• Journal of Gastric Cancer
• /
• v.12 no.4
• /
• pp.237-242
• /
• 2012

Purpose: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. Materials and Methods: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. Results: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. Conclusions: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.

• Restorative Dentistry and Endodontics
• /
• v.22 no.1
• /
• pp.93-109
• /
• 1997

Finding a right repair material for furcation perforation is one of the major issues in clinical endodontics. In this experiment, three materials, calcium sulfate, amalgam, and calcium hydroxide were tested for perforated furcation repair. Sixty premolars and molars of five dogs were used. A #4 round bur was used to create the perforation. All experimental teeth were divided into two repair-time groups. One was immediate-repair group, where the perforation was repaired immediately, the other was delayed-repair group, where the perforation was left open for four weeks and then repaired with the same manner as in the immediate-repiar group. All chamber openings were sealed with amalgam and then radiographed. The animals were sacrificed at eighth week following the repair procedure. Radiographic evaluation for furcal bone destruction was done. Histologic evaluation was ranked as 0,1,2,3 according to the inflammation degrees. New bone formation was also recorded. The following conclusions were drawn within the limits of the experimental results: 1. In immediate-repair group, no significant differences existed between the materials. 2. In delayed-repair group, calcium sulfate showed significantly less furcal bone destruction and lower inflammation degree than amalgam.(p<0.05) 3. Overextruded specimens showed more severe inflammation than unextruded specimens. 4. Most of the specimens showed certain degrees of inflammatory reaction and incomplete hard tissue healing. 5. In delayed-repair group, treated group showed less inflammation than untreated control group.

• Restorative Dentistry and Endodontics
• /
• v.43 no.2
• /
• pp.17.1-17.7
• /
• 2018

Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.33 no.3
• /
• pp.281-285
• /
• 2011

Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

• Journal of Chest Surgery
• /
• v.31 no.1
• /
• pp.46-51
• /
• 1998

Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

• Proceedings of the Korea Concrete Institute Conference
• /
• 2003.11a
• /
• pp.577-580
• /
• 2003

Problem of repairing by boring is that it deteriorates stabelety and durability of structure by permeation of seawater from underneath after damage and repair of reinforcing rod regarding of spot. The purpose of this study is to improve the porblem by using the repair method of general boring to mend the of large mat basis. Direction of thes experiment is to apply the new repair material and the method to control the blazing fire factor caused by the crack from the foundation of large mat and also to estimate it's integrity. New method of construction is method of contruction that do speace scurity in vertical drilling and bottom useing water jet. New material used bantonite and rubberized asphalt. Test result existent repair method of construction large size mat basis perforation is difficult and reinforcing rod can be damaged coule there were a lot of problems with re-water leakage of crack repair region, but overcomes existent short coming by method that apply in this study.

• Journal of Chest Surgery
• /
• v.51 no.4
• /
• pp.277-279
• /
• 2018

A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

• The Journal of the Korean dental association
• /
• v.55 no.8
• /
• pp.565-573
• /
• 2017

Root canal perforations are defined as the communication between the pulp cavity, the periodontal tissue and alveolar bone. The occurrence of perforations during endodontic treatment is reported to range from 2.3%~12%, which is not a complication rarely happens. Perforations have iatrogenic or pathological etiologies that involve caries or resorption. It leads to inflammation and the destruction of periodontal fibers and alveolar bone, followed by periodontal defects. Mineral trioxide aggregate (MTA) is currently the most indicated material for repair of root perforation, because of its favorable biocompatibility and sealing ability. Using magnification with dental operating microscope enhance the accessibility and visibility to manage the root perforation. It is important to diagnose and repair perforations immediately if possible.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.759-762
• /
• 1996

Fifteen patients with esophageal perforation were treated at the Department of Thoracic and Cardiovacular Surgery, Chungnam National University Hospital during the period from June, 1985 to September, 1995. The ratio between male and female patients was 9 : 6, their age ranged from 19 years to 71 years old(a erage : 49 years old). The causes of the perforation were various, spontaneous in 4 cases, foreign body in 4 cases, instrumental trauma in ) cases, chest trauma in 1 case, drug ingestion (chlorocalchi) induced in 1 case, tracheostomy induced in 1 case, unknown in 1 case. The perforation sites were intrathoracic esophagus in 9 cases and cervical in 6 cases. The Patients complained of chest or cervi- cal pain in 11 cases, fever in 9 cases, dysphagia in 8 cases and dyspnea in 5 cases. We have performed the following surgical procedures : incision and drainage, primary repair, gastrostomy for cervical esophageal perf'oration and primary repair, primary repair and pleural flap reinforcement, gastrostomy for thoracic esophageal perforation. A patient died of sepsis.

• Journal of Trauma and Injury
• /
• v.24 no.1
• /
• pp.45-47
• /
• 2011

Esophageal perforation due to blunt trauma is rare. A 67-year-old male presented to Konyang University Hospital with painful neck swelling. His neck was injured by blunt trauma at work. Esophageal perforation was detected by neck CT and esophagography. We performed primary repair of cervical esophagus through the Lt. neck approach. The postoperative course was uneventful and the patient was discharged at postoperative day 15.