• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권1호
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• pp.158-164
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• 1990

저자는 20세 남자환자에게 발생한 섬유골성병소에 대한 문헌고찰과 더불어 섬유골성병소중 치주인대로부터 유래된 백아질골섬유종에 대해 En-bloc절제술과 결손부에 대해 이물성형재료인 $Pyrost^{\circledR}$이식을 시행한 뒤 현재까지 재발소견없이 양호한 치유상태를 보여 이에 보고하는 바이다.

• Clinical Endoscopy
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• 제55권2호
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• pp.248-255
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• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancer (EGC). However, very few studies have been conducted in South America. This study aimed to assess the efficacy and safety of ESD for EGC. Methods: We analyzed data from a prospective cohort from 2013 to 2020. A total of 152 superficial gastric neoplasms that fulfilled the absolute or expanded criteria for ESD were included. Outcomes were en bloc, R0, and curative resection rates, incidence of adverse events, and length of procedure. Results: The age of the enrolled patients was 68.4±11.3 years. The number of included patients based on the absolute and expanded indications was 150 and 2, respectively. En bloc, R0, and curative resections were achieved in 98.0%, 96.1%, and 89.5% of the cases, respectively. Bleeding and perforation were reported in 5.9% and 6.6% of the cases, respectively. Histopathological examination revealed low-grade dysplasia, high-grade dysplasia, well-differentiated adenocarcinoma, and poorly differentiated adenocarcinoma in 13, 20, 117, and 2 cases, respectively. Conclusions: Our study shows that ESD performed by properly trained endoscopists in reference centers is safe and effective, with comparable therapeutic outcomes to those reported in the Eastern series.

• 대한골관절종양학회지
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• 제10권1호
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• pp.29-33
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• 2004

원위 요골의 거대 세포종은 빈도가 많지는 않다. 통상적으로 골 소파술 및 골 시멘트 충전술로 치료하지만, 재발한 경우나 처음부터 골피질 파괴가 심하고 관절 침범이 있을 경우에는 일괄 절제(en bloc resection) 후 근위 비골을 이용하여 재건하는 술 식이 많이 이용되어 왔다. 본 연구는 고식적 술 식으로 치료한 후 국소 재발한 원위 요골의 거대 세포종 환자에서, 근위 비골을 이용한 재건술을 시행하여도 일차 술 식 시 오염의 범위가 심하여 다시 재발할 가능성이 높아 초고분자량 폴리에틸렌(ultrahigh molecular weight polyethylene, UHMWPE)과 골수강내 고정물 및 골 시멘트를 조합하여 원위 요골을 재건한 1례를 보고 하고자 한다.

• 대한골관절종양학회지
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• 제13권2호
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• pp.81-87
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• 2007

목적: 연골모세포종은 원발성 골종양의 드문 양성 종양으로 국소 재발이나 원격 전이를 일으키는 것으로 알려져 있다. 본 연구에서는 연골모세포종 30례의 치료 결과를 분석하고 예후에 미치는 인자들을 분석하고자 하였다. 대상 및 방법: 1981년부터 2005년까지 연골모세포종으로 치료 받은 30례의 환자를 후향적으로 분석하였다. 최종적으로 30명이 분석에 포함되었으며 남자가 16명, 여자가 14명이었고 술 후 평균 추시관찰 기간은 평균 7.2년이었다.(범위, 1.6~21.2년) 발생 부위로는 상완골 근위부(6례), 경골 근위부(6례), 대퇴골 원위부(6례)와 대퇴골 근위부(4례)에서 주로 발생하였다. 발생 연령은 평균 20세였으며, 20명(67%)에서는 성장판이 닫힌 이후에 발생하였다. 대부분의 예에서 적극적 소파술(과 골 이식 또는 골 시멘트 주입술) 또는 광범위 en bloc 절제술을 시행하였다. 연골모세포종의 국소 재발율과 재발에 관련이 있는 것으로 알려진 임상적, 병리학적 인자들과 국소 재발과의 관계를 분석하였다. 결과: 국소 재발은 4례(13%)에서 발생하였고 발생 시기는 각각 술 후 4개월, 6개월, 7개월과 16개월이었다. 재발한 4례에서 1회(2례) 또는 2회(2례)의 소파술을 재시행 후 국소 재발은 발생하지 않았고 최종 추시시 모두 무병생존 상태였다. 종양이 불완전하게 제거된 2례에서 모두 재발하였고, 재발한 다른 두 례는 소파술과 골 이식(1례) 또는 골 시멘트 주입술(1례)을 시행한 환자였다. 성장판의 개폐 여부(open physis), 동맥류성 골낭종의 동반 여부와 종양의 발생 부위 등은 국소 재발과 관계가 없는 것으로 관찰되었다. 결론: 연골모세포종의 국소재발을 막기 위해 종양의 완전한 제거를 위한 적극적인 소파술 또는 광범위 절제술이 필요할 것으로 생각된다. 기존에 알려져 있는 성장판의 개폐 여부, 동맥류성 골낭종의 동반 여부와 종양의 발생 부위 등은 재발과 관련 없는 것으로 보인다.

