• 한국간담췌외과학회지
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• 제27권4호
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• pp.366-371
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• 2023

Backgrounds/Aims: Biliary surgery in patients with extrahepatic portal vein obstruction with portal cavernoma (PC) is technically challenging, and associated with the risk of bleeding. Therefore, prior portal vein decompression is usually recommended before definitive biliary surgery. Only a few studies have so far reported the safety of isolated laparoscopic cholecystectomy. We aimed to evaluate our experience of laparoscopic cholecystectomy in patients with PC without prior portal decompression. Methods: Prospectively maintained data for patients with PC who underwent laparoscopic cholecystectomy for symptomatic gallstone disease without portal decompression were analyzed. Clinical features, imaging, intraoperative factors, conversion rate, complications of surgery, and long-term outcomes were assessed. Results: Sixteen patients underwent cholecystectomy without portal decompression from 2012 to 2021, of which interventions 14 were laparoscopic cholecystectomies. One patient required conversion (7.1%) to open surgery. Jaundice was present in 5 patients (35.7%), and underwent endoscopic stone clearance before surgery. Median intraoperative blood loss, operative time, and hospital stay were 100 mL (20-400 mL), 105 min (60-220 min), and 2 days (1-7 days), respectively. Blood transfusion was required in two patients (14.2%). Prior endoscopic or percutaneous intervention was associated with significant blood loss and prolonged intraoperative time. Conclusions: In centers with experience, prior portal decompression can be avoided in patients with PC requiring isolated cholecystectomy to treat gallstones or their complications. Laparoscopic surgery is safe and feasible for these patients, and gives excellent outcomes in the selected group.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.479-485
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• 2001

Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

• Clinics in Shoulder and Elbow
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• 제3권1호
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• pp.54-60
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• 2000

As a surgical treatment of ulnar nerve entrapment syndrome includes simple decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve into a subcutaneous or submuscular bed have been widely used. Despite many reports of these surgical procedure, there is little to guide the choice of one surgical technique. The purpose of our study is to analyse clinical and electrodiagnostic result after minimal invasive decompression by decompression and medial epicondyloplasty(deepening of ulnar groove). We have experienced 9 cases of ulnar nerve entrapment syndrome who were treated with decompression and medial epicondyloplasty. Male were five and female were four. The mean age at operation was 36 years ranging from 23 to 47 years. Operative procedure was to incise the medial intermuscular septum and aponeurotic arch of flexor carpiulnaris and to deepen the ulnar groove. Patients are allowed to do range of motion(ROM) exercise on the average 5days. All patient were relieved pain and improved motor and sensory function, and this procedure allows early ROM exercise after operation because the muscle have not been detached.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.6-11
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• 2023

Spinal cord injury (SCI) has a significant negative effect on the quality of life due to permanent neurologic damage and economic burden by continuous treatment and rehabilitation. However, determining the correct approach to ensure optimal clinical outcomes can be challenging and remains highly controversial. In particular, with the introduction of the concept of early decompression in brain pathology, the discussion of the timing of decompression in SCI has emerged. In addition to that, the concept of "time is spine" has been added recently, and the mortality and complications caused by SCI have been reduced by providing timely and professional treatment to patients. However, there are many difficulties in establishing international clinical guidelines for the timing of early decompression in SCI because policies for each country and medical institution differ according to the circumstances of medical infrastructure and economic conditions in the surgical treatment of SCI. Therefore, we aim to provide a current review of timing of early decompression in patient with SCI.

• 한국임상수의학회지
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• 제22권4호
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• pp.297-301
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• 2005

개에 실험적으로 후구마비를 유발한 후 감압술과 전침술을 병행 처치하였을 때 그 임상적 효과를 알아보고자 본 실험을 실시하였다. 3.15.0kg, 12년령의 신경계 질환이 없는 임상적으로 건강한 10두의 수캐를 각 5두씩 감압술 및 전침술 병용군 (A군)과 감압술 단독군 (B군)으로 편성하여 각 군의 실험견에 약 $40\%$의 척수압박을 하여 심부통각 지각이 있는 후구마비를 유발하였다. 후구마비 유발 48시간 후, 두 군 모두에 편측추궁절제술을 실시하고 압박물을 제거하였고, 감압술 및 전침술 병용군은 감압 이틀 후부터 회복시점까지 2일에 1회씩 전침 치료를 하였다. 실험기간 중, 매일 Talrov's grading system 변법을 사용하여 임상적 평가를 하였다. 실험전과 치료종료 시점의 체성감각유발전위(SEPs)를 측정하여 측정된 유발전위를 신경전도 속도로 환산하여 신경기능을 확인하였다. 감압술 및 전침술 병용군에서는 술후 보행능력 회복까지 $10.0\pm2.7$일이 걸렸으며, 완전회복까지는 $17.2\pm3.9$일이 소요되어 보행능력 회복에서 완전회복까지 $7.2\pm1.8$일의 재활기간이 필요하다. 한편 감압술 단독 적용군은 술 후 보행능력 회복까지 $13.4\pm3.7$일이 걸렸으며, 완전회복까지는 $34.2\pm14.5$일이 소요되어 보행능력 회복에서 완전회복까지 $20.8\pm11.8$일의 재활기간이 필요했다. 완전회복 후의 SEPs의 전도속도는 실험전의 정상범위로 회복된 양상을 보였다. 감압술 적용 후, 보행능력 획득까지의 기간은 두 군간에 유의적인 차가 없었으나, 완전회복 및 재활기간에 있어서는 감앗술과 전침 병용군이 더 짧은 치료기간을 보였다. 이상의 결과로 보아 개에서 추간판 탈출증에 의한 후구마비가 있는 경우, 감압술과 전침 치료를 병행하면 기능회복 기간을 단축시킬 수 있을 건으로 판단된다.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.206-210
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• 2014

