• 제목/요약/키워드: Preoperative planning

검색결과 162건 처리시간 0.03초

The Prognostic Significance of Patient-Prosthesis Mismatch after Aortic Valve Replacement

  • Nardi, Paolo;Russo, Marco;Saitto, Guglielmo;Ruvolo, Giovanni
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.161-166
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    • 2018
  • Patient-prosthesis mismatch (PPM) is a controversial issue in current clinical practice. PPM has been reported to have a negative impact on patients' prognosis after aortic valve replacement in several studies, showing increased all-cause and cardiac mortality. Moreover, a close relationship has recently been described between PPM and structural valve deterioration in biological prostheses. In patients at risk for PPM, several issues should be considered, and in the current era of cardiac surgery, preoperative planning should consider the different types of valves available and the various surgical techniques that can be used to prevent PPM. The present paper analyses the state of the art of the PPM issue.

견갑하근 상 1/3 파열 (Partial Tear of Upper Portion of Subscapularis)

  • 김동휘;김국진;문영래
    • Clinics in Shoulder and Elbow
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    • 제8권1호
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    • pp.9-13
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    • 2005
  • An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

요족의 진단과 치료 (Diagnosis and Treatment of Cavus Foot)

  • 서재완;최우진;이진우
    • 대한족부족관절학회지
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    • 제20권2호
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    • pp.55-61
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    • 2016
  • The cavus foot is a deformity characterized by an elevated medial longitudinal arch and a hindfoot varus with plantarflexed 1st ray. The etiology of cavus foot is usually related to neuromuscular disease or idiopathic cause. Thorough clinical and radiographic evaluation is required for differentiating etiology of the cavus. Most cases of cavus foot are stable and slowly progressive deformities which can initially be managed with conservative treatment including orthoses and physical therapies. Determining whether the deformity is flexible or rigid, the apex of the deformity and any muscle imbalances in foot and ankle is important for achievement of an adequately balanced plantigrade foot. Treatment should include systematic preoperative planning for selection of appropriate procedures for maintaining a functional and flexible foot with combinations of soft-tissue release, osteotomy, tendon transfer, and arthrodesis.

Mandibular Reconstruction with Free Fibular Flap and Dental Implant after Ablative Oral Cancer Surgery Using 3D RP Model: A Case Report

  • Kim, Duck-Hoon;Cha, Hyun-Suk;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • 제1권2호
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    • pp.90-94
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    • 2014
  • Reconstruction of the mandible after ablative oral cancer surgery requires esthetic and functional rehabilitation. Restoring facial symmetry and dentition need accurate preoperative surgical planning and meticulous surgical technique. Free fibular flap is most useful tools to reconstruct mandible because of its adequate length and height, simultaneous harvest of soft and hard tissues and placing dental implants. In this case report, recurred squamous cell carcinoma in the right mandible had been resected and free fibular flap was utilized for mandible reconstruction using 3D rapid prototype. Simulation surgery before dental implant placement has been performed for esthetic and functional prosthodontics.

족근 골 결합 (Tarsal Coalitions)

  • 박용욱;서일우
    • 대한족부족관절학회지
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    • 제16권3호
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    • pp.141-147
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    • 2012
  • A tarsal coalition is an abnormal union between 2 or more tarsal bones of the hind- and midfoot, which can be congenital or acquired. The documented overall incidence of tarsal coalition is 1% or less. The resulting abnormal articulation leads to accelerated degeneration within adjacent joint. Pain is often diffuse, exacerbated by strenuous activity or following an ankle sprain. The findings on physical examination is protruded mass, diminished range of motion of the involved joint. It is possible to identify of tarsal coalitions with conventional radiography, but CT scanning necessary to evaluate of the size, location, characteristic and preoperative planning of tarsal coalitions. The initial treatment for a tarsal coalition is conservative, but tarsal coalitions unresponsive to conservative treatment, are managed by coalition resection, or arthrodesis in case of presence of degenerative changes.

