• Title/Summary/Keyword: 위 절개술

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A case report of Successful Laparascopic Myotomy for Achalasia (식도이완불능증의 복강경 수술)

  • 황성욱;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.157-160
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    • 2002
  • Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for Ihe achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.

Gastrotomy Approach Retrieval of Esophageal Foreign Body using Long Forceps Technique in Five Dogs (위 절개술 접근과 긴 겸자를 이용한 식도 내 이물 제거 5례)

  • Yoon, Hun-Young;Kang, Myung-Gon;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.628-631
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    • 2009
  • Five dogs presented to the Veterinary Medical Teaching Hospital of the Konkuk University and Hangang Animal Hospital with a history of foreign body ingestion. On physical examination, five dogs showed lethargy, anorexia, or vomiting. Plain radiographs revealed that radiopaque foreign bodies lodged in the heart base or caudal thoracic esophagus. Positive contrast esophagogram revealed that large foreign bodies severely expanded the esophagus and there was no evidence of leakage of the contrast agent from the esophagus into the thoracic cavity. Gastrotomy for retrieval of esophageal foreign bodies using long forceps technique was performed. Esophageal foreign bodies were successfully retrieved in all dogs. The follow-ups were completed 10 days to 2 years after surgery. The follow-up information was based on physical examination by veterinarians and telephone interview with owners. The owners reported that there was no evidence of complications related to surgery such as vomiting, regurgitation, dysphagia, gagging, hyper-salivation, or anorexia in all dogs.

Delayed Primary Repair of Esophageal Rupture (식도천공 후 만기 일차 봉합술의 성적)

  • 김길동;정경영;김창수;박한기
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.46-51
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    • 1998
  • Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

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Endoscopic Retrieval of Esophageal Fishhooks Using Cerclage Wire: A Case Report (내시경과 Cerclage Wire를 이용한 식도내 낚시바늘 제거: 증례보고)

  • Kim, Young-Ki;Uhm, Mi-Young;Seo, Eu-Gene;Ha, Mi-Hyun;Wang, Ji-Hwan;Jeong, In-Jo;Chang, Hong-Hee;Lee, Hee-Chun;Cho, Kyu-Woan;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.622-626
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    • 2007
  • A 1.6-year-old, intact male beagle dog was presented with three day history of odynophagia and anorexia. According to the history and radiographic findings, the patient was diagnosed with esophageal and gastric foreign body due to ingesting fishhooks. Gastroesophagoscopy revealed that one fishhook located in the thoracic esophagus cranial to the heart base and the other located in the cardia region were connected with a single fishing line. Gastrotomy was performed to remove the fishhook in the cardia region and to sever the connecting fishing line. After gastrotomy, endoscopic attempts to remove the esophageal fishhook with a three, five pronged endoscopic grasping forceps, and a biopsy were unsuccessful because the fishhook was embedded deeply in the mucosa membrane. A handmade cerclage wire(16G) shaped like a snare forceps was advanced into the esophagus while visualizing the fishhook endoscopically. The cerclage wire was used to hang and retract the foreign body. The fishhook was retracted orally, resulting in successful removal. Ten days after the operation, the patient fully recovered and was discharged.

Comparison of Arthroscopic versus Mini Open Repair in Medium and Large Sized Full Thickness Rotator Cuff Tear - Short Term Preliminary Results - (중 대 범위 전층 회전근 개 파열에서 관절경 하 봉합술과 소 절개 봉합술의 비교 - 단기 추시 예비 결과 -)

  • Ko Sang Hun;Cho Sung Do;Lew Sogu;Park Moon-Su;Kwag ChangYul;Woo Jong Ken
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.73-80
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    • 2004
  • Purpose: To compare the results of a miniopen repair with those of complete arthroscopic repair in medium and large sized full thickness rotator cuff tears. Materials and Methods: The thirty four(34) patients with medium and large sized complete rotator cuff tear were observed, Group I (complete arthroscopic repair) were 13 cases and group II (miniopen repair) were 21 cases. The tear sizes are from 1cm to 5cm. The average follow up periods are 24(range;12$\~$36) and 28(range; 12$\~$36) months. Subjective pain was evaluated with VAS (visual analogue scale) in rest state. ADL (Activity of Daily Living) and UCLA scoring system were used to evaluate clinical results. Results: At last follow-up periods, pain and functional scores were improved but they had not been shown statistical significance (p>0.05). In the group I and group II, there are no significant difference in VAS, ADL; UCLA score, satisfaction (p>0.05). Conclusions: In medium and large sized full thickness rotator cuff tears, there are no significant clinical results between the arthroscopic and miniopen group.

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Simultaneous Repair of Pectus Excavatum and Secundum Atrial Septal Defect (심방중격결손을 동반한 누두흉의 동시교정)

  • 김재범;이광숙;이재훈;유영선;박창권;최세영
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.784-786
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    • 2001
  • We at Keimyung University Dongsan Medical Center experienced simultaneous repair of pectus excavatum and secundum atrial septal defect We used resection deformed perichondrium, raising sternum at right angle to secure good operative field for open heart surgery. Mechanical ventilation was applied which could be weaned on postoperative 2 hours. The hospital course was uneventful without any other sequale. The patient was discharged on postoperative day 6.

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Risk Assessment of Arsenic by Human Exposure of Contaminated Soil, Groundwater and Rice Grain (오염된 토양, 지하수 및 쌀의 인체노출에 따른 비소의 위해성 평가)

  • Lee Jin-Soo;Chon Hyo-Taek
    • Economic and Environmental Geology
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    • v.38 no.5 s.174
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    • pp.535-545
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    • 2005
  • Environmental survey from some abandoned metal mine areas was undertaken on to assess the risk of adverse health effects on human exposure to arsenic influenced by past Au-Ag mining activities. Elevated levels of As were found in tailings from the studied mine areas. This high concentration may have a impact on soils and waters around the tailing piles. In order to perform the human risk assessment, chemical analysis data of soils, rice grains and waters fur As have been used. The HQ values fer As via the rice grain and groundwater consumption were significantly higher compared with other exposure pathways in all metal mine areas. However, there were minimal soil and water dermal contact risks. The resulting Hl values of As from the Dongil, Okdong and Hwacheon mine areas were higher than 5.0, and their toxic risk due to drinking water and rice grain was strong in these mine areas. The cancer risk of being exposed to As by the rice grain route from the Dongil, Okdong and Hwacheon mine areas was $5.2\times10^{-4},\;6.0\times10^{-4}\;and\;8.1\times10^{-4}$, respectively. The As cancer risk via the exposure pathway of drinking water from these mine areas exceeded the acceptable risk of 1 in 10,000 fer regulatory purposes. Thus, the daily intakes of groundwater and rice grain by the local residents from the Dongil, Okdong and Hwacheon mine areas can pose a potential health threat if exposed by long-term arsenic exposure.