Objective : Lumbar spinal stenosis is a common degenerative spine disease that requires surgical intervention. Currently, there is interest in minimally invasive surgery and various technical modifications of decompressive lumbar laminectomy without fusion. The purpose of this study was to present the author's surgical technique and results for decompression of spinal stenosis. Methods : The author performed surgery in 57 patients with lumbar spinal stenosis between 2006 and 2010. Data were gathered retrospectively via outpatient interviews and telephone questionnaires. The operation used in this study was named central decompressive laminoplasty (CDL), which allows thorough decompression of the lumbar spinal canal and proximal two foraminal nerve roots by undercutting the lamina and facet joint. Kyphotic prone positioning on elevated curvature of the frame or occasional use of an interlaminar spreader enables sufficient interlaminar working space. Pain was measured with a visual analogue scale (VAS). Surgical outcome was analyzed with the Oswestry Disability Index (ODI). Data were analyzed preoperatively and six months postoperatively. Results : The interlaminar window provided by this technique allowed for unhindered access to the central canal, lateral recess, and upper/lower foraminal zone, with near-total sparing of the facet joint. The VAS scores and ODI were significantly improved at six-month follow-up compared to preoperative levels (p<0.001, respectively). Excellent pain relief (>75% of initial VAS score) of back/buttock and leg was observed in 75.0% and 76.2% of patients, respectively. Conclusion : CDL is easily applied, allows good field visualization and decompression, maintains stability by sparing ligament and bony structures, and shows excellent early surgical results.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.19-25
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• 2013

Objective : We compared the results of two surgical techniques by retrospective study of 60 elderly patients (65 years or older) who underwent either decompression alone or fusion for the treatment of two-level or more lumbar spinal stenosis. Methods : During the period of 2003 and 2008, two-level or more decompression alone or fusion was performed for lumbar spinal stenosis by three surgeons at our institution. Patients were allocated to two groups by surgical modality, namely, to a decompression group (31 patients) or a fusion group (29 patients). Overall mean age was 71.1 years (range, 65-84) and mean follow-up was 5.5 years (range, 3-9). A retrospective review of clinical, radiological, and surgical data was conducted. Results : No significant difference between the two groups was found with respect to age, follow-up period, surgical levels, or preoperative condition. At the last follow-up, correction of lumbar lordotic angle (determined radiologically) was better in the fusion group. However, clinical outcomes including visual analogue scale, Oswestry Disability Index, and the Odom's criteria were not significantly different in the two groups. On the other hand, surgical outcomes, such as, operation time, estimated blood loss, and surgical complications were significantly better in the decompression alone group. Conclusion : Our findings suggest that decompressive laminectomy alone achieves good outcomes in patients with two-level or more lumbar spinal stenosis, associated with an advanced age, poor general condition, or osteoporosis.

• 척추신경추나의학회지
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• 제2권2호
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• pp.41-48
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• 2007

Objectives : These studies are designed to make a survey of the effectiveness of the non surgical decompression treatment. Methods : These studies 15 cases of L-spine herniated lumbar intervertebral disc(HIVD) which was treated with non surgical spinal decompression and other medicine treatment(acupuncture, cupping, interferential current therapy, ultra-sound therapy and hot poultice). Each patient has been treated with spine decompression and other medicine treatment. And degree of improvement has been evaluated by Visual Analogue Scale and the Roland-Morris Disability Questionnaire score for low back pain. Results and Conclusions : Through the results, the medical treatment proved to have valid effect for L-spine HIDV. And further clinical studies comparing non surgical spinal decompression treatment and other medicine treatment is necessary.

• 한방재활의학과학회지
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• 제21권4호
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• pp.131-143
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• 2011

Objectives: The purpose of this study is to make a survey of the effectiveness of the non surgical spinal decompression treatment in patients with cervical disc herniation documented on magnetic resonance imaging(MRI). Methods: We studied about 27 cases of cervical disc herniation which were treated with non surgical spinal decompression and other medical treatment (acupuncture, interferential current therapy and ice poultice). Each patient has been treated with spine decompression and other medical treatment. And degree of improvement has been evaluated by short form-McGill pain questionnaire(SF-MPQ), visual analogue scale(VAS) and neck disability index(NDI) before treatment and 5th, 10th times after treatments. Results: 1. The VAS SF-MPQ and NDI scores showed statistically significant improvement after 5th and 10th treatment. 2. The VAS, SF-MPQ and NDI scores after 5th treatment showed better improvement than those of after 10th treatment. 3. The VAS, SF-MPQ and NDI scores in Subacute stage showed more statistically significant improvement among the other stages. Conclusions: As a result, non surgical spinal decompression treatment has clinical effects of pain reduction on patient with cervical disc herniation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권5호
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• pp.242-247
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• 2018

Ameloblastoma treatment varies based on the clinical, histopathologic, and radiographic characteristics. Aggressive surgical treatments, such as marginal or segmental resection, have traditionally been implemented, but some conservative surgical methods are also being introduced, including decompression, enucleation, or curettage. The aim of the present study was to evaluate the possibility of applying these conservative surgical treatments to ameloblastoma and to analyze the prognosis of the procedures and their healing aspects. Among all patients who visited our clinic (Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) from 2009 to 2017, three who had undergone conservative surgery were recruited. One of these three patients underwent both excision of the lesion and an iliac bone graft during the same procedure. In the other two patients, due to the size of the lesion, decompression was performed to reduce the size of the lesion, and then conservative surgical treatments followed. As shown in the cases of this study, patients were only treated with conservative surgical methods, such as decompression or enucleation. During the follow-up period, there were no recurrences. In conclusion, the use of conservative surgical treatment in ameloblastoma can be a reliable, safe, and successful method.