• Title/Summary/Keyword: Invasive surgical treatment

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The Effect of Less Invasive Methods with VATS in the Management of Descending Necrotizing Mediastinitis (하행성 괴사성 종격동염의 치료에서의 비디오 흉강경을 이용한 저침습적 방법의 효용성)

  • 민호기;심영목;김진국
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.630-633
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    • 2002
  • Although the incidence of descending necrotizing mediastinitis(DNM) is low, this is a serious disease because it"s mortality have been reported to be as high as 40∼50%. Currently, many authors have emphasized aggressive surgical approaches rather than medical treatment alone. We report good results in 2 DNM patients treated by less invasive approach with video-assisted thoracoscopic surgery, Less invasive methods with video-assisted thoracoscopic surgery can reduce hospital stay and morbidity if effective drainage can be achieved in selected DNM patients.

Minimally Invasive Trans-Mitral Septal Myectomy to Treat Hypertrophic Obstructive Cardiomyopathy

  • Kim, Hong Rae;Yoo, Jae Suk;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.419-421
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    • 2015
  • A 43-year-old man with symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was admitted to our hospital with aggravated exertional dyspnea and successfully treated with robotic transmitral septal myectomy. Minimally invasive transmitral septal myectomy may be a feasible surgical option for the treatment of HOCM in selected cases as an alternative to transaortic myectomy.

Minimally Invasive Stabilization with Percutaneous Screws Fixation of APC-3 Pelvic Ring Injury

  • Kim, Beom-Soo;Oh, Jong-Keon;Cho, Jae-Woo;Yeo, Do-Hyun;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.60-65
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    • 2019
  • Pelvic fractures are associated with life-threatening injuries and high rates of morbidity and mortality. Management of internal blood loss associated with unstable pelvic ring injuries is paramount during the initial period. The reconstruction of the pelvic ring is of importance because it is a major contributor to the stability of the pelvic ring. We report the case of a 25-year-old man who had an unstable pelvic ring fracture combined with rupture of an obturator artery and had a successful and satisfactory treatment using minimally invasive surgery with percutaneous antegrade screw fixation.

Clinical Outcome of Treatment for Stage IIA, IIB and III Osteosarcomas (Comparative Studies between Invasive Surgical Treatment and Non-invasive HIFU Technique) (진행된 장관골 골육종의 수술 및 비수술적 강력 집속 초음파 치료의 장기 추적 결과)

  • Wenzhi, Chen;Wei, Wang;Zhibiao, Wang;Hui, Zhu;Kequan, Li;Hao, Piao Xiang;Haibing, Su;Chengbing, Jin;Feng, Wu;Jin, Bai;Rhee, Seung-Koo;Kang, Yong-Koo;Bahk, Won-Jong;Chung, Yang-Guk;Huh, Sung-Woo;Lee, Eun-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.37-46
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    • 2006
  • Purpose: To evaluate the end results between the surgical treatment with neo-adjuvant chemotherapy in Korea and non-invasive high intensity focused ultrasound (HIFU) technique in China for osteogenic sarcomas. Materials and Methods: The surgical treatment with neoadjuvant chemotherapy for total 67 cases (4 IIA, 58 IIB, and 5 III) in Korea since 1993 and the HIFU therapy for total 71 cases (57 II and 14 III) in China since 1997 was performed. In Korea, neo-adjuvant chemotherapy in 66 cases out of total 67 patients, but the adjuvant chemotherapy in only one case was done. On the contrary, in China, full chemotherapy for more than 9 times for 37 patients with stage II out of total 71 cases, but for less than 8 times of partial chemotherapy for 23 patients (stage II) and 14 patients (stage III) was done. The surgical treatment in total 67 Korean patients was done with wide resection and reconstruction for 56 patients, but wide resection without reconstruction for 5 patients and amputation for 6 patients. In china, total 71 patients was treated with average 1.5 times (1~4 times) of HIFU, and if there are some evidences of residual tumor after HIFU with following MRI, the second HIFU therapy was given 2~4 weeks later. After then, the bony defect was in no touch, keep bracing for long time expecting regeneration. All of them were followed for average 46 Mo (12~150 Mo) in Korea, but followed for average 22 Mo (9 years~8 months) in China. Results: The 5 year survival rate (stage II), was average 92.7% (IIA 100%, IIB 85.5%) in Korea series, and average 78.7% (full chemotherapy 91.8%, part chemotherapy 56.6%) in China series. The 3 year survival rate (stage III) was 20% in Korea and 7.1% in China. So, the final overall survival rate was 65.2% in Korea and 51.8% in China. The overall functional outcome score by ISOLS was 24.3 (81%) in Korea and 19.8 (73%) in China. There are 25.4% (17/67 cases) of complications in Korea and 31% (27 complications in 22 patients out of total 71 cases) in China after each treatment. Conclusions: The end results of Korea series which was treated with neoadjuvant chemo- and surgical methods are better than that of non-invasive thermal ablation in china. But we also believe the HIFU, as one of, was also effective to decrease the local recurrence and symptomatic releaf for stage II or even in III of osteogenic sarcomas.

