• Title/Summary/Keyword: Interposition

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Reconstruction of a Severely Crushed Leg with Interpositional Vessel Grafts and Latissimus Dorsi Flap

  • Park, Chan Woo;Kim, Youn Hwan;Hwang, Kyu Tae;Kim, Jeong Tae
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.417-421
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    • 2012
  • We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

Clinical experience of arteriovenous fistula and associated operations for hemodialysis in 290 patients (혈액투석을 위한 동정맥루 조성술 및 그 관련술 290례에 대한 임상적 고찰)

  • 윤영철
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.761-768
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    • 1993
  • Angioaccess has become increasingly important to vascular surgeons as more patients with end stage renal disease[ESRD] are being supported by hemodialysis. Because of the rapid increase in the number of patients undergoing hemodialysis in recent years, it has become necessary to develope alternative vascular access procedures. During the period from December 1986 to December 1992, 290 cases of arteriovenous fistula and associated operations for hemodialysis were performed at Department of Thoracic & Cardiovascular Surgery, Seoul Paik Hospital, Inje University. They Consisited of 175 male and 115 female, ranging in age from 8 and 79 years. The procedure of first choice, the Brescia`s original radial artery-cephalic vein arteriovenous fistula was performed upon 219 patients. In many patients, the radial artery-cephalic vein fistula cannot be performed because of inadequate vein or failure of previous radial artery-cephalic vein fistula. The waiting time until initiation of venous puncture for the first hemodialysis session was 3 days. The second choice of angioaccess, using the brachiocephalic arteriovenous fistula and brachiobasilic arteriovenous fistula at antecubital fossa, ulnobasilic arteriovenous fistula, femorosaphenous arteriovenous fistula, and radiobasilic arteriovenous fistula with saphenous in situ routes, was obtained in 17, 7, 4, 2 and 1 patients. Interposition grafts, the third choice of angioaccess, were performed upon 2 patients. Twenty seven patients underwent revisions or thrombectomies. The purpose of this report is to review the technique of this procedure and discuss the longterm results.

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The Result of Reconstruction of the Lower Esophagus With Jejunum for Carcinoma of the Lower Esophagus and the Cardia (공장을 대용식도로 이용한 하부식도암의 수술성적)

  • 김근호
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.195-201
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    • 1981
  • The results of reconstruction of the lower esophagus with jejunum in a total of 24 cases of primary carcinoma of the lower third esophagus and gastroesophageal carcinoma were presented, and clinical values of substitution for the esophagus with jejunum were also discussed. They were operated in the department of thoracic and cardiovascular surgery, Hanyang University Hospital during the period of 9 years from 1972 to 1981. Surgical managements to lower esophageal reconstruction with jejunum were carded out with not the same procedure in all cases studied, but with three different procedure mentioned below/ In 13 cases of lower third esophagectomy with or without partial `8astrectomy of a total of 24 cases, interposition of jejunum between the esophagus and the stomach were performed after the fashion to esophagojejunostomy with mobilized jejunal loops and 8astro-JeJunostomy with side to side anastomosis. In 7 cases of lower third esophagectomy and total gastrectomy, the continuity of the esophagus were performed the fashion to esophagojejunostomy with mobilized jejunum. In 4 cases of unresectable gastro-esophageal carcinoma, bypass operation of the lower esophagus and the stomach were performed after the fashion to esophagojejunostomy with side to and anastomosis. After the bypass operation, it was observed that oral feeding to the patients was excellent. Following these consecutive series of 20 cases of radical operation for lower esophageal carcinomas and 4 cases of bypass operation for unresectable gastroesophageal carcinomas, no complication such as postoperative leakage and stenosis from anastomotic site or Infection In operating area and operative death were observed.

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Clinical Analysis of Pediatric Thoracic Surgery: Non-Cardiovascular Disease (소아 흉부질환에 대한 임상적 고찰 [비심장혈관계 질환])

  • 안욱수
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.202-209
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    • 1981
  • The results of reconstruction of the lower esophagus with jejunum in a total of 24 cases of primary carcinoma of the lower third esophagus and gastroesophageal carcinoma were presented, and clinical values of substitution for the esophagus with jejunum were also discussed. They were operated in the department of thoracic and cardiovascular surgery, Hanyang University Hospital during the period of 9 years from 1972 to 1981. Surgical managements to lower esophageal reconstruction with jejunum were carded out with not the same procedure in all cases studied, but with three different procedure mentioned below/ In 13 cases of lower third esophagectomy with or without partial `8astrectomy of a total of 24 cases, interposition of jejunum between the esophagus and the stomach were performed after the fashion to esophagojejunostomy with mobilized jejunal loops and 8astro-JeJunostomy with side to side anastomosis. In 7 cases of lower third esophagectomy and total gastrectomy, the continuity of the esophagus were performed the fashion to esophagojejunostomy with mobilized jejunum. In 4 cases of unresectable gastro-esophageal carcinoma, bypass operation of the lower esophagus and the stomach were performed after the fashion to esophagojejunostomy with side to and anastomosis. After the bypass operation, it was observed that oral feeding to the patients was excellent. Following these consecutive series of 20 cases of radical operation for lower esophageal carcinomas and 4 cases of bypass operation for unresectable gastroesophageal carcinomas, no complication such as postoperative leakage and stenosis from anastomotic site or Infection In operating area and operative death were observed.

