• 제목/요약/키워드: Invasive surgical treatment

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혈액종양 질환 환자에서 발생한 침습성 폐 국균증의 수술적 치료 - 2예 보고 - (Surgical Management of Invasive Pulmonary Aspergillosis in Hemtologic Malignancy Patients - Report of 2 cases -)

  • 범민선;송상윤;김병표;박정민;이교선;나국주
    • Journal of Chest Surgery
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    • 제40권1호
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    • pp.69-73
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    • 2007
  • 혈액종양 질환 환자에서 항암요법에 의한 골수기능 저하상태에서 발생할 수 있는 침습성 폐 국균증은 항진균제의 사용에도 불구하고 사망률이 높다. 적절한 항진균제의 사용과 함께 수술적 절제가 침습성 폐 국균증의 사망률을 낮출 수 있다고 보고되고 있다. 최근 저자들은 급성 림프구성 백혈병으로 진단된 환아 2명에서 침습성 폐 국균증을 효과적인 항진균제와 함께 수술적 절제를 통해 치료하여 좋은 결과를 치험하였다. 이에 문헌고찰과 함께 보고하는 바이다.

누두흉과 선천성 낭종성 선종양 기형의 최소 침습적인 동시수술 -1예 보고- (Minimally Invasive Simultaneous Treatment for Congenital Cystic Adenomatoid Malformation associated with Pectus Excavatum - A case report -)

  • 조덕곤;조민섭;김경수;왕영필;조규도
    • Journal of Chest Surgery
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    • 제39권2호
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    • pp.171-175
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    • 2006
  • 최소 침습성 흉부수술은 최근에 가장 발전되어온 중요한 수술의 한 분야이다. 선천성 낭종성 선종양 기형은 비교적 드물게 발생하는 폐질환으로 누두흉, 선천성 심장 및 폐혈관 질환 같은 여러 가지 선천성 기형 등이 동반될 수 있다. 저자들은 우하엽 폐에 선천성 낭종성 선종양 기형이 있으며 누두흉이 동반된 5세 된 남아 환자를 최소 침습적인 방법으로 치료 경험하였다. 저자들은 흉강경을 이용하여 우하엽 폐절제술을 실시하였고, 동시에 누두흉에 대해서는 흉골 하 금속막대를 이용한 너스 술식으로 교정하였다. 이와 같이 이러한 질환에 대한 최소 침습적인 수술방법은 유용하고 미용적으로 우수하다.

Comparative Analysis of the Result of Minimally Invasive Anterior Plating and Open Reduction and Internal Fixation in Humerus Shaft Simple Fracture

  • Ko, Sang-Hun;Choe, Chang-Gyu;Lee, Ju-Hyung
    • Clinics in Shoulder and Elbow
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    • 제18권2호
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    • pp.75-79
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    • 2015
  • Background: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. Methods: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. Results: We found that bone union was achieved in all patients, and the mean union periods were $20.7{\pm}3.34$ and $20.3{\pm}3.91$ weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were $91.4{\pm}7.97$, $33.4{\pm}1.15$, and $90.8{\pm}2.23$ for group 1, and $95.2{\pm}1.53$, $33.3{\pm}1.43$, and $90.17{\pm}1.85$ for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. Conclusions: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.

개방성 종골 골절의 수술적 치료 결과 (Results in Operative Treatment of Open Calcaneal Fracture)

  • 김바롬;이준영;차동혁
    • 대한족부족관절학회지
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    • 제25권3호
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    • pp.133-140
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    • 2021
  • Purpose: This paper reports the surgical treatment results of open calcaneal fractures performed at the author's clinics focusing on open calcaneal fractures to help understand the appropriate treatment and realistic outcomes. Materials and Methods: This study was conducted on 22 cases out of 30 patients who visited the hospital from February 2009 to December 2019 and were followed up for more than one year. In open fractures, the fracture was classified using the Gustilo-Anderson classification and was evaluated using the soft tissue status at the time of visit. Intra-articular calcaneal fractures were classified using Sanders classification. The radiological parameters were measured for the Böhler angle, Gissane angle, calcaneal length, height, and width before and after surgery, and at the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and investigated complications. In addition, statistical analysis of the incidence and associated factors of posttraumatic arthritis was conducted. Results: In all cases, the surgical treatment was performed by minimally invasive surgery. The AOFAS ankle-hindfoot scale conducted for a clinical evaluation of the final follow-up was averaged 72.5 points. In the classification of open fractures, the Gustilo-Anderson classification type IIIA was the most common, and the Sanders type III was the most common. Of the 22 cases after surgery, 15 cases had complications, 11 cases had posttraumatic arthritis, eight cases had an infection, and 4 cases had both complications. Only the Sanders classification showed a statistically significant correlation with the incidence of posttraumatic osteoarthritis (p-value 0.032). Conclusion: In treating open calcaneal fractures, internal fixation by a minimally invasive approach showed relatively satisfactory results. However, follow-up research will be needed, including the results of a long-term follow-up through a large number of cases and comparative studies with other surgical methods.

