• Title/Summary/Keyword: End to side anastomosis

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Congenital Esophageal Atresia with Tracheoesophageal Fistula -A Case Report- (선천성 식도폐쇄 및 기관식도루 -1례 보고-)

  • Lee, Mun-Geum;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.489-493
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    • 1994
  • Our patient was a 2.3 kg, male of 33 weeks gestation and spontaneous vaginal delivery. Copious salivary secretion, mild aspiration pneumonia episode due to tracheoesophageal fistula and intermittent cyanotic appearance due to hypoxia were noted shortly after birth. Head up position, frequent upper pouch suction, and adequate fluid and antibiotic therapy were done in incubator. Combined Chest and abdominal film was revealed gas in the stomach and an haziness in right chest with mediastinal shift to the right side. Esophagogram revealed markedly dilated proximal esophagus as blind pouch, and Two dimensional echocardiography showed the Ventricular Septal Defect. The conclusion was congenital esophageal atresia with tracheoesophageal fistula, Vogt-Gross type C, Waterston Risk Category B. Surgical correction with Beardmore anastomosis was performed extrapleurally through 3rd rib bed after the cannulation of umbilical vein and preliminary gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought down to the presenting surface of the lower esophageal segment that incised, and end to side anastomosis was underwent using interrupt suture placed through the full thickness of both upper pouch and lower esophageal segment. The postoperative patient was well tolerated and recovered uneventfully, permitted feeding on 7th postoperative day after esophagogram.

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Subclavian Artery Aneurysm; Report of a Case (쇄골하동맥에 발생한 동맥류 수술치험 1례)

  • 김형국
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.557-559
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    • 1993
  • We report a case of 62-year-old female who had an aneurysm of the right subclavian artery developed due to atherosclerosis. The preoperative diagnosis was made by chest computed tomography and arteriography. After resection of a 10x10x7cm-diametered and round aneurysm, end to side anastomosis of the right subclavian artery to the right carotid artery was done. She is well for 2 years after surgery.

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Bypass for Esophageal Stenosis due to Gastro-esophageal Carcinoma:A Report of 4 Cases (절제불능한 위식도암에 대한 Bypass 수술 4례)

  • Jung, Young-Whan;Kim, Kun-Ho
    • Journal of Chest Surgery
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    • v.4 no.1
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    • pp.35-42
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    • 1971
  • This is a report on four cases of bypass for esophageal stricture due to gastro-esophageal carcinoma in the Department of Thoracic Surgery, Chonnam University Hospital. Bypass was performed intrathoracal esophago-jejunostomy by a segment of jejunum. Three patients received end to end anastomosis and the other one side to end esophagojejunostomy. Postoperative results were as follow; There was no swallowing disturbance with regular diet and the patients appear to be more comfortable by bypass than gastrostomy or jejunostomy. Postoperative condition of all the patients was satisfactory because other organs were intact. However, two patients expired in 12 months and 6 months after operation by wide metastasis and the other 2 cases are living now with regular diet in 4 months and 2 months after operation.

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The Free Vascularized Groin Flap for the Reconstruction of Extremity (사지재건을 위한 서혜부 유리피부편 이식술)

  • Hahn, Soo-Bong;Park, Young-Hee;Kang, Ho-Jung
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.1-9
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    • 1998
  • From January 1985 to February 1997, 96 patients had undergone the free vascularized groin flap on the upper and lower extremities with microsurgical technique at the department of orthopaedic surgery, Yonsei University College of Medicine. The results were as follows: 1. Average age at the time of operation was 24.9 years. and there were 71 men and 25 women and mean follow up was 62.4 months. 2. The lesion site was 82 cases on the lower extremity: foot(40), leg(20), ankle(13), and 14 cases on the upper extremity: forearm(6), elbow(3), hand(3), wrist(2). 3. The anatomical classification of the superficial circumflex iliac artery was as follows: 1) 39.8% of common origin with superficial inferior epigastric artery, 2) 30.1% of isolated origin and absent superficial inferior epigastric artery, 3) 13.3% of separate origin, 4) 16.9% of origin from the deep femoral artery. 4. There was no statistical significance on arterial anastomosis between end to end and end to side, and on venous anastomosis(end to end) between one vein and two veins. 5. The success rate was average 84.4% in 81 of 96 cases. 6. In the 15 failed cases, the additional procedures were performed: 5 cases of free vascularized scapular flap, 6 cases of full thickness skin graft, 2 cases of cross leg flap, 1 case of latissimus dorsi flap, 1 case of split thickness skin graft. In conclusion, the free vascularized groin flap can be considered as the treatment of choice for the reconstruction of the extensive soft tissue injury on the extremities, and show the higher success rate with the experienced surgeon.