• Journal of Chest Surgery
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• 제29권4호
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• pp.472-476
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• 1996

악성 섬유성 조직구종은 연부조직에 발생한 아주 드문 육종이며, 다각적 인 치료에도 불구하고 조기에 국소적 재발 및 원발성 전이를 일으키는 매우 악성도가 높은 질 환으로특히 흉부외과 영역에서의 보고는 매우 드물다. 최근 전북대학교병원 흉부외과학 교실에서는 좌측 흉벽에서 기 원하여 폐까지 침범된 악성 섬유성 조직구종을 가진 37세 남자환자를 치험 하였다 심하게 유착된 종괴와 제 1,제2, 제3 늑골과 종양이 침범된 좌상엽을 한덩 어 리로 적출하고 결손된 흉벽 에는 marlex mesh를 이용하여 흉벽재건을 시행하였다. 그러나 술후 방사선 및 항암요법에도 불구하고 술후 12개월내에 국소적 재발 및 원발성 전이를 보였다.

• Journal of Korean Neurosurgical Society
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• 제40권2호
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• pp.117-121
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• 2006

The surgical removal of solid deep-seated hemangioblastomas remains challenging, because treatment of these lesions is often complicated by severe bleeding associated with the rich vascularity of this tumor, and by severe neural tissue injury associated with the difficulty of en bloc resection, especially when the tumor is located at the cervicomedullary junction. Therefore, preoperative embolization of deep-seated solid hemangioblastomas may play an important role in successful surgical removal by reducing major bleeding and neural tissue damage. A 24-year-old woman, 28-weeks pregnant, was admitted to our hospital for the evaluation of quadriparesis, and brain magnetic resonance imaging[MRI] revealed intra-axial mass lesion in the cervicomedullary junction. After delivery, her neurologic symptoms became aggravated, and we decided to operate. Preoperative angiography revealed a hypervascular tumor in the posterior fossa, and embolization of the main feeding artery using gelfoam and microcoil, resulted in marked reduction of tumor vascularity. She underwent a midline suboccipital craniotomy involving the removal of the arch of C-1. The tumor was totally removed through a midline myelotomy, and at her 6-month follow-up she walked independently. We report on the combined use of the preoperative embolization of feeding vessels and subsequent operative resection in a patient with a solid hemangioblastoma at the cervicomedullary junction immediately after delivery.

• 대한두경부종양학회지
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• 제30권2호
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• pp.115-118
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• 2014

Papillary thyroid carcinoma is known as its relatively high cure rate after surgical treatment. But invasion of the trachea by thyroid carcinoma is poor prognostic factor and the best management is en bloc surgical resection of the tumor invading the trachea. A 55-year-old man was diagnosed as papillary thyroid cancer with tracheal invasion. We treated the patient by total thyroidectomy with window resection of invading trachea followed by immediate reconstruction with sternohyoid muscle flap and tracheostomy. At 48 days after surgery, tracheostoma was closed and the patient had no functional complication by the surgical process. Until 10 months after surgery, there was no sign of recurrence and the patient led social life without any discomfort. We present this case with a review of the related literatures.

• Clinical Endoscopy
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• 제56권4호
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• pp.423-432
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• 2023

Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.

• Clinical Endoscopy
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• 제56권6호
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• pp.769-777
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• 2023

Background/Aims: Endoscopic submucosal dissection (ESD) for superficial non-ampullary duodenal tumors (SNADETs) is associated with a high rate of en bloc resection. However, the technique for ESD remains challenging. Recent studies have demonstrated the effectiveness of S-O clips in colonic and gastric ESD. We evaluated the efficacy and safety of duodenal ESD using an S-O clip for SNADETs. Methods: Consecutive patients who underwent ESD for SNADETs between January 2011 and December 2021 were retrospectively enrolled. Propensity score matching analysis was used to compare patients who underwent duodenal ESD with the S-O clip (S-O group) and those who underwent conventional ESD (control group). Intraoperative perforation rate was the primary outcome, while procedure time and R0 resection rate were the secondary outcomes. Results: After propensity score matching, 16 pairs were created: 43 and 17 in the S-O and control groups, respectively. The intraoperative perforation rate in the S-O group was significantly lower than that in the control group (p=0.033). A significant difference was observed in the procedure time between the S-O and control groups (39±9 vs. 82±30 minutes, respectively; p=0.003). Conclusions: The S-O clip reduced the intraoperative perforation rate and procedure time, which may be useful and effective in duodenal ESD.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.109-113
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• 2024

Cholangiocarcinoma is a heterogeneous group of aggressive tumors that correspond to the second most common primary liver tumor. They can be classified according to their anatomical position concerning the biliary tree, and each subtype demonstrates different behavior and treatment. A 38-year-old male patient presenting solely right lumbar pain was diagnosed with a 7 cm hepatic tumor involving segments I, Iva, and VIII associated with involvement of the hepatic veins. He underwent a bloc resection of hepatic segments I, II, III, IV, partial V, partial VII, and VIII; right, middle, and left hepatic veins; and inferior vena cava segment, with perfusion of the remaining liver in situ with a preservation solution. As the patient had a large accessory inferior right hepatic vein draining the remaining liver, no reimplantation of hepatic veins was necessary. He remained clinically stable in outpatient follow-up, with excellent performance status-current survival of 2 years 6 months after surgical treatment.