• Title/Summary/Keyword: 외과 절개

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Endobronchial Lipomatous Hamartoma Removed by Bronchotomy - One case report- (기관지 절개로 제거된 기관지 내 지방종성 과오종 -1예 보고-)

  • Kim, Jae-Wuk;Huh, Jin-Gook;Lee, Hyun-Kyung;Joo, Mee;Kim, Seung-Woo;Ku, Bon-Il;Yum, Ho-Kee
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.870-873
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    • 2003
  • Hamartoma is rare but the most common benign neoplasm in the lung. However endobronchial lipomatous hamartoma has been rarely reported. A 73-year-old male patient was admitted to our hospital due to hemoptysis 1 month prior to admission. On bronchoscopic examination, a large pedunculated endobronchial mass right upper lobar bronchus. The endobronchial mass was enucleated by bronchotomy that is no evidence of malignancy in frozen specimens. We report a case of endobronchial lipomartous hamartoma which was resected by bronchotomy.

Transsternal Approach for BPF closure -A Case Report (정중흉골절개를 통한 기관늑막루의 폐쇄술 -1례 보고-)

  • 정원상;양수호;전순호;신성호;김영학;서정국;김경헌;이준영
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.540-543
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    • 1998
  • A patient with post-pneumonectomy empyema was treated sucessfully by modification of Clagett's operation after closure of bronchopleural fistula using a transsternal, transpericardial approach. His primary disease was pulmonary tuberculosis, and he had a past history of left upper lobe lobectomy 34 year ago. Recently recurred pulmonary tuberculosis with aspergilloma in the remaining left lung, empyema with bronchopleural fistula had developed on the post-operative 4th day after completion pneumonectomy. Closed thoracostomy was done at the lowest point of the left pleural cavity immediately. The pleural cavity was irrigated with small amount of normal saline through pigtail catheter. The 2nd operation was done by closure of bronchopleural fistula using a stapler through transsternal, transpericardial approach, and then the pleural space was irrigated with normal saline with Tobramycin which shows sensitivity to isolated organism from pleural cavity. After negative conversion of pleural fluid culture, we performed modified Clagett's operation under local anesthesia. The patient had no evidence of recurrence of empyema and discharged from hospital after 10 days of the 3rd procedure.

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

  • Park, Kwang;Seo, Ku-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.353-357
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    • 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.

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Intraluminal Pedunculated Leiomyoma in the Cervical Esophagus - Report of 1 Case - (경부식도에 발생한 강내 육경성 평활근종의 수술 치험)

  • 이형렬;김흥수;박준호;조정수;강대환;이창훈
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.621-625
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    • 2002
  • Though leiomyoma is the most common tumor of esophagus, it accounts for only 1% of all esophageal tumors. Most of the leiomyomas are intramural type originating from the muscularis propria and only l% of them is intraluminal pedunculated type originating from muscularis mucosae. Recently, a 30-year-old male was admitted to our hospital because of dysphagia. Radiologic examination showed that intraluminal tumor 5cm in diameter was found at the cervical esophagus. Endoscopic examination showed that the tumor was covered with normal mucosa. The patient underwent surgical excision through the left cervical approach. After full, longitudinal esophagotomy, the intraluminal pedunculated tumor was successfully enucleated. Esophageal leiomyoma was confirmed histopathologically. Postoperative course was uneventful and the patient was relieved from dysphagia.

Tricuspid Replacement through Right Thoracotomy in Reoperation - A case report - (재수술 시 우측 개흉을 통한 삼첨판막 치환술 -1예 보고)

  • Kim Hyuck;Han San Woong;Chung Won Sang;Kang Jung Ho;Chon Soon Ho;Lee Chul Bum;Kim Young Hak
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.714-716
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    • 2005
  • In an extremely enlarged right heart, the repeated midline sternotomy was considered to involve the risk of massive hemorrhage. A right thoracotomy provides a convenient and safe way to approach the tricuspid valve in patient who have had previous heart surgery through a midline sternotomy.

Extraanatomic Aortic Bypass through a Median Sternotomy in a Patient with Coarctation of Aorta Associated with Annuloaortic Ectasia - A case report - (대동맥근부 확장을 동반한 대동맥 축착증 환자에서 정중흉골절개를 통한 외해부학적 대동맥 우회로술 - 1예 보고 -)

  • Kim, Kyung-Hwa;Jo, Jung-Ku;Choi, Jong-Bum;Seo, Yeon-Ho;Kim, Tae-Yun
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.308-311
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    • 2010
  • Coarctation of the aorta is frequently associated with intracardiac disease. It is very difficult to decide on the best method for surgically treating adult patients with these combined heart diseases. We performed single-stage repair via a modified Bentall operation and by creating an intrapericardial ascending-descending aortic bypass through a median sternotomy in a patient with coarctation of the aorta and annuloaortic ectasia, and the latter was associated with aortic valve regurgitation.

