• Title/Summary/Keyword: Less invasive

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Review of Bladder cancer (방광암의 이해)

  • You, Hyun Wook
    • The Journal of the Korean life insurance medical association
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    • v.33 no.2
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    • pp.18-24
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    • 2014
  • Bladder cancer is one of the most common cancers affecting men and women and thus has a profound impact on health care. The majority of patients (75%) with newly diagnosed urothelial tumors have non-muscle invasive disease confined to the bladder mucosa or the lamina propria. The most important risk factors for the development of bladder cancer are smoking and occupational exposure to toxic chemicals. Painless visible hematuria is the most common presenting symptom of bladder cancer. Cystoscopy and urine cytology are currently the recommended tools for diagnosis of bladder cancer. Excluding muscle invasion is an important diagnostic step, as outcomes for patients with muscle invasive bladder cancer (MIBC) are less favorable. For non-muscle invasive bladder cancer (NMIBC), the high rate and frequency of recurrence and the concern for disease progression - especially in patients with high-risk tumors - mandate careful strategies for tumor surveillance. The surveillance strategies should be based on available prognostic factors and in particular data from the EORTC risk tables.

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Giant coronary aneurysm caused by Kawasaki disease: consistency between catheter angiography and electrocardiogram gated dualsource computed tomography angiography

  • Hwang, Eun-Ha;Ju, Jung-Ki;Cho, Min-Jung;Lee, Ji-Won;Lee, Hyoung-Doo
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.501-504
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    • 2015
  • We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography offered additional advantages such as minimal invasiveness and less radiation exposure.

Abstract Minimally Invasive Aort ic Valve Surgery -A Report of Two Cases (최소 침습성 대동맥 판막 수술 -2례 보고-)

  • 백완기;김현태
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1139-1141
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    • 1997
  • Recently, minimally invasive approach via limited incision becomes one of the rapidly developing strategy in cardiac surgery as it gives less surgical trauma and is more satisfactory to the patients in respect to operative scar although the surgical technique is more demanding. Here, we report two cases of aortic valve replacement via limited transsternal incision. The methodology is described with review of the relevant literature.

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Less invasive transoral resection of esophageal fibrovascular polyps: case reports

  • Janusz Wlodarczyk;Tomasz Smeder
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.683-687
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    • 2022
  • We report five patients treated for esophageal fibrovascular polyps using a minimally invasive technique. Esophageal fibrovascular polyps are benign pedunculated submucosal tumors of considerable size. The treated polyps size ranged from 1.5 to 13 cm. The polyps were removed by relocation to the oral cavity under endoscopic control. No perioperative complications occurred after the treatment. The follow-up of patients after surgery was 9-89 months, with no evidence of polyp recurrence. Thus, the described treatment is safe but requires experience with endoscopy as well as esophageal surgery.

Distribution Pattern of White Snakeroot as an Invasive Alien Plant and Restoration Strategy to Inhibit Its Expansion in Seoripool Park, Seoul

  • Lee, Han-Sol;Yoo, Hae-Mi;Lee, Chang-Seok
    • Animal cells and systems
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    • v.7 no.3
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    • pp.197-205
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    • 2003
  • White snakeroot (Ageratina altissima (L.) R. King & H. Robinson) as an invasive alien plant appeared more abundantly at lower elevations where frequent artificial interferences prevailed than at higher elevations where such impacts were less. They appeared abundantly in introduced forests such as black locust plantation but they did not appear or were rare in natural forests such as oak forest. But an exceptional phenomenon where white snakeroot did not appear was found in a Korean pine stand with dense cover afforested recently. Appearance status of white snakeroot in each section of trampling path depended on breadth of the path and relative light intensity. Growth of white snakeroot measured as the number of ramet per genet, height, and biomass was better near the trampling path and was reduced toward the forest interior. The growth was proportionate to the relative light intensity measured according to distance from the trampling path. Such results support the fact generally known in relation invasion and expansion of the invasive alien plants. From this viewpoint, we suggest a management plan that applies ecological restoration principles to address ecosystems infected with white snakeroot by restoring the integral feature of the degraded nature and more thoroughly conserving the remaining nature.

Minimally Invasive Cardiac Surgery - Three different approaches - (최소 침습성 심장수술 -세가지 다른 접근법-)

  • Chung, Sung-Hyuk;Yang, Ji-Hyuk;Nam, Hye-Won;Kim, Ki-Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.438-441
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    • 1999
  • Background: Minimally invasive cardiac surgery has emerged as a new approach to the conventional median sternotomy. The suggested advantages of the minimally invasive technique includes improved cosmesis, simplicity of opening and closing the chest, less postoperative pain, less risk of infection and bleeding, early rehabilitation, and reduced length of hospital stay. Material and Method: Between March 1997 and December 1997, we performed 36 cases of minimally invasive cardiac surgery via three different approaches ; right paramedian, transverse sternotomy and mini-sternotomy with upper sternal split. Result: There was no operative mortality. Postoperative complications were atrial fibrillation in 4 patients, bleeding that required reoperation in 1 patient, and delayed wound closure in 1 patient who underwent 3rd redo operation. Average length of skin incision was 9.1${\pm}$0.9 cm. Average duration of stay in the intensive care unit was 48${\pm}$29 hours and the patients were discharged 10${\pm}$7 days after the operation. Conclusion: In spite of the difficulties in defibrillation, deairing, and cardiac decompensation, minimally invasive approaches will be applied increasingly because of the suggested advantages.

