• Title/Summary/Keyword: Operative procedures

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Comparision of Imaging Features with Surgical Findings in the Patients with Craniosynostosis (두개골조기유합증 환자에서 영상소견과 수술소견의 비교)

  • Kim, Hyung Soo;Park, Se-Hyuck;Cho, Byung Moon;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1417-1421
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    • 2001
  • Objective : The purposes of this study are to compare imaging features with operative findings and to determine significance of imaging studies for early detection of craniosynostosis(CS). Methods : Plain radiograph of skull and three-dimensional(3D) CT reconstruction were analyzed in 10 consecutive patients with CS to assess the presence and the extent of synostosis. The radiological findings were investigated and compared with operative findings. Results : The locations of lesion were coronal suture in 6, sagittal suture in 3 and multiple sutures in one patient, and the age ranged 1 to 53 months(mean age : 17.4 months). Reconstructive procedures with or without advancement of supraorbital rim were performed in coronal CS patients and ${\pi}$-procedures or synostectomy were done in sagittal CS patients. Radi-ological abnormalities such as sutural indistinctness or sclerosis, bony ridge, bossing and other bony deformities were nearly consistent with surgical findings. Conclusion : The interpretation of imaging study are very important for early detection of craniosynostosis, especially, the plain radiographs of skull. Also 3D CT imaging is helpful in diagnosis and surgical planing of craniosynostosis. There are no significant differences between imaging features and operative findings in CS patients.

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Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

  • Kim, Seong-Hun;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.48-55
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    • 2018
  • While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.

Congenital esophageal atresia with tracheoesophageal fistula -Report of one case- (선천성 식도폐쇄 및 기관식도루 -1예 보고)

  • 김종진
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.358-362
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    • 1986
  • Esophageal atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. Recently we were experienced a case of esophageal atresia with distal tracheoesophageal fistula in infant patient who presented the symptoms of projectile vomiting and dyspnea. The diagnosis was made by the esophagography and the Haight`s operation was performed transpleurally through 4th intercostal space after gastrostomy. Operative patient tolerated all the operative procedures well in spite of postoperative respiratory complication and recovered uneventfully, permitted feeding on 10th postoperative day. On follow up study after 5th months, Patient reveals good health without other problem.

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Surgical treatment of benign tumors of the lung (폐양성종양의 수술요법에 대한 연구)

  • 김주현
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.475-483
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    • 1984
  • Here presented six cases of benign tumors of the lung treated surgically between Dec. 1957 and Dec. 1983 in the Department of Thoracic Surgery, Seoul National University Hospital. They include four cases of hamartoma, one case of benign mesothelioma, and one case of Castlemans disease. The operative procedures are three cases of lobectomy, one case of segmentectomy, and two cases of mass excision. The operative results are excellent without complication.

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Result of modified Heller operation with gastric fundoplication in esophageal achalasia (Achalasia 의 외과적 치료)

  • 오봉석
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.451-455
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    • 1982
  • For recently 2 years, 3 cases of esophageal achalasia were surgically treated by modified Heller operation with gastric fundoplication. Esophageal achalasia is functional disorder of lower esophagus of which symptoms are dysphasia, regurgitation, and weight loss. Preoperative diagnosis was made by clinical manifestations and radiologic examination, esophagoscopy and confirmed at operative table. Operative procedures are variable, but modified Heller operation is common method to handicap reflux esophagitis and postoperative esophageal stricture. Now, our patients who were surgically treated were well alive without complaining of specific symptoms for followed period.