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The Sinus Tarsi Approach for the Treatment of Intra-Articular Calcaneal Fractures (족근동 접근법을 이용한 관절 내 종골 골절의 치료)

  • Sato, Toru;Shiota, Naofumi;Tetsunaga, Tomonori;Kim, Bom Soo
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.257-263
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    • 2013
  • Open reduction and internal fixation is currently considered as a gold standard of treatment in most of the intra-articular calcaneal fractures. Among various different approaches, extensile lateral approach is the most popular since it provides good exposure to the subtalar joint. However, wide skin incision followed by extensive soft tissue dissection leading to increased risk of wound breakdown is the most serious drawback. Sinus tarsi approach, a minimal invasive technique to approach the subtalar joint and reduce the intra-articular calcaneal fractures, provides good clinical outcome and less wound complications compared to the extensile lateral approach. This article introduces the surgical technique and review of the literature regarding the sinus tarsi approach.

Thoracoscopic Resection of Mediastinal Tumor - Two Case Report - (흉강경을 이용한 양성 종격동 종양의 절제;2례 보고)

  • 이승열
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.719-722
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    • 1992
  • Two cases of benign mediastinal tumor were treated by complete resection under the video-thoracoscopic guidance. The procedure has been performed on the 2 patients, allowing definite treatment and was less invasive than standard surgical treatment. The 2 patients have been benefited by decreased postoperative pain, reduced scarring of the skin and rapid recovery. Two patients had benign mediastinal tumors; teratodermoid on anterior mediastinum and neurilemmoma on posterior mediastinum. There were no operative death and complication, median hospital stay was four days.

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A case of laparoscopic excision of choledochal cyst, hepaticojejunostomy, and Roux-en-Y anastomosis using Artisential®

  • Younghoon Shim;Chang Moo Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.2
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    • pp.266-269
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    • 2024
  • Choledochal cyst is a condition involving an abnormal dilation of the bile ducts, which can lead to various symptoms and comorbidities, including cancer. The treatment of choice for choledochal cyst is surgical correction including choledochal cyst excision and Roux-en-y hepaticoenterostomy. Minimal invasive methods like laparoscopic methods or robotic methods are used for surgical correction of choledochal cysts; however, it is still controversial which method is superior. A Korean company, LIVESMED, developed Artisential®, a laparoscopic surgical instrument that can overcome the drawbacks of laparoscopic methods. This article presents a case of the first Artisential®-performed surgical excision of a choledochal cyst and hepaticojejunostomy.

Surgical Excision for Refractory Ischiogluteal Bursitis: A Consecutive Case Series of 21 Patients

  • Sun-Ho Lee;Won-Young Jang;Min-Su Lee;Taek-Rim Yoon;Kyung-Soon Park
    • Hip & pelvis
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    • v.35 no.1
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    • pp.24-31
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    • 2023
  • Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

Minimally Invasive Surgery in a Pediatric Palatal Plasmacytoid Myoepithelioma (소아의 구개부에 발생한 plasmacytoid myoepithelioma의 최소 침습적 제거술)

  • Nam, Okhyung;Lee, Baeksoo;Lee, Sooeon;Kim, Kwangchul;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.1
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    • pp.79-84
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    • 2016
  • Myoepithelioma is a rare disease in the salivary gland. Myoepithelioma is more common in adults than in children or adolescents. An 8-years-old female patient visited our clinic with a chief complaint of a painless swelling on the palate. Conservative treatment that preserves the overlaying palatal mucosa while surgically excising the tumor was carried out under general anesthesia, because the patient was young and the size of the tumor was relatively large. The surgical wound healed well and there had not been any sign of recurrence during the regular follow-up period of 40 months. Minimally invasive surgical treatment which preserves peripheral palatal tissue can be useful in a pediatric myoepithelioma.

Surgical Treatment of Carpal Tunnel Syndrome through a Minimal Incision on the Distal Wrist Crease: An Anatomical and Clinical Study

  • Yoo, Hye Mi;Lee, Kyoung Suk;Kim, Jun Sik;Kim, Nam Gyun
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.327-333
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    • 2015
  • Background An anatomical analysis of the transverse carpal ligament (TCL) and the surrounding structures might help in identifying effective measures to minimize complications. Here, we present a surgical technique based on an anatomical study that was successfully applied in clinical settings. Methods Using 13 hands from 8 formalin-fixed cadavers, we measured the TCL length and thickness, correlation between the distal wrist crease and the proximal end of the TCL, and distance between the distal end of the TCL and the palmar arch; the TCL cross sections and the thickest parts were also examined. Clinically, fasciotomy was performed on the relevant parts of 15 hands from 13 patients by making a minimally invasive incision on the distal wrist crease. Postoperatively, a two-point discrimination check was conducted in which the sensations of the first, second, and third fingertips and the palmar cutaneous branch injuries were monitored (average duration, 7 months). Results In the 13 cadaveric hands, the distal wrist crease and the proximal end of the TCL were placed in the same location. The average length of the TCL and the distance from the distal TCL to the superficial palmar arch were $35.30{\pm}2.59mm$ and $9.50{\pm}2.13mm$, respectively. The thickest part of the TCL was a region 25 mm distal to the distal wrist crease (average thickness, $4.00{\pm}0.57mm$). The 13 surgeries performed in the clinical settings yielded satisfactory results. Conclusions This peri-TCL anatomical study confirmed the safety of fasciotomy with a minimally invasive incision of the distal wrist crease. The clinical application of the technique indicated that the minimally invasive incision of the distal wrist crease was efficacious in the treatment of the carpal tunnel syndrome.