Arterial Thoracic Outlet Syndrome - a case report- (동맥성 흉곽출구 증후군 -1례 보고-)

  • 이철범;함시영;정원상;김영학;강정호;이홍기;박충기
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.903-906
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    • 1998
  • A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.

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Result of Cox Maze Procedure with Bipolar Radiofrequency Electrode and Cryoablator for Persistent Atrial Fibrillation - Compared with Cut-sew Technique - (양극고주파전극과 냉동프로브를 이용한 지속성 심방세동의 수술 결과 - 절개/봉합술식과 비교 -)

  • Lee, Mi-Kyung;Choi, Jong-Bum;Lee, Jung-Moon;Kim, Kyung-Hwa;Kim, Min-Ho
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.710-718
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    • 2009
  • Background: The Cox maze procedure has been used as a standard surgical treatment for atrial fibrillation for about 20 years. Recently, the creators have used a bipolar radiofrequency electrode (Cox maze IV procedure) instead of the incision and suture (cut-sew) technique to make atrial ablation lesions for persistent atrial fibrillation. We investigated clinical outcomes for the Cox maze procedure with a bipolar radiofrequency electrode and cryoablator in patients with persistent atrial fibrillation, and compared results with clinical outcomes of the cut-sew procedure. Material and Method: Between April 2005 and July 2007, 40 patients with persistent atrial fibrillation underwent Cox maze IV procedure with a bipolar radiofrequency electrode and cryoablator (bipolar radiofrequency group). Surgical outcomes were compared with those of 35 patients who had the cut-sew technique for the Cox maze III procedure. All patients had concomitant cardiac surgery. Postoperatively, the patients were followed up every 1 to 2 months. Result: At 6 months postoperatively, the conversion rate to regular sinus rhythm was not significantly different between the two groups: 95.0% for the bipolar radiofrequency ablation group; 97.1% for the cut-sew technique (p=1.0). At the end of the follow-up period, the conversion rate to regular sinus rhythm was also not significantly different (92.5% vs. 91.6%, p=1.0). In multivariate analysis using a Cox-regression model, the postoperative atrial dimension was an independent determinant of sinus conversion in the bipolar radiofrequency ablation group (hazard ratio 31, p=0.005). In the Cox-regression model for both groups, atrial fibrillation at 6 months postoperatively (hazard ratio 92.24, p=0.003) and the postoperative left atrial dimension (hazard ratio 16.05, p=0.019) were independent risk factors of continuance or recurrence of atrial fibrillation after Cox maze procedures. Aortic cross-clamp time and cardiopulmonary bypass time were significantly shorter in the radiofrequency group than in the cut-sew group. Conclusion: In the Cox maze procedure for patients with persistent atrial fibrillation, the use of bipolar radiofrequency ablation and a cryoablator is as good as the cut-sew technique for conversion to sinus rhythm. The postoperative left atrial dimension is an independent determinant of postoperative continuance and recurrence of atrial fibrillation.

SURGICAL REDUCTION OF DISPLACED SUBCONDYLAR FRACTURES OF MANDIBLE USING OF SAGITTAL SPLIT AND OBLIQUE SUBCONDYLAR OSTEOTOMY (시상골절단과 사선골절단술을 이용한 하악골 과두골절의 외과적 치험예)

  • Kim, Hyoun-Chull
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.87-95
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    • 1989
  • The therapeutic methods and follow - up prognosis of subcondylar fractures in adults have always been sources of controversy. To improve the therepeutic results in subcondylar fractures with displacement, and especially, the bicondylar ones, the auther employ the surgical reduction using of sagittal split and oblique subcondylar osteotomy. This report is illustrated by six clinical cases.

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Anatomic Study for Hamstring Tendon Harvest (슬괵건 채취를 위한 해부학적인 고찰)

  • Son, Jung-Hwan;Park, Chan-Jae;Jung, Gu-Hee
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.33-37
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    • 2007
  • Purpose: The harvest of hamstring tendon is technically demanding because of the inadequate identification of hamstring tendon separation and accessory tendon of semitendinosus tendon. We conducted therefore conducted an anatomic study, aiming at the anatomic knowledge for graft harvest. Materials and Methods: 20 human cadaveric knees (10 cadavers) were used for the study. The location of tendon separation in conjoined tendon and accessory tendon of semitendinosus tendon were described and recorded. Results: The location of tendon separation of conjoined tendon was average $39.68{\pm}9.97mm$ vertically and $18.57{\pm}2.91mm$ horizontally from the tibial spine. We found that the accessory structure of the semitendinosus tendon was mostly fascia-like structure(17 knees), the tendinous structure, 3 cases which was straightly located 15cm from the tibial crest. Conclusion: We propose that the expected incision for hamstring tendon harvest is centered on the inferior 40mm, medial 20mm from the tibial spine. The accessory structure of the semitendinosus tendon was mostly found of fascia-like structure.

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