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Minimally Invasive Lumbar Spinal Decompression : A Comparative Study Between Bilateral Laminotomy and Unilateral Laminotomy for Bilateral Decompression

  • Kim, Seok-Won;Ju, Chang-Il;Kim, Chong-Gue;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.195-199
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    • 2007
  • Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

Breast Cancer in Men: a Report from the Department of Radiation Oncology in Kermanshah Province, Iran

  • Amirifard, Nasrin;Sadeghi, Edris
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2593-2596
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    • 2016
  • Background: Male breast cancer (MBC) is a rare disease that accounts for less than 1% of all cancers in men and less than 1% of all diagnosed breast cancers. In this study, we retrospectively evaluated the clinicopathological features, treatment options and overall survival in Kurdish MBC cases. Materials and Methods: Seventeen MBC were referred to Department of Radiation Oncology in Imam Reza Hospital, Kermanshah, Iran, between 2010 and 2016. Immunohistochemical analysis was performed for ER, PR and Her2 biomarkers and FISH for those with Her2 2+. Median follow-up period was 30 months (2-65 months). We excluded from the study patients who did not have follow-up after initial diagnosis. Treatment methods were chemotherapy, radiotherapy, hormonal therapy, target therapy and palliative care. Survival was estimated by the Kaplan Meier method (Prism 5). Results: The mean age at diagnosis was $49.24{\pm}17$ years (range, 24-85 years). Grade II was the most grade in MBC (65%). Fourteen patients (82%) had invasive ductal carcinoma, one (6%) had ductal carcinoma in situ and 2 (12%) had invasive papillary. ER, PR and Her2 were significantly positive in 14/17, 8/17 and 2/17 cases, respectively. The treatment included modified radical mastectomy for most patients. Chemotherapy with TAC and CEF regimens was delivered to 15/17 cases. Tamoxifen therapy was delivered to 14/17 cases. Three stage IV patients received Avestin and two with Her2 3+ were given Trastuzumab (Herceptin). Patients received adjuvant radiotherapy following surgery and chemotherapy. The site of metastasis was the bone in 2 cases, lung in 1 case and liver in 1 case. Zoledronic acid (Zometa) was prescribed for patients with bone metastasis. Five-year overall survival rate was 64%. Conclusions: MBC is rare. Thus, we need larger studies are in collaboration with several research centers in the field of breast cancer. ER positive, grade II of invasive ductal carcinoma, stage II and right side happened more with MBC. Overall survival is similar to other studies.

Clinical Outcomes of Minimally Invasive Surfactant Therapy via Tracheal Catheterization in Neonates with a Gestational Age of 30 Weeks or More Diagnosed with Respiratory Distress Syndrome

  • Seo, Moon Young;Shim, Gyu Hong;Chey, Myoung Jae
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.109-117
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    • 2018
  • Purpose: Minimally invasive surfactant therapy (MIST) is currently used as a method of surfactant replacement therapy (SRT) for the treatment of respiratory distress syndrome (RDS) in preterm infants with a gestational age of less than 30 weeks. However, few studies have been conducted on MIST in neonates with a gestational age of 30 weeks or more. In this study, we compared MIST with endotracheal intubation as a rescue SRT for spontaneously breathing neonates with a gestational age of 30 weeks or more who were diagnosed with RDS. Methods: We investigated the clinical characteristics of spontaneously breathing neonates admitted to the neonatal intensive care unit of the Inje University Sanggye Paik Hospital from January 1, 2014 to December 31, 2016. These neonates were born at a gestational age of 30 weeks or more and were diagnosed with RDS. The neonates who were administered surfactant by MIST were categorized into the MIST group (n=16) and those who underwent endotracheal intubation were categorized into the control group (n=45). Thereafter, the clinical characteristics between the groups were compared. Results: Compared to the control group, the MIST group was less likely to require mechanical ventilation within 72 hours (P<0.001). The frequency of bradycardia during SRT was also low in the MIST group (P=0.033). Conclusion: MIST is considered relatively feasible and safe for treating RDS for reducing the need for mechanical ventilation and decreasing the occurrence of bradycardia during surfactant administration in neonates with a gestational age of 30 weeks or more.