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An Experimental Study on the Heterotopic Canine Heart Transplantation: Pathologic Observation (동종 심장이식의 병리조직학적 연구)

  • 손광현;서경필;이영균
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.155-166
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    • 1969
  • Heterotopic abdominal homograft of canine heart was carried out in 20 pairs of dogs. Of these 12 cases were subjected as a control and 8 were subjected to immunosuppressive group. The dosage of immunosuppressive agent was 5mg/kg/day of Imuran [Azathioprine] for 3 days preoperatively, 10mg/kg on operative day and 5mg/kg/day postoperatively. For reducing the metabolic demand, the donor heart was preserved in 4degree heparinized saline solution for approximately I4 minutes. In the most of the cases, transplantation was performed with the technique of end-to-side aorto-aortic anastomosis and end-to-side pulmonary artery-inferior vena cava anastomosis at the infrarenal portion. Five out of 20 grafted dogs were survived more than one day. The longest survived 18 days in the control group and survive more than 60 days in the treated group. The survival cases were 3 out of 8[37. 5%] in the group of dogs treated with lmuran and 2`out of 12 [16.6%] in the group of non-treated. A prominent gross findings of the grafted heart was a minimal to moderate degree of dilatation of the heart with or without thrombosis in the cardiac chambers and/or anastomotic site. The case number 10, 15, and 19 showed moderate hypertrophy in grossly. The microscopic findings were as follows; 1. There were early hypersensitive histologic reactions such as interstitial edema, cellular infiltrations and early degenerative changes in the myocardium in the cases of 3 hour survival. 2. In the cases of more than 6 hours survival, organizing thrombosis of myocardial vessels, vasculitis,myocardial necrosis and lymphocyte, plasma cell, round cell infiltrations were noted. In the cases of more than 12 hours survival, the degree of these histologic changes especially in the non-treated group were more intensified than in the treated. 3. In the cases which survived more than one day, so called homograft specific histologic changes were milder in the immunosuppressive group compared with the control. 4. All the host hearts showed no evidence of pathologic findings histologically. Among the homologous canine cardiac transplantation tissue reaction, was milder and suvival time longer in the group treated with immunosuppressive drug.

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Vessel Remodeling after Intima-to-Intima Contact Anastomosis

  • Yeo, Hyeonjung;Kim, Hyodong;Son, Daegu;Hong, Changbae;Kwon, Sun Young
    • Archives of Plastic Surgery
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    • v.44 no.2
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    • pp.95-100
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    • 2017
  • Background Intima-to-intima microanastomotic vascular remodeling was explored, utilizing a polylactide-caprolactone absorbable vein coupler model (PAVCM), which was designed to simulate a non-absorbable counterpart system with the sole exception of being absorbable. Methods Six New Zealand white rabbits were used. After transection of the jugular vein, 2 PAVCMs were placed, 1 at each transected end. The stumps were slipped through the PAVCMs, and the venous wall was everted $90^{\circ}$ to achieve intima-to-intima contact. Reanastomosis of the transected jugular vein was performed bilaterally in 3 rabbits. In the other 3 rabbits, the jugular vein (20 mm) harvested from one side was interpositionally grafted to the jugular vein on the opposite side to ease the anastomotic tension. Patency testing, ultrasonography, and histologic assessments were conducted postoperatively at weeks 2, 4, 12, 16, 22, and 26. Results All anastomotic sites were patent, without stenosis, occlusion, or dilatation. In the histologic sections, immature endothelial regeneration was observed at week 2, which was completed by week 4. Regeneration of the tunica media was noted at week 12. Between week 22 and week 26, the tunica media fully regenerated and the coupler dissipated entirely. Conclusions Despite the absence of a coupler to act as an anastomotic buttress, the structure and function of all the vessels appeared normal, even histologically. These outcomes are true milestones in the development of an absorbable vein coupler.

Surgical Treatment of Abdominal Aortic Aneurysm (복부 대동맥류의 외과적 치료)

  • 김동원
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.31-36
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    • 1995
  • Between January 1984 to June 1994, fourteen patients from 37 to 80 years of age [mean 66.42 11.71 years of age have undergone surgical treatment of abdominal aortic aneurysm in Kyung Hee Univ. Hospital. There were 11 males and 3 female patients. All but one were infra-renal type. The etiology of the aneurysm consisted of twelve atherosclerotic, one inflammatory and one traumatic abdominal aortic aneurysm.Two patients were operated on for ruptured abdominal aortic aneurysm. We performed dacron graft interposition in all patients and one patient was also performed aorto-renal end to side anastomosis. Two patients died of postoperative complications which was a pulmonary insufficiency in one, acute renal failure in another patient.Remaining twelve patients were discharged with good condition and followed up from 2 months to 87 months.[mean $34.58{\pm}29.79$ months.

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Surgical Treatment of Pulmonary Atresia with VSD - A Report of 2 Cases - (심실중격결손증을 동반한 폐동맥 폐쇄증 [Pulmonary Atresia] 의 외과적 치료-2예 보고-)

  • 강면식
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.780-785
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    • 1987
  • Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

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Congenital Esophageal Atresia with Tracheoesophageal Fistula - A Case Report - (선천성 식도폐쇄 및 간식도루 1례 보)

  • 손동섭
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.565-569
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    • 1987
  • The first description of the pathologic anatomy of esophageal atresia was presented by Duration in 1670, it was not successfully treated until 1939 when the first two survivors of staged correction were described by Ladd and Levin. In 1941 Haight and Towsley performed the first successful primary repair. Recently we were experienced a case of esophageal atresia with tracheoesophageal fistula an infant patient who presented the symptoms of vomiting and dyspnea. The diagnosis was made by the esophagography with Diagnosis. The operation was performed extrapleurally through 4th intercostal space after gastrostomy. The fistula was closed by triple ligation and the upper pouch was then brought into apposition with the presenting surface of the lower esophageal segment and an end to side anastomosis was fashioned with a single layer of sutures. Operative patient tolerated all the operative procedure well in spite of postoperative respiratory complication and recovered uneventfully, permitted feeding on 9th postoperative day after esophagography.

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