• Title/Summary/Keyword: 위 절개술

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Effect of Operative Wound Protection on Surgical Wound Complications (수술 증 절개창 보호 방법이 수술 후 절개창 합병증에 미치는 영향)

  • Lim, Jin-Hong;Kim, Sung-Soo;Choi, Won-Hyuk;Oh, Sung-Jin;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.248-253
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    • 2007
  • Purpose: Surgical wound complications remain a cause of morbidity and mortality among postoperative patients, and the cost of caring for patients with a surgical wound complication is substantial. The purpose of this study was to evaluate the ability of a vinyl wound protector to reduce the rate of wound complications when used in clean-contaminated surgery. Materials and Methods: Between May 2006 and September 2006, 295 patients with a gastric cancer that underwent gastric surgery were studied prospectively, and the patients were randomized into one of two groups: the no wound protector group (n=137) or the polyethylene protector group (n=132). Results: The demographics and operation type and operation time were similar for patients in both groups. The rate of wound complication was different between patients in the no protector group (n=42) and the polyethylene protector group (n=12) (P=0.001) and the rates of seroma (P=0.001), infection (P=0.030) and dehiscence (P=0.282) were different for the two groups. The postoperative hospital stay was significantly shorter in the polyethylene protector group of patients (P=0.040). Conclusion: The use of a polyethylene protector resulted in a reduction of the surgical wound complication rate, and the cost of caring for patients, and morbidity and mortality among postoperative patients could be reduced.

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Treatment of Potassium Titanyl Phosphate Laser and Radiation Therapv for Tracheal Stenosis (기관 협착에서 레이저와 방사선 치료의 적용)

  • 김광택;김맹호
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1237-1241
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    • 1997
  • Tracheal stenosis is a difficult disease entity to manage. Laser ablation is one effective treatment for treacheal stenosis and can be utilized if tracheal reconstructive surgery is impossible. Potassium titanyl phosphate laser, transmitted via flexible quartz fiber, can be precisely manipulated through flexible bronchoscope under local anesthesia. We treated 7 patients with trach al and broncheal lesion under local anesthesia with KTP laser from January 1995 to July 1996. The patients included three males and four females. The age of patients ranged from 22 to 66 years with a mean of 43.7 years The etiology of tracheal stenosis in patients was stenosis after tracheostomy(3 cases), prolong inturbation in cases of sepsis(1 cases), and the recurrence of lung cancer within endobronchial lesion(2 cases). In the cases of tracheal stenosis treated with laser ablation, there were 2 cases of recurrence of stenosis at the anastomosis site after the operation, 3 cases of stenosis at tracheostomy site, and 2 cases of local recurrence of lung cancer. The site of the tracheal stenosis was the balloon site of the tracheostomy tube(3-4cm inferior to the tracheostomy site, 2-3cm superior to the carina) and the anastomosis site that were narrowed to less than 5mm(4 cases). For the stenosis lesion in the endobronchial area, there were 2 patients with a lesion at the anterior wa l, 1 patient with a lesion at the posterior wall, 2 patients with circumferential stenosis. Laser ablation time was 25.4 $\pm$5.9min and used energy was 1768 $\pm$365J. We have used KTP laser via (lexible bronchoscope without major complications. Adjuvant radiation therapy may prevent fibroblast proliferation which leads to restenosis. In three patients of restenosis after laser ablation, adjuvant irradiation started within 4 hours after laser ablation, and the radiation doses were 1500cGy given in five fraction. In patients with adjuvant radiation therapy, stenosis has not recurred

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A Rat Pylorus Stricture Model to Create Stent-induced Granulation Tissue Formation (백서 날문부에서 스텐트 유도 조직 과증식 형성을 위한 전임상 모델에 관한 연구)

  • Kim, Min-Tae
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.559-565
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    • 2022
  • In this study, we intend to develop a granulation tissue formation model. As a pilot experiment, a contrast agent was injected into the pylorus in 3 rats, the normal pylorus lumen size was confirmed, and a stent was placed. Stent migration was confirmed in to the duodenum within 1 week. In this experiment, stent was sutured and fixed to induce granulation tissue formation after gastrostomy under a fluoroscopic guidance. Twenty rats were divided into Healthy Group / Gastrostomy Group. After anesthesia of the Gastrostomy Group, an abdominal incision was performed, and gastrostomy was performed under a fluoroscopic guidance, and a stent was placed into the pylorus. In order to prevent stent migration due to peristalsis, suture between the pylorus and the proximal end of the stent was performed. Postoperative behavior and weight changes were monitored daily. Four weeks after surgery, gastrointestinal fluoroscopy imaging was performed and rats were sacrifices. To evaluate the degree of granulation formation, the stent was sectioned transversely. Gastrostomy group was statistically significantly higher than Healthy Group in granulation area ratio (all p<.001). In conclusion, it is considered that the level of tissue overgrowth formation for preclinical evaluation of the pylorus stricture model through gastrostomy is appropriate as a research evaluation tool.