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A Clinical Study of the Operative Treatment in Hallux Valgus (무지 외반증의 수술적 방법에 대한 임상적 고찰)

  • Park, I.H.;Lee, K.B.;Song, K.W.;Lee, J.Y.;Kim, I.J.
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.65-73
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    • 1997
  • Hallux valgus deformity has been slowly getting popular in Korea. Many surgical procedures are available for treating the hallux valgus, but it is still controversial for the best treatment. We operated 25 feet(15 patients) of hallux valgus between May. 88 and December. 94. The clinical results were as follow ; 1. Age distribution was 25 to 82, and all female. 10 patients have bilateral hallux valgus. 2. 19 feet were treated by soft tissue procedures only and 6 feet by combined soft tissue and bony procedures. 3. Bunion deformity was recurred in 2 feet (1 Patient) which were treated with modified McBride Method. 4. Lateral sesamoidectomies were performed in 7 feet without development of hallux varus. 5. The cosmetic and functional results were good in 6 cases treated by proximal metatarsal osteotomy. 6. 9 feet had other digits deformities, which need surgical correction. 7. Tightening repair of medial capsule seems to be important for prevention of recurrence of bunion.

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Bronchoplasty -A report of 5 cases (기관지 성형술 5례 보고)

  • Kim, Eung-Jung;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.497-505
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    • 1985
  • Bronchoplastic techniques represent the ideal surgical therapy for benign endobronchial tumors as well as tumors of low-grade malignant potential, such as bronchial adenomas, and for repair of traumatic airway injuries and benign strictures. This approach is also applicable to a select group of patients with carcinoma of the lung, with long-term survival being comparable to that achieved by standard pneumonectomy. Five bronchoplastic procedures were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 7 months periods from Dec. 1984 to Jun. 1985. Of the 5 patients, 3 patients were male and 2 patients were female and ages ranged from 8 years to 55 years old. The final diagnoses of 5 patients were as followed; traumatic bronchostenosis, endobronchial tuberculoma, carcinoid tumor, tuberculous bronchostenosis and traumatic bronchial fracture. Operative procedures of 5 patients were as followed; resection and end-to-end anastomosis of right main bronchus, left lower lobectomy and wedge resection of bronchus, left upper sleeve lobectomy, right middle and lower sleeve lobectomy and resection and end-to-end anastomosis of left main bronchus. And 2 lungs and 3 lobes could be preserved by these bronchoplastic procedures. There was no post-operative complication or mortality and all patients are being followed up without specific problem.

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Complications in the Recipient Sites of Autologous Rib Cartilage Grafts for Microtia (소이증에서 자가늑연골 이식수혜부의 합병증)

  • Kim, Suk Wha;Ahn, Seung Hyun
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.703-708
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    • 2008
  • Purpose: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. Methods: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. Results: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. Conclusion: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

  • Prasetyono, Theddeus O.H.;Koswara, Astrid Felicia
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.164-172
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    • 2015
  • Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.

Clinical Analysis of Esophageal Carcinoma (식도암의 임상적 고찰)

  • 임종수
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.122-127
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    • 1990
  • The management of esophageal carcinoma continues to be a difficult problem with most surgically treated patients under-going extensive operative procedures for palliation only. Although recent advances in preoperative and postoperative care have decreased the operative mortality rate, survival has not changed significantly. Twenty five patients with esophageal carcinoma who were treated with operative intervention at the Department of Thoracic and Cardiovascular Surgery in Kyung Hee University Hospital between January, 1980 and December, 1987 had been evaluated clinical manifestation and operative results. The stamm typed feeding gastrostomy and Celestin tube insertion were performed for the cases of nonresectable esophageal cancer. Also 14 cases with esophagogastrostomy and are case with esophagocologastrostomy were performed for the resectable cases. Two deaths with resectable cases occurred within 30days of operation, a hospital death rate of 8 per cent. There were significant differences in the survival rate between T.N.M. staging I, II, and III, IV group after the resection of the esophageal cancer. The former group revealed higher one year survival rate than the later group. [p< 0.05]. In conclusion, the clinical manifestations and operative results were similar to the western ones and the postoperative survival rate was very poor. So, the earlier the operation of the esophageal cancer was done, the better result will be achieved. To defect the early esophageal cancer; routine esophagoscopy should be recommended.

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