• 제목/요약/키워드: Salvage procedure

검색결과 71건 처리시간 0.022초

하지동맥폐쇄환자에서의 비해부학적 우회술의 임상적 고찰 (Extra-anatomic bypass for Treatment of Leg Ischemia)

  • 조재호
    • Journal of Chest Surgery
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    • 제27권10호
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    • pp.846-849
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    • 1994
  • Extra-anatomic bypass is indicated for the limb salvage of patients with threatened limb loss especially those who have high risk of infection and death after general anesthesia. We did extra-anatomic bypass procedure nineteen times over a seven year, two month period on sixteen patients. Their mean follow up period was 41.3 months. Male to female ratio was 7:1. Major complaints were resting pain[36.8%], claudication[31.6%], cyanosis[15.8%] and ulcerative change[15.8%]. Associated diseases were hypertension, tuberculosis, chronic renal failure, atrial fibrillation, complete heart block and laryngeal cancer. Postoperative patency rates were 76.9% at 1 year, 72.7% at 2 years and 70% at 3 years. Limb salvage rate was 78.9%. Postoperative mortality rate was 10.5%.

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대장유리피판(Colon Free Flap)을 이용한 식도재건의 구제술 (Salvage of Esophageal Reconstruction with Colon Free Flap)

  • 이상우;민경원
    • Archives of Plastic Surgery
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    • 제33권2호
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    • pp.245-248
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    • 2006
  • Besides gastric pull-up or colonic interposition, microvascular technique in esophageal reconstruction has been approved reliable methods. When free intestinal transfer is considered, jejunal free flap is commonly used. We treated the patient who had undergone reconstruction with a right colon interposition and suffered from inability of swallowing because of stricture and necrosis of the interposed flap. Although we have planned jejunal free transfer, we couldn't use jejunum due to adhesion by previous gastrojejunostomy and colon interposition. Salvage procedure with microvascualr free left colon flap was executed successfully. After 9 month follow-up, the patient was able to consume a normal diet.

A Salvage Operation for Total Penis Amputation Due to Circumcision

  • Ince, Bilsev;Gundeslioglu, Ayse Ozlem
    • Archives of Plastic Surgery
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    • 제40권3호
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    • pp.247-250
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    • 2013
  • Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocautery during circumcision. Although penile replantation was attempted, it was unsuccessful due to burn damage to the veins. After restoration of the functional structures, the penis was buried in the inguinal area by reepithelization to maintain blood circulation. The recovery of the penis was successful. This case is presented as a novel example of groin flap surgery to achieve a functionally and aesthetically acceptable outcome in a salvage operation for a penis with significant traumatic injury, which has not been previously reported in the literature.

소아 슬관절 상부 절단단 연장 성형술 - 증례 보고 2례 - (Lengthening of the Above-knee Amputation Stump - Reports of 2 cases -)

  • 김태승;김종구;황건성
    • 대한골관절종양학회지
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    • 제4권1호
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    • pp.53-58
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    • 1998
  • Limb-salvage surgery has become more popular than amputation for the treatment of malignant bone tumor because no differences in local recurrence and the 5-year survival rate have been found. However for young patients with sarcoma, skeletal immaturity may be a contraindication to limb-salvage surgery due to the expected leg length discrepancy. If limb-sparing procedure should be impossible for skeletally immature patients, amputation has to be given first consideration. To minimize the functional difficulty from short amputation stump of above knee amputation, we performed lengthening of the amputation stump using ipsilateral tibia. One patient was lengthened 17cm using ipsilateral tibia and the other, 12cm. Two patients and their families were satisfied both clinically and psychologically.

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Crossbar Technique for the Failed Clavicular Hook Plate Fixation in an Acute Acromioclavicular Joint Dislocation: Salvage for Acromial Fracture after Clavicular Hook Plate

  • Koh, Kyoung Hwan;Shin, Dong Ju;Hwang, Seong Mun
    • Clinics in Shoulder and Elbow
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    • 제22권3호
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    • pp.149-153
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    • 2019
  • We experienced acromial erosion and subsequent fracture after the treatment of Rockwood type V acromioclavicular dislocation with hook plate and coracoclavicular ligament augmentation. It was treated by using a surgical technique to address an acromial fracture and subsequent losses of reduction in acromioclavicular joint with two trans-acromial cortical screws (crossbar technique). The reduction state of acromioclavicular joint could be maintained by these two screws. Our crossbar technique could be considered as a good salvage procedure for the reduction loss caused by cutout or significant erosion of acromion after insertion of clavicular hook plate.

