• Title/Summary/Keyword: 재절제

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Parachordoma of Inguinal Region - A Case Report - (서혜부에 발생한 유척색종 - 증례 보고 -)

  • Moon, Sang-Ho;Kim, Dong-Jun;Kong, Gyu-Min;Lee, Soo-Won;Shim, Jong-Ok;Park, Jean-Kyung;Kim, Sung-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.68-72
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    • 2008
  • Parachordoma is an extremely rare tumor that histologically resembles chordoma of axial skeleton but occurs in a peripheral site. It is considered an indolent neoplasm with potential for local recurrence. We present a case of soft tissue parachordoma at inguinal subcutaneous tissue which recurred 2 months after primary simple excision under local anesthesia and was performed revisional wide excision. Bone scan showed no other metastatic lesion. Immunohistochemical findings revealed tumor cells to be reactive to EMA, S-100 protein, vimentin and cytokeratin.

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Surgical Treatment of Tracheal Stenosis (기관 협착증의 외과적 치료)

  • 최준영;장인석;김종우;김병균;이정은;김성호;이상호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.565-569
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    • 2000
  • Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.

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Hemilaminectomy for Herniated Discs at the Cervicothoracic Junction in a Beagle Dog (편측추궁절제술을 이용한 비글견의 경흉연접부 추간판 탈출증의 치료)

  • Kang, Byung-Jae;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.511-514
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    • 2014
  • A 7-year-old, female Beagle dog presented with a primary complaint of severe neck pain and paretic gait. A lesion was suspected between C6 and T2 on the basis of neurological examinations. Magnetic resonance imaging of the cervicothoracic spine revealed herniation of disc material from the C7-T1 intervertebral space resulting in marked spinal cord compression. Hemilaminectomy was performed to treat the intervertebral disc disease at C7-T1. Treatment was effective and the clinical condition of the dog was remarkably improved. This result suggests that hemilaminectomy is an effective option for surgical treatment of intervertebral disc disease at the cervicothoracic junction in dogs.

A Study on the Factors that Influence the Surgical Outcomes of Choledochal Cyst in Children (소아에서 담관 낭종의 수술 성적에 영향을 주는 요인에 대한 연구)

  • Kim, Jong-Kyu;Noh, Gyoung Tae;Min, Seok-Ki;Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.18 no.1
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    • pp.1-11
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    • 2012
  • 담관 낭종은 흔하지는 않지만, 외과적 절제가 필요한 주요 질환이다. 절제하지 않고 남겨두면 다른 질환으로의 이환이나 다양한 합병증에 의한 사망까지도 야기할 수 있기 때문에 적절한 수술적 치료가 필수적이다. 최근 수술에 따른 다양한 문제들이 계속 보고되고 있으며, 출생 전이나 건강 검진 시 발견되는 무증상의 담관 낭종의 수술 시기에 대해서도 아직 논란이 되고 있다. 저자들은 1995년부터 2009년까지 담관 낭종으로 수술 받은 환자 중 수술 받을 당시의 연령이 18세 이하인 32명 환자의 임상 양상과 수술 기록을 후향적으로 분석하여, 수술 성적에 영향을 주는 요인들을 알아보고자 하였다. 전체 32명 중 남자 10명, 여자 22명이었으며, 수술 당시의 평균 연령은 5.4세였다. 췌담관 합류이상은 9명(28.1%)이었으며, 평균 추적 관찰 기간은 34.6개월이었다. 술 전 증상을 호소한 환자는 30명(93.8%)이었으며, 복통(63.3%), 황달(40.0%), 구토(23.3%), 복부종물(16.7%), 발열(16.7%)등의 순서였다. 술 전 혈액 검사에서 AST/ALT의 상승이 18명(56.3%), 고빌리루빈혈증이 8명, 백혈구 증가증이 7명(21.9%)이었다. 술 후 합병증은 5명(15.6%)에서 나타났는데, 2명은 담관염이었고, 나머지 3명은 문합부 협착, 술 후 출혈, 장 폐쇄가 각각 1명 있었다. 술 후 평균 재원 기간은 12.2일 이었으며, 추적 관찰 기간 중 3명(9.0%)이 재입원 하였다. 수술 성적에 영향을 미치는 요인으로, 수술 당시의 나이가 많을수록 평균 수술 시간과 재원 기간이 증가하였다(p=0.004, p=0.028). 증상이 있었던 환자군에서 무증상 환자군보다 재원 기간이 더 길었다(p=0.001). 또한 췌담관 합류이상이 있었던 환자군에서 재입원율이 유의하게 높았다(p=0.005). 소아의 담관 낭종은 진단이 되면 증상 발현 전이라도 조기에 수술하는 것이 수술 시간 및 재원 기간을 단축시킬 수 있으며, 췌담관 합류이상이 동반된 경우에는 술 후에 재입원할 가능성이 높으므로 주의깊게 추적 관찰하는 것이 바람직할 것이다.

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Surgical Treatment of Primary Lung Cancer (원발성 폐암의 외과적 치료)

  • 김성완;구본원;이응배;전상훈;장봉현;이종태;김규태;강덕식
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.134-141
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    • 1998
  • Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.

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Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Open Heart Surgery with Pulmonary Resection (개심술과 폐엽절제술의 동시 수술 경험)

  • 이용재
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.234-235
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    • 1993
  • We have experienced a case of congenital heart disease who developed pulmonaryaspergilloma and then had open heart surgery associated with pulmonary resection. A 53 year old female patient was admitted of fever and chill without cyanosis and hemoptysis. Chest CT showed cavitary lesion with enhanced wall in right midle lung and huge pulmonary artery. Secundum atrial septal defect was identified by echocardiography and catheterization, preoperatively. The patient was identified finally as atrial septal defect associated with pulmonary aspergilloma, in operation and pathology.

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Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

Diagnosis, Treatment and Prognosis of Low Grade Central Osteosarcoma (저등급 중심부 골육종의 진단, 치료 및 예후)

  • Song, Won Seok;Cho, Wan Hyeong;Lee, Kwang-Youl;Kong, Chang-Bae;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.47-53
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    • 2014
  • Purpose: We analyzed the diagnosis and the treatment outcomes of patients with central low grade osteosarcoma. Materials and Methods: We retrospectively reviewed 16 patients with central low grade osteosarcoma were treated at out institution between 1994 and 2011. Results: There were 4 men and 12 women with mean age of 26 years. Eleven patients were correctly diagnosed but 5 patients were misdiagnosed as osteoid osteoma, non ossifying fibroma, aneurysmal bone cyst, desmoplastic fibroma. 15 patients finally received wide margin en bloc excision and one of them treated under neoadjuvant chemotherapy. Final survival status was continuous disease free in 14 and 1 patient died of renal cell cancer. Remaining 1 with multifocal lesions is alive with disease for 7 years only treated radiation therapy on residual tumors. Nine (56%) of 16 tumors showed extra-osseous extension of tumor (56%) and 1 of them showed extra-compartmental tumors. Conclusion: The diagnosis of central low grade osteosarcoma is challenging, however, considering of the clinical suspicion, the typical findings of radiologic and pathologic features, proper diagnosis is needed. This tumor should be treated with wide excision, even after an intralesional excision, to avoid local recurrence or transformation to higher histologic grade.