• Title/Summary/Keyword: Early surgery

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Management of Failed Thumb Replantation (Early Soft Tissue Removal with Vascularized Flap Coverage of Amputated Phalangeal Bone) (무지 재접합 실패예에 대한 조기 치료로서 절단부의 수지골과 유리 피판술을 이용한 무지의 재건)

  • Chung, Duke-Whan;Kim, Ki-Bong
    • Archives of Reconstructive Microsurgery
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    • v.10 no.2
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    • pp.86-92
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    • 2001
  • Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

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THE IMPORTANCE OF THE PROPHYLACTIC NECK DISSECTION IN THE EARLY-STAGE TONGUE CANCER (초기설암치료시 예방적 경부곽청술의 의의)

  • Hong, Chang-Soo;Kim, Chin-Soo;Jang, Hyun-Joong;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.73-81
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    • 1995
  • The poor survival rates of patients with carcinoma of a tongue, despite of modern therapy, is well recognized. One of the most important prognostic factors is status of the cervical lymph nodes. There have been a long-standing debate about the treatment of cervical lymph nodes in early-stage tongue cancer. There are two major treatment opinion. The one is surgical excision of primary tumor with prophylactic neck dissection, simultaneously, and the other is to delay the cervical therapy until cervical lymph node is palpable. Recently we have experienced the early cervical metastasis in three patients who had been diagnosed as a carcinoma of the tongue. They were T1, T2 lesion and no palpable node was found. But histopathologic examination showed the occult metastasis or delayed cervical metastasis was occured. By the review of literature and clinical experience, we could conclude the prophylactic neck dissection offers a better chance for success than therapeutic neck dissection of palpable lymph nodes, in case of oral tongue cancer.

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Early and Late Clinical Results of Cardiac Valvular Surgery (심장판막질환의 수술성적)

  • 김형묵
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.247-253
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    • 1981
  • A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

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Historical Perspectives of Korean Society for Thoracic and Cardiovascular Surgery: Inauguration and Activities of the Historical Records Preservation Committee

  • Park, Kook-Yang;Lee, Sungsoo;Chang, Byung-Chul;Oh, Tae Yun
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.191-194
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    • 2019
  • The Korean Society for Thoracic and Cardiovascular Surgery (KTCVS) was founded in 1968 and celebrated the 50th anniversary of its founding in 2018. The launch of the KTCVS may seem somewhat recent, given that the American Association for Thoracic Surgery was founded in 1917. However, considering the circumstances of the Korean medical community after the Japanese occupation (1910-1945), World War II (1940-1945), and the Korean War (1950-1953), this apparent delay is understandable. Even before the foundation of the KTCVS, the early pioneers of thoracic and cardiovascular surgery promptly adopted medical technologies from more advanced countries such as the United States, and contributed significantly to both cardiac and thoracic surgery despite difficult circumstances. In 2012, before the 50th anniversary of the founding of the KTCVS, members shared the opinion that objective records of the activities of the early pioneers should be identified and preserved, and reacted positively towards the necessity for historians who would preserve such records. With this background, the Historical Records Preservation Committee of the KTCVS (hereinafter, referred to as 'the Committee') was launched. The Committee published a white paper on the history of thoracic and cardiovascular surgery in 2015 and held an exhibition of the achievements of the pioneers at the 50th anniversary of the founding of the KTCVS. The Committee also published a book entitled "The history of Korean thoracic surgery with photographs: celebrating the 50th anniversary of the society." The Committee will keep making efforts to find and preserve materials related to activities during the early development of thoracic and cardiovascular surgery in Korea.

Early Diagnosis of Acute Hematogenous Osteomyelitis Using the Ultrasonography in a Child: A Case Report (초음파를 이용한 소아 급성 혈행성 골수염의 조기 진단: 증례보고)

  • Min, Kyoung-Dae;Ahn, Joong-Hyun;Cho, Woo-In;Hwang, Seok-Ha;Cho, Sang-Hyuck;Song, Sang-Hun;Lee, Byung-Ill
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.76-80
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    • 2013
  • It is very important to make an early diagnosis of acute hematogenous osteomyelitis in children to avoid various complications. We report a case of a five-year-old patient with tibial subperiosteal abscess, who was diagnosed using ultrasonography and treated at the early point of the disease.

