• 제목/요약/키워드: Post-operativePatients

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Outcomes of Non-Operative Treatment for Duodenal Stump Leakage after Gastrectomy in Patients with Gastric Cancer

  • Ali, Bandar Idrees;Park, Cho Hyun;Song, Kyo Young
    • Journal of Gastric Cancer
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    • 제16권1호
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    • pp.28-33
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    • 2016
  • Purpose: We evaluated the clinical outcomes of the non-operative management of post-gastrectomy duodenal stump leakage in patients with gastric cancer. Materials and Methods: A total of 1,230 patients underwent gastrectomy at our institution between 2010 and 2014. Duodenal stump leakage was diagnosed in 19 patients (1.5%), and these patients were included in this study. The management options varied with patient condition; patients were managed conservatively, with a pigtail catheter drain, or by tube duodenostomy via a Foley catheter. The patients' clinical outcomes were analyzed. Results: Duodenal stump leakage was diagnosed in all 19 patients within a median of 10 days (range, 1~20 days). The conservative group comprised of 5 patients (26.3%), the pigtail catheter group of 11 patients (57.9%), and the Foley catheter group of 3 patients (15.8%). All 3 management modalities were successful; none of the patients needed further operative intervention. The median hospital stay was 18, 33, and 42 days, respectively. Conclusions: Non-operative management of duodenal stump leakage for selected groups of patients with gastric cancer was effective for control of intra-abdominal sepsis. This management modality can help obviate the need for surgical intervention.

대장암 수술 후 퇴원 환자에게 적용한 컴퓨터 기반 애니메이션 동영상 교육의 효과 (Effects of a Discharge Education Program using Computerized Animation Video for Post-operative Colon Cancer Patients)

  • 김영미;김민영;권원경;김호숙;박승현;천명숙;한혜정
    • 재활간호학회지
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    • 제16권1호
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    • pp.37-46
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    • 2013
  • Purpose: This study was to identify the effects of a nurse-led education program using computerized animation video for post-operative colon cancer patients. Methods: a total of 163 patients and 51 nurses were participated in this study. With a non-equivalent control group post-test design, patients were divided into three groups (77 got traditional education, 46 were applying brochure, 40 were watching video). Twelve-item animation video and brochure about the management after discharge for post-operative colon cancer patients were developed based on patient survey and the items of Korea Healthcare Accreditation. Results: The computerized video watching group had better satisfaction than the others, but there was no significant difference about comprehension. When video was applied, satisfaction, usefulness, application, and perceived patients' comprehension of nurses were all increased. Conclusion: This video education program was developed by nurses and it had a special thing for patient to access the same program even after discharge using the authorization system. It would be helpful for nurses to be more concentrated on the direct care for hospitalized patients as well as for patients to provide self-care at home. This program would be adjusted into more various diseases and settings.

Decreased post-operative pain using a sublingual injection of dexamethasone (8 mg) in lower third molar surgery

  • Gozali, Peiter;Boonsiriseth, Kiatanant;Kiattavornchareon, Sirichai;Khanijou, Manop;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권1호
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    • pp.47-53
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    • 2017
  • Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

Radiographic Liver Size Evaluation after Portosystemic Shunts Ligation in 13 Cases

  • Hong, Sung-kyun;Kim, Hye-jin;Lee, Si-heon;Kim, Wan-hee;Kweon, Oh-kyeong;Jung, Joo-hyun;Yoon, Jung-hee;Choi, Min-cheol
    • 한국임상수의학회지
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    • 제34권3호
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    • pp.189-192
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    • 2017
  • Thirteen dogs were diagnosed as congenital extrahepatic single PSS by intraoperative mesenteric portovenography or computed tomographic examination, repair surgery was performed by using an ameroid constrictor. Hepatic size was measured from the right lateral view using liver length/T11 length ratio. This measurement was performed on follow-up check of PSS ligation patients. Hepatic size parameter of pre-operative PSS patients is $4.13{\pm}0.13$ (range, 3.11-4.83). After surgery, hepatic size parameter of post-operative PSS patients is $4.79{\pm}0.19$ (range, 3.78- 5.93). Although follow-up periods varied 2 and 26 weeks, all patients showed increased liver size compared to that on pre-operative radiographs (P < 0.01). The increase rate was 1.01-1.46 times than those of preoperative radiographs. But in 5 patients, post hepatic liver size was small compared to the others, which showed low increase rate of body weight, total protein, albumin, and glucose level. It was thought that small value of hepatic size parameter was due to delay of hepatic regeneration. In conclusion, radiographic hepatic size parameter of pre- and post-operative patients is considered an effective evaluation for restoring after PSS surgery.