Surgical Treatment of Sliding Hiatal Hernia by Incisional Gastropexy at Fundus and Pylorus in a Chihuahua Dog (치와와견에서 위저부 및 유문부의 절개성 위고정술을 통한 축성열공허니아의 수술적 치료)

  • Jang Ha-young;Yoon Hun-young;Kim Jun-young;Han Hyun-jung;Jeong Soon-wuk
    • Journal of Veterinary Clinics
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    • v.22 no.1
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    • pp.76-78
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    • 2005
  • A 1 year 2 months old, male Chihuahua dog weighing 0.92 kg was presented with a history of intermittent vomiting after eating since two weeks ago. Based on the history, clinical signs, physical examination, and contrast radiographs, the diagnosis of sliding hiatal hernia was made. Diaphragmatic plication, esophagopexy and left-sided gastropexy concurrently required for surgical correction but in this case, diaphragmatic plication and esophagopexy could not be applied because of the patient's special condition. Instead, left-sided gastropexy was performed with additional pyloropexy. To treat reflux esophagitis, cimetidine and sucralfate were administrated and patient was fed in an upright position. Two days after the surgery, the patient showed normal activity and after then there was not found recurrence or complication.

Arthroscopic Subscapularis Tendon Repair - Preliminary Report of 8 cases study - (관절경하 견갑하건 봉합술 - 8 례에 대한 예비보고 -)

  • Yun, Ho-Hyun;Moon, Gi-Hyuk;Jang, Jong-Hoon;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.124-131
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    • 2004
  • Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

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Left Ventricular Inflow Obstruction Caused by a Persistent Left Superior Vena Cava and a Dilated Coronary Sinus - A case report - (관상정맥동 확장에 의한 좌심실 유입로 폐쇄 - 1예 보고 -)

  • Sim, Hyung-Tae;Jhang, Won-Kyoung;Jang, Wan-Sook;Ko, Jea-Kon;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.499-502
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    • 2007
  • Left ventricular inflow obstruction can be caused by a persistent left superior vena cava (SVC) and a dilated coronary sinus. A 31-day-old male infant with secondum atrial septal defect (ASD) and bilateral SVC underwent an operation for treating his uncontrollable congestive heart failure. The preoperative 2-dimensional echocardiography showed a normally sized mitral valve shrouded by a dilated coronary sinus. The operation consisted of pericardial patch closure of the ASD, coronary sinus unroofing and left SVC transfer to the right atrial auricle. The postoperative course was complicated by persistent chylothorax, which was controlled by thoracic duct ligation, He was discharged to home at the postoperative day 39. He has been followed up for 9 months and has displayed normal development.

The Effect of Acupuncture on the Post-Thoracotomy Pain Control (개흉술후 동통억제를 위한 침의 효과)

  • 조규석;김수철
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.187-194
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    • 1997
  • The management of post-thoracotomy pain is on of the difficult clinical problems. A variety of pain management methods have been used with variable efficacy. We compared the effect of acupuncture with the effect of analgesics for the post-thoracotomy pain control. From March 1995 to September 1995, 20 patients who underwent elective thoracotomy were randomized into two groups. The patients were treated with analgesics in control group(n=10) and acupuncture in the other group(n: 10). Postoperative analgesic effects were evaluated by the scoring system which was made by the Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center. No significant difference was observed between two groups concerning the subjective pain and limitation of motion of operated side. Although the number of analgesic requirement was reduced significantly in the acupuncture group(P < 0.05). We conclude that acupuncture is an effective method to control post-thoracotomy pain and it is safer than the analgesics bacause of its lower side effects.

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Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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Arthroscopic Reduction and Internal Fixation with Cannulated Screw of a Transverse Glenoid Fracture (유경 나사를 이용한 견갑골 관절와 횡골절의 관절경적 정복 밑 내고정)

  • Noh Kyu Cheol;Yoo Jung Han;Kang Ki Man
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.176-180
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    • 2003
  • We describe in this report the accurate reduction of a transverse displaced glenoid fracture through arthroscopic control . We used the lateral and superior (Neviaser portal) portal of the arthroscopic surgery in the shoulder joint for the U 4.0-mm titanium cannulated cancellous screw fixation. The advantages of this treatment are excellent intra-articular visualiBation, decreased soft tissue dissection ,less blood loss, shortened postoperative recovery and early ROM exercise. There(ore, we report the method of operation and the cases .

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Video Assisted Thoracoscopic Sympathetic Ramus Clipping in Essential Hyperhidrosis -Cadaver Fitting Test and Clinical Application (다한증 환자에서 클립을 이용한 교감신경 교통가지 차단술 -사체 연구 및 임상적용-)

  • Lee, Sung-Ho;Cho, Seong-Joon;Jung, Jae-Seung;Kim, Tae-Sik;Son, Ho-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.595-601
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    • 2003
  • Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.