재건을 위한 유리 공장 이식술)

  • O, Sang-Jun;Kim, Chang-Ho
    • Journal of Chest Surgery
    • /
    • v.24 no.5
    • /
    • pp.515-521
    • /
    • 1991
  • Since Carrel in 1907 reported transfer of a free jejunal segment in dog, reconstruction of the cervical esophagus and hypopharynx has been accomplished successfully with free jejunal transplantation using microvascular technique. Free jejunal graft is useful in cases of failed colonic interpositions. Three patients with benign esophageal stricture had undergone reconstruction with right colon interposition. Because of necrosis and stricture of the interposed colon, in each case the defect was reconstructed with a free jejunal graft by using microvascular technique. The postoperative course in two patients was uncomplicated, and they were able to eat general diet. Graft necrosis occurred in one patient, but she is waiting for a reoperation.

  • PDF

Salvage of Esophageal Reconstruction with Colon Free Flap (대장유리피판(Colon Free Flap)을 이용한 식도재건의 구제술)

  • Lee, Sang Woo;Min, Kyung Won
    • Archives of Plastic Surgery
    • /
    • v.33 no.2
    • /
    • pp.245-248
    • /
    • 2006
  • Besides gastric pull-up or colonic interposition, microvascular technique in esophageal reconstruction has been approved reliable methods. When free intestinal transfer is considered, jejunal free flap is commonly used. We treated the patient who had undergone reconstruction with a right colon interposition and suffered from inability of swallowing because of stricture and necrosis of the interposed flap. Although we have planned jejunal free transfer, we couldn't use jejunum due to adhesion by previous gastrojejunostomy and colon interposition. Salvage procedure with microvascualr free left colon flap was executed successfully. After 9 month follow-up, the patient was able to consume a normal diet.

Jejunal Interposition after Total Gastrectomy (위전절제시 단순공장간치술의 임상적 의의)

  • Bae Jin-Sun;Noh Seung-Moo;Jeong Hyun-Yong;Lee Byong-Seok;Cho June-Sik;Shin Kyung-Sook;Song Kyu-Sang;Lee Tae-yong
    • Journal of Gastric Cancer
    • /
    • v.1 no.4
    • /
    • pp.210-214
    • /
    • 2001
  • Purpose: The aim of this study was to evaluate the shortterm outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to $86.0\%$ and $87.6\%$ of the recent original body weight in the jejunal interposition (JI) group and to $90.8\%,\;87.0\%$, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the JI group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the JI group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the JI group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the JI group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in $7.1\%$ of the patients in the JI group and in $3.5\%$ in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy.

  • PDF

Arthroscopically Assisted Lateral Release and Medial Imbrication for Recurrent Patella Dislocation (재발성 슬개골 탈구에서 관절경적 외측 유리술 및 내측부 중첩술)

  • Kang, Sung-Shik;Yoo, Jae-Doo
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.9 no.2
    • /
    • pp.98-103
    • /
    • 2010
  • Purpose: We reported the results of arthroscopically assisted lateral release and medial imbrication for the recurrent patella dislocation. Materials and Methods: Twenty patients (20 knees) underwent arthroscopically assisted surgery for the recurrent patella dislocation. There were 4 males and 16 female. The average age was 20.2 years. All patients had definite trauma history and average follow-up period was 19 months. The surgical results were evaluated according to the Lysholm knee score and the Kujala score. The congruence angle and lateral patellofemoral angle were measured on plain radiograph and the tibial tubercle-trochlear groove distance was calculated on computerized tomography. Results: The median value of preoperative congruence angle was $16.5^{\circ}$ (range, $0.0{\sim}+34^{\circ}$) and the average final follow-up was $-6.4^{\circ}$ (range, $-19{\sim}10^{\circ}$) with statistically significant improvement (p=0.025). The median value of preoperative Lysholm knee score was 70 (range, 63~81) and the final follow-up score had changed to 88 (range, 80~95) with statistically significant improvement (p=0.0341). The median value of preoperative Kujala score was 72 (range, 65~80) and the average final follow-up score showed 87 (range, 80~92) with statistically significant improvement (p=0.024). Recurrent dislocations after surgery occurred in 2 cases, one case which showed positive "thumb to forearm test" had been treated with medial patellofemoral ligament reconstruction. Conclusion: Arthroscopically assisted lateral release and medial imbrication for recurrent patella dislocation without bony malaligmenent showed the effective treatment, but would be inappropriate for the patients with the generalized joint laxity.

  • PDF

The effects of functional movement recovery of physical therapy after ACL reconstruction with MCL injury (물리치료가 슬관절 내측측부인대 손상을 동반한 전방십자인대 재건술 후 운동기능 회복에 미치는 영향)

  • Kim, In-Sup;Lim, Weon-Sik;Vae, Sung-Soo
    • The Journal of Korean Physical Therapy
    • /
    • v.14 no.1
    • /
    • pp.27-37
    • /
    • 2002
  • This is the study of the knee joint injured patients at the orthopaedic surgery clinic where is located in Daejon, who has MCL combine injured ACL reconstruction caused by sport activity and accident during the period from Jan. 2001 to Oct. 2001. By comparing with groups between 7th case of I-group for MCL combined stitch and II-group for ACL reconstruction since 6weeks cast. We have been concluded with that following results. 1. Range of motion for the knee was not limited at 5th case(37%) of I-group, 6th case(42%) of II-group and the cases of Flexion deficit less then 10 -degree were 2nd case(13%) of I-group and II-group 1st case(8%) with no extension deficit more then 5 -degree. 2. The level of activity that tells you whether you are capable of exercise for six month after operation. It han been divided by 3 levels. The case of capable of doing low risk exercise(swimming, cycling, etc.) was 5th case of I-group, the case of capable of doing medium risk exercise(jogging, etc.) was 3rd case of I-group and 4th case of II-group and the case of capable of doing high risk exercise(football, etc.) were 3rd case of I-group and 3rd case of II-group. 3. The timing of the return to their job were average 6.4 weeks for I-group and average 22.9 weeks for II-group(P<.05, statistical difference). 4. There was no statistical difference between I-group and II-group for the timing of the return to their job(P>.05). 5. By using VAS to compare them there was no statistical difference between I-group and II-group of clinical results according to Lysholm scale.

  • PDF