Protection and Dissection of Recurrent Laryngeal Nerve in Salvage Thyroid Cancer Surgery to Patients with Insufficient Primary Operation Extent and Suspicious Residual Tumor

  • Yu, Wen-Bin;Zhang, Nai-Song
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7457-7461
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    • 2015
  • Some thyroid cancer patients undergone insufficient tumor removal in the primary surgery in China. our aim is to evaluate the impact of dissection of the recurrent laryngeal nerve during a salvage thyroid cancer operation in these patients to prevent nerve injury. Clinical data of 49 enrolled patients who received a salvage thyroid operation were retrospectively reviewed. Primary pathology was thyroid papillary cancer. The initial procedure performed included nodulectomy (20 patients), partial thyroidectomy (19 patients) and subtotal thyroidectomy (10 patients). The effect of dissection and protection of the recurrent laryngeal nerve and the mechanism of nerve injury were studied. The cervical courses of the recurrent laryngeal nerves were successfully dissected in all cases. Nerves were adherent to or involved by scars in 22 cases. Three were ligated near the place where the nerve entered the larynx, while another three were cut near the intersection of inferior thyroid artery with the recurrent laryngeal nerve. Light hoarseness occurred to four patients without a preoperative voice change. In conclusion, accurate primary diagnosis allows for a sufficient primary operation to be performed, avoiding insufficient tumor removal that requires a secondary surgery. The most important cause of nerve damage resulted from not identifying the recurrent laryngeal nerve during first surgery, and meticulous dissection during salvage surgery was the most efficient method to avoid nerve damage.

Safe and Simplified Salvage Technique for Exposed Implantable Cardiac Electronic Devices under Local Anesthesia

  • Jung, Chang Young;Kim, Tae Gon;Kim, Sung-Eun;Chung, Kyu-Jin;Lee, Jun Ho;Kim, Yong-Ha
    • Archives of Plastic Surgery
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    • 제44권1호
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    • pp.42-47
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    • 2017
  • Background Skin erosion is a dire complication of implantable cardiac pacemakers and defibrillators. Classical treatments involve removal of the entire generator and lead systems, however, these may result in fatal complications. In this study, we present our experience with a simplified salvage technique for exposed implantable cardiac electronic devices (ICEDs) without removing the implanted device, in an attempt to reduce the risks and complication rates associated with this condition. Methods The records of 10 patients who experienced direct ICED exposure between January 2012 and December 2015 were retrospectively reviewed. The following surgical procedure was performed in all patients: removal of skin erosion and capsule, creation of a new pocket at least 1.0-1.5 cm inferior to its original position, migration of the ICED to the new pocket, and insertion of closed-suction drainage. Patients with gross local sepsis or septicemia were excluded from this study. Results Seven patients had cardiac pacemakers and the other 3 had implantable cardiac defibrillators. The time from primary ICED placement to exposure ranged from 0.3 to 151 months (mean, 29 months. Postoperative follow-up in this series ranged from 8 to 31 months (mean follow-up, 22 months). Among the 10 patients, none presented with any signs of overt infection or cutaneous lesions, except 1 patient with hematoma on postoperative day 5. The hematoma was successfully treated by surgical removal and repositioning of the closed-suction drainage. Conclusions Based on our experience, salvage of exposed ICEDs is possible without removing the device in selected patients.

BG 방법을 활용한 제조설비의 경제적 감가상각률 추정방안 (A Study on the Estimation of Economic Depreciation Rate on Industrial Property Using Broad Group Procedure)

  • 오현승;권세혁;조진형
    • 산업경영시스템학회지
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    • 제35권1호
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    • pp.148-153
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    • 2012
  • When the number of items of same type of industrial property is quite large, calculating depreciation for a group of such items may be more efficient than depreciating each item separately. Several different depreciation systems may be used for group depreciation. If the life of each vintage in an account are not estimated, then the BG procedure can be used; the BG procedure puts all vintages of the same type of property into a single broad group for depreciation purposes. In this case, only an estimate of the PASL and the net salvage ratio for all the property in the broad group is needed to calculate the depreciation charge.

Ilizarov술식을 이용한 사지 구제술 - 2례 보고 - (Limb-Salvage Surgery using Ilizarov Technique - Report of 2 cases -)

  • 조덕연;고은성;이지섭
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.226-232
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    • 1995
  • Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

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수지 재접합 실패시 허혈 상태의 수지골과 피판술을 이용한 구제술 (Salvage of Failed Digital Replantation Using Necrotizing Phalangeal Bone and Flap Coverage)

  • 권부경;정덕환;이재훈
    • Archives of Reconstructive Microsurgery
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    • 제16권2호
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    • pp.86-92
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    • 2007
  • Failure of reattachment of finger is inevitable in replantation surgery and that failure rate is about 10 % are reported in many authors. Management of the failed finger replantation is challenge to microsurgeons. We report 7 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as reverse radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; pinch power was average 1.2 pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

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