일반외과 환자의 수술부위 감염 관련 요인 분석 (Factors Related to Surgical Site Infections in Patients Undergoing General Surgery)

  • 안유진;송경애
    • 기본간호학회지
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    • 제12권1호
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    • pp.113-120
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    • 2005
  • Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

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라식수술 후 환자만족도에 영향을 미치는 요인 (Assessing the Factors Influencing Patient Satisfaction after Receiving Laser in situ Keratomileusis (LASIK))

  • 조우현;김지윤;최윤정;이종호;이제명;강혜영
    • Journal of Preventive Medicine and Public Health
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    • 제37권2호
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    • pp.111-119
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    • 2004
  • Purpose : To identify those factors influencing the post-operative satisfaction in myopia patients receiving laser in situ keratomileusis (LASIK) Methods : This study included 288 consecutive patients who received LASIK between July and December 2001 from two eye clinics located in Seoul and Pusan. Factors that were considered to influence post-operative satisfaction included pre-operative baseline characteristics, pre-operative expectation for treatment outcomes, and treatment outcomes. Before undergoing LASIK, study subjects were asked to rate the degree of their expectation for the improvement of visual functions and symptoms after LASIK on a 5-point Likert-type scale: where 1 referred to 'somewhat worse,' 2 to 'no change,' 3 to 'somewhat improved,' 4 to 'improved,' and 5 to 'very improved.' Self-administered questionnaire was used to evaluate baseline visual functions and symptoms on a 5-point scale before LASIK. At 6 months after LASIK, the evaluation was repeated to measure treatment outcomes in terms of the difference in the score before and after LASIK. Post-operative satisfaction was also measured at 6 months on a 5-point scale. Multiple regression analysis was performed to examine the independent relationship between influencing factors and postoperative satisfaction. Results : A total of 171 patients (59.4%) participated in the 6-month follow-up investigation. The average expectation scores for the improvement in visual functions and symptoms were 3.8 and 3.4, respectively. The average score for the 7 questions assessing satisfaction was 4.0. The results of the regression analysis showed that the post-operative satisfaction increased with improvement in the visual function ($\beta$=0.16, p<0.05) and symptoms ($\beta$=0.25, p<0.05), the degree of preoperative refractive error ($\beta$ =0.26-0.67, p<0.05) and in male patients ($\beta$=0.31, p<0.1). The pre-operative expectation was not a statistically significant factor in explaining postoperative satisfaction in the regression model. Conclusion : The finding from this study was that patients with very severe myopia tended to be more satisfied with the treatment than those with mild myopia, which implies that LASIK can be more beneficial to those suffering from a severe visual condition. Patient satisfaction was also significantly affected by the treatment outcomes experienced after LASIK. This suggests that improving the clinical outcome is the most fundamental requirement for the improvement of patient satisfaction.

거골하 신연 골편 관절 유합술 (Subtalar Distraction Bone Block Arthrodesis (Five Cases))

  • 류총일;은일수;정용욱
    • 대한족부족관절학회지
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    • 제8권1호
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    • pp.101-106
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    • 2004
  • Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.

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개심술시의 심근손상에 관한 고찰 (Evaluation of Myocardial Damage during Open Heart Surgery (enzymatic and electrocardiographic evaluation))

  • 안혁
    • Journal of Chest Surgery
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    • 제13권1호
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    • pp.41-47
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    • 1980
  • Fifty one consecutive patients undergoing open heart surgery, twenty eight congenital and twenty three acquired heart disease, were studied between May and August 1979 in Dept. of Thoracic and Cardiovascular Surgery SNUH. During the same time 10 patients of PDA were included in this study as control group. Four out of fifty one OHS patients, two ASD and two pulmonic stenosis patients, were operated without aortic cross-clamp. In all patients, serial determination of total level of creatine phosphokinase [CPK], lactic dehydrogenase [LDH], glutamic oxaloacetic transaminase [SGOT] were made preoperatively, operative day [immediate post-op], and post-operative days up to 7th day. Electrocardiograms were also evaluated serially. Open heart surgery patients were divided into two groups; Group A was aorta clamp time beyond SO minutes, and Group B was below 50 minutes. The peak level of each enzyme was compared, and electrocardiographic changes were also compared between groups. Although the electrocardiographic changes were more frequent in Group A [50%] than Group B [24%], the peak levels of each enzymes were almost same in Group A and Group B.

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Botulinum toxin-A injection into the anterior belly of the digastric muscle for the prevention of post-operative open bite in class II malocclusions: a case report and literature review

  • Kang, Yei-Jin;Cha, Bong Kuen;Choi, Dong Soon;Jang, In San;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.17.1-17.5
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    • 2019
  • Background: Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. Case presentation: A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. Conclusion: In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.

치료 효과 감지정도와 신체적 고통 감지정도가 수술직후 암환자의 희망에 미치는 영향 (Influences of Perceived Treatment Effect and Perceived Physical Suffering on Hope of Cancer Patients in Post-operative Period)

  • 안성윤;김달숙
    • 성인간호학회지
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    • 제15권1호
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    • pp.78-87
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    • 2003
  • Purpose: The purposes of the study were 1) to examine what relationships exist between PTE(perceived treatments effect) and PPS (perceived physical suffering) as the independent variables and hope as the dependent variable and 2) to examine whether PTE and PPS predict hope in cancer patients in their post-operative period within the Stotland's hope theory. Method: The Visual Analog Scale was used for measuring PTE and PPS and the Kim & Lee's Hope Scale which had acceptable reliability and validity was used for measuring hope. The data was collected from 38 hospitalized cancer patients who were in the post-operative period with a convenient sampling method. Result: There was a significant positive relationship between hope and the PTE in the low PTE group. There was a significant negative relationship between hope and the PPS in the low PPS group. There were no significant relationships between hope and the PTE in the high PTE group, and between hope and the PPS in the high PPS group. And the PTE explained hope with 71.2% of the variance in the low PTE group. Conclusion: PTE in the low PTE group and PPS in the low PPS group were identified as the factors to explain hope.

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