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Risk Factors for Early Recurrence of HBV-related Hepatocellular Carcinoma Meeting Milan Criteria after Curative Resection

  • Zhu, Wen-Jiang;Huang, Chu-Ying;Li, Chuan;Peng, Wei;Wen, Tian-Fu;Yan, Lv-Nan;Li, Bo;Wang, Wen-Tao;Xu, Ming-Qing;Yang, Jia-Yin;Jiang, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7101-7106
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    • 2013
  • Background: The prognosis of patients with hepatocellular carcinoma (HCC) after curative resection varies greatly. Few studies had investigated the risk factors for early recurrence (recurrence-free time ${\leq}$ 1 year) of hepatitis B virus (HBV)-related HCCs meeting Milan criteria. Methods: A retrospective analysis was performed on the 224 patients with HCC meeting Milan criteria who underwent curative liver resection in our center between February 2007 and March 2012. The overall survival (OS) rate, recurrence-free survival (RFS) rate and risk factors for early recurrence were analyzed. Results: After a median follow-up of 33.3 months, HCC reoccurred in 105 of 224 patients and 32 died during the period. The 1-, 3- and 5-year OS rates were 97.3%, 81.6% and 75.6% respectively, and the 1-, 3- and 5-year RFS rates were 73.2%, 53.7% and 41.6%. Cox regression showed alpha-fetoprotein (AFP) > 800 ng/ml (HR 2.538, 95% CI 1.464-4.401, P=0.001), multiple tumors (HR 2.286, 95% CI 1.123-4.246, P=0.009) and microvascular invasion (HR 2.518, 95% CI 1.475-4.298, P=0.001) to be associated with early recurrence (recurrence-free time ${\leq}$ 1-year) of HCC meeting Milan criteria. Conclusions: AFP > 800 ng/ml, multiple tumors and microvascular invasion are independent risk factors affecting early postoperative recurrence of HCC. In addition resection appears capable of replacing liver transplantation in some situations with safety and a better outcome.

Facial Nerve Palsy after Bilateral Sagittal Split Ramus Osteotomy: Case Report (양측 하악지 시상골 절단술 후 발생한 안면 신경 마비의 증례)

  • Jin, Soo-Young;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong;Oh, Ji-Su;Jeong, Kyung-In;Jeon, Woo-Jin;Yun, Dae-Woong;Yang, Seok-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.276-280
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    • 2011
  • BSSRO (bilateral sagittal split ramus osteotomy) is an effective surgical method for maxillofacial deformities. Rigid fixation using a plate and screws can stabilize bony segments and induce early mouth opening. Though this procedure has a low complication rate, normal function and esthetic recovery is achieved through proper and early management of the complications. Complications consisting of temporomandibular disorders, sensory disturbances due to inferior alveolar nerve damage, open bite, malunion or nonunion, and facial nerve palsy occur, but these rarely develop. Facial nerve palsy causes the muscles involved in facial expression to depress, which results in ocular dryness or retinal damage. When facial nerve palsy develops, early management involving steroid medication and physical therapy is effective. In the case of severe damage, surgical intervention should be considered. A 20-year-male patient came to the oral and maxillofacial surgery department for orthognathic surgery. The mandible was set back by BSSRO under general anesthesia. Facial nerve palsy was observed on the left side of the face: steroid and vitamins were administered early and physical therapy was performed daily. These forms of management can aid in function and allow for gradual esthetic recovery. Presumed causes were excessive soft tissue retraction or soft tissue injury by the osteotome at the horizontal osteotomy of the ramus. Careful dissection, retraction and a precise osteotomy are needed for protection of the facial nerve. If nerve damage is observed, early management can help in the recovery of facial nerve function and esthetics.

Function-Preserving Surgery in Gastric Cancer

  • Bueno, Jan Andrew D.;Park, Young-Suk;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.141-147
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    • 2018
  • The rising incidence of early gastric cancer has enabled the development of function-preserving gastrectomy with the focus on post gastrectomy quality of life and adherence to sound oncologic principles. It is concurrent with the growing popularity of minimally invasive surgery; and both are commonly used together. The different kinds of function-preserving gastrectomy included in this review are: pylorus-preserving and proximal gastrectomy, vagus nerve preservation, sentinel node navigation, and various endoscopic & minimally-invasive techniques. In this article the indications, techniques, oncologic safety, functional benefit, and outcomes of each kind of function-preserving gastrectomy are discussed.