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A clinical study of peripheral vascular surgery using prosthetic or autogenous vein grafts -34 cases- (인조혈관 및 자가혈관을 이용한 말초혈관 수술 34예에 대한 임상적 고찰)

  • 이정렬
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.412-420
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    • 1986
  • From 1968 through September 1986, the authors have experienced 34 cases of peripheral arterial surgery using various vascular grafts. Almost all patients [32] were men, and age distribution was variable according to the disease entities. There were twenty eight cases of chronic occlusive peripheral vascular disease including ASO [21], Buerger`s disease [6], Aortoenteric fistula complicating infrarenal abdominal aortic aneurysm [1], four cases of vascular trauma, one case of acute arterial embolism [1] and one case of unknown etiology. The indications of operations for chronic vascular disease was intermittent claudication in 48%, rest pain in 45%, ischemic pregangrene or gangrene in 28%, and sensory change in 10% of patients. Types of operation used were arterial bypass in 28 cases [Aortobifemoral in 5, Aortoiliac in 3, Aortofemoral in 4, Aortoiliac with Aortofemoral in 1, Femorofemoral in 1, Femoropopliteal in 8, Femoroperoneal in 2, Axillofemoral in 3 cases of patients], graft interposition in four and patch angioplasty in three cases. Thirty four prosthetic vascular grafts including Dacron, Gore-Tex, Nylon and two autogenous saphenous vein graft and patch were used for vascular reconstruction in thirty four patients. Unfortunately recently performed one vein bypass was failed immediate postoperatively due to severity of disease and poor case selection. The authors experienced five post operative complications: wound infection [1], graft infection [1], bleeding [1], great saphenous neuralgia [1], pseudoaneurysm [1]. Twenty two of thirty four patients were followed up for more than one month and their cumulative patency rate was 81% [17/22] at 1 month and, 31% [7/22] at 5 month.

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Efficiency Analysis of Buffer Layer Using UF on the Electrical Characteristics of OLED (불화리튬 버퍼층에 의한 유기 발광 소자의 전기적인 특성 및 효율 분석)

  • Bae, Sang-Ho;Park, Hyung-Jun;Nam, Eun-Kyoung;Jung, Dong-Geun;Yi, Jun-Sin
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2007.11a
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    • pp.422-423
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    • 2007
  • In this work, Organic Light Emitting Diodes using LiF as a electron-injecting interfacial have been fabricated for efficiency enhancements. This interfacial layer is interposed between Al/$Alq_3$ layer. The brightness and specific character as current density are higher than those of the device without it. To find best thickness of LiF layer, we used some samples with various thickness. The LiF interposition at the Al/$Alq_3$ interface encouraged the electrons injection and balances the injection numbers of hole and electron in the emission layer.

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Bronchoesophageal Fistula Complicated by Broncholithiasis in a Patient with Silicosis - 1 case - (규폐증 환자에서 기관지 결석증으로 인한 기관지식도루 -1예 보고-)

  • Hwang You-Ju;Jeon Yang-Bin;Park Chul-Hyun;Park Kook-Yang;Lee Jae-Ik
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.450-453
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    • 2005
  • Broncholithiasis is uncommon in patients with silicosis. Bronchoesophageal fistula complicated by broncholithiasis is especially rare and only one case has been reported in Korea. Surgical treatment of broncholithiasis should be as conservative as possible to preserve the adequate pulmonary function. Meticulous dissection and division of the fistula with the interposition of viable tissues will prevent recurrence, We report a rare case of bronchoesophageal fistula complicated by broncholithiasis in a patient with silicosis.

Surgical Treatment of Achalasia of the Esophagus -Report of 9 Cases Performed Modified Heller Operation- (Achalasia 의 외과적 치료 -Modified Heller Operation을 시행한 9례의 관찰성적-)

  • 이호일
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.53-60
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    • 1968
  • Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

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Aorto-Esophageal Fistula Complicated by Esophageal Metalic Stent -A case report- (식도 내 금속 스텐트 삽입 후 발생한 대동맥 식도 누공 -치험 1례-)

  • 윤영철;조광현;김기봉;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.479-482
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    • 2002
  • Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

An Isolated True Aneurysm of the Superficial Femoral Artery in a Young Woman - A case report -

  • Lee, Seok-Kee;Kang, Shin-Kwang;Oh, Hyun-Kong;Kang, Min-Woong;Yu, Jae-Hyeon;Na, Myung-Hoon;Lim, Seung-Pyung
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.361-363
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    • 2011
  • A 39-year-old woman was admitted to the hospital due to a pulsatile mass on her right inner thigh that was evident for two months. She did not exhibit any risk factors of atherosclerosis, no evidence of vasculitis, or any signs of previous trauma history. Ultrasound and computed tomography revealed an adult fist-sized aneurysm on the distal superficial femoral artery. The aneurysm was resected and peripheral circulation was restored with the interposition of a saphenous vein graft. The resected aneurysm had three layers that showed atherosclerosis on histological examination.