The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

  • Lim, Hyun-Dae;Lee, You-Mee;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • 제39권4호
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    • pp.152-155
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    • 2014
  • Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

Minimally Invasive Suturectomy and Postoperative Helmet Therapy : Advantages and Limitations

  • Chong, Sangjoon;Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • 제59권3호
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    • pp.227-232
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    • 2016
  • Various operative techniques are available for the treatment of craniosynostosis. The patient's age at presentation is one of the most important factors in the determination of the surgical modality. Minimally invasive suturectomy and postoperative helmet therapy may be performed for relatively young infants, whose age is younger than 6 months. It relies upon the potential for rapid brain growth in this age group. Its minimal invasiveness is also advantageous. In this article, we review the advantages and limitations of minimally invasive suturectomy followed by helmet therapy for the treatment of craniosynostosis.

하악 구치부 치주조직에 발생한 침윤성 국균증환자의 치험례 (INVASIVE ASPERGILLOSIS ON LOWER MOLAR PERIODONTAL TISSUES : CASE REPORT)

  • 김일규;천세영;오성섭;최진호;장금수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권1호
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    • pp.81-85
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    • 2002
  • This paper describes that invasive aspergillosis was found in oral cavity, especially in lower molar periodontium in a immunocompromised 34-year-old woman who had been admitted in hemato-oncology with the diagnosis of acute myeloid leukemia. Antifungal therapy and surgical excision of involved teeth, bone and gingiva were the treatment of choice. After treatment infected area was healed very well. We would like to report our case because we could not find any paper reporting on invasive aspergillosis occurring in lower molar periodontium.

Temporomandibular joint dislocation: experiences from Zaria, Nigeria

  • Agbara, Rowland;Fomete, Benjamin;Obiadazie, Athanasius Chukwudi;Idehen, Kelvin;Okeke, Uche
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권3호
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    • pp.111-116
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    • 2014
  • Objectives: Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment. Materials and Methods: A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records. Results: In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications. Conclusion: Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected.

소아환자의 점액종 치료 시 최소침습적 방법: 증례 보고 (Minimally Invasive Techniques for the Treatment of Mucoceles in Young Patients: A Case Series)

  • 김종성;김기민;이제식;김현정;남순현
    • 대한소아치과학회지
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    • 제49권1호
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    • pp.113-120
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    • 2022
  • 구강 점액종은 구강의 소타액선의 병적인 변화로 인해 타액의 축적을 야기하며 발생하는 흔한 외향성 병소이다. 구강 점액종은 대개 증상이 없으며 무통성이며 반투과성의 구상의 파동성 결절모양인 것이 특징이다. 일반적인 구강 점액종의 치료방법으로는 외과적 제거술, 조대술, 냉동절제술, 그리고 스테로이드 주사 등이 있다. 본 증례는 치료 시 협조도를 얻기에 충분하지 못한 영아나 소아환자에서 외과적인 치료 대신에 최소침습적 방법의 일환으로 미세조대술과 봉합법을 사용하여 구강에 발생한 점액종을 성공적으로 치료한 증례를 보고한다. 본 증례를 바탕으로 영유아와 행동조절에 문제가 있는 아동를 대상으로 치료하는 소아치과분야에서 구강 점액종 치료 시 미세조대술과 봉합법은 하나의 대안적 방법이 될 수 있음을 시사한다.

Ureterosciatic hernia causing obstructive uropathy successfully managed with minimally invasive procedures

  • Kim, Yeong Uk;Cho, Jae Ho;Song, Phil Hyun
    • Journal of Yeungnam Medical Science
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    • 제37권4호
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    • pp.337-340
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    • 2020
  • Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.