How to optimize aesthetic outcomes in implant-based breast reconstruction

  • Nava, Maurizio Bruno;Catanuto, Giuseppe;Rocco, Nicola
    • Archives of Plastic Surgery
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    • 제45권1호
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    • pp.4-13
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    • 2018
  • The evolution of breast reconstructive surgery keeps pace with the evolution of breast oncologic surgery. The reconstructive choice should always balance the optimal local control of disease and the best cosmetic result, reflecting an informed decision that is shared with the patient, who is always at the center of the decision-making process. Implant-based breast reconstruction following mastectomy represents a complex choice. In order to obtain optimal results, the following considerations are mandatory: thorough preoperative planning, a complete knowledge of the devices that are used, accurately performed surgery, and appropriate follow-up.

Retroperitoneal Yolk Sac Tumor in Adult Woman Presenting as Spinal Cord Compression and Fatal Pulmonary Tumor Embolism

  • Yi, Hyeong-Joong;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • 제39권4호
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    • pp.296-299
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    • 2006
  • A 35-year-old woman, previously treated for systemic metastases from retroperitoneal yolk sac tumor, presented with progressive painful paraparesis. Preoperative images showed severe cord compression by the metastatic infiltration of the lumbar vertebrae and epidural mass as well as a huge retroperitoneal mass. While performing unremarkable surgery in prone position, the patient abruptly fell into hypoxic insults and circulatory arrest. Intraoperative pulmonary tumor embolism was deemed a cause of death. When planning operative procedure for this dangerous malignancy, scrupulous manipulation is mandated and the possibility of fatal pulmonary tumor embolism should also be addressed and fully discussed preoperatively.

Distally-based free anterolateral thigh flap with a modified vena comitans

  • Kang, Chan-Su;Kim, Tae-Gon
    • Archives of Plastic Surgery
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    • 제46권1호
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    • pp.84-87
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    • 2019
  • With the recent development in microsurgery, the use of a perforator flap has been widely implemented. If the length of the ALT flap pedicle is insufficient despite adequate preoperative planning, pedicle length extension is necessary. We planned for a reverse ALT free flap using the distal vessel of the descending branch for pedicle length extension in the case of ALT perforator branch originating from the proximal portion of the descending branch. For the management of venous congestion, the distal venae comitantes were anastomosed to the proximal venous stump in an antegrade manner, successfully resolving the venous congestion. Modified reverse-flow ALT free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch, unlike the initial surgical plan.

Uncommon configuration of intercostobrachial nerves, lateral roots, and absent medial cutaneous nerve of arm in a cadaveric study

  • Rosemol Xaviour
    • Anatomy and Cell Biology
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    • 제56권4호
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    • pp.570-574
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    • 2023
  • The intercostobrachial nerve (ICBN) originates from the second intercostal nerve's lateral cutaneous branch, while the median nerve (MN) typically arises from the brachial plexus's lateral and medial roots. The medial cutaneous nerve of the arm, a branch of the medial cord of the brachial plexus, often connects with the ICBN. Variations were observed during the dissection of a 50-year-old male cadaver, including MN having two lateral roots (LR), LR1 and LR2, joining at different levels. Three ICBNs innervated the arm in this case, with the absence of the medial cutaneous nerve of the arm compensated by branches from the medial cutaneous nerve of the forearm. Understanding these anatomical variations is crucial for surgical procedures like brachioplasty, breast augmentation, axillary lymph node dissection, and orthopedic surgery. Surgeons and medical professionals must be aware of these variations to enhance preoperative planning, minimize complications, and improve patient outcomes in these procedures.

Surgical management of hilar cholangiocarcinoma: Controversies and recommendations

  • Suvendu Sekhar Jena;Naimish N Mehta;Samiran Nundy
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.227-240
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    • 2023
  • Hilar cholangiocarcinomas are highly aggressive malignancies. They are usually at an advanced stage at initial presentation. Surgical resection with negative margins is the standard of management. It provides the only chance of cure. Liver transplantation has increased the number of 'curative' procedures for cases previously considered to be unresectable. Meticulous and thorough preoperative planning is required to prevent fatal post-operative complications. Extended resection procedures, including hepatic trisectionectomy for Bismuth type IV tumors, hepatopancreaticoduodenectomy for tumors with extensive longitudinal spread, and combined vascular resection with reconstruction for tumors involving hepatic vascular structures, are challenging procedures with surgical indications expanded. Liver transplantation after the standardization of a neoadjuvant protocol described by the Mayo Clinic has increased the number of patients who can undergo operation.