• Asian Pacific Journal of Cancer Prevention
• /
• 제17권7호
• /
• pp.3325-3328
• /
• 2016

Background: There are limited studies on oncoplastic breast conserving surgery in Asian women. We aimed to determine the applicability and safety of oncoplastic surgery, highlighting the specific circumstances when it will be most useful and compare our preferred technique with the worldwide practice of oncoplastic approaches. Materials and Methods: Breast cancer patients who underwent oncoplastic breast conserving surgery at a single institution from 1st May 2014-31st March 2015 were included. Data on patient demographics, tumor characteristics and the type of oncoplastic surgery performed were collected. Results: Nineteen breast cancer patients were identified. 42.1% of patients had grade I ptosis. The indications for surgery included a large tumor to breast size ratio (52.6%), multifocal/multicentric lesions (36.8%) and asymmetric breasts (10.6%), averting a mastectomy in 89.4%. Round block was the commonest technique in 63% of patients, in contrast to the inverted T pattern most frequently used in renowned institutions in the West. Mean and median tumor size and weight of specimen were 29.4/25mm (11 - 75mm) and 77g/64g (10 - 246g) respectively. Re-excision rate was 10.5%. Complete mastectomy was performed for one patient. One patient developed wound dehiscence which was treated conservatively. Cosmetic outcome was rated as excellent/good by 94.7% of patients. The patients remained clinically well after a median 16 months follow up. Conclusions: Oncoplastic breast conserving surgery is useful in a specific subgroup of Asian patients with a relatively small breast volume and minimal ptosis. Round block was the commonest technique in our series, in contrast to the worldwide utility of oncoplastic techniques. It is oncologically safe and has good cosmetic outcomes.

• Journal of Chest Surgery
• /
• 제35권2호
• /
• pp.166-169
• /
• 2002

흉골 절개술 후 종격동염은 드물게 발생하나 심장 수술후 생명을 위협하는 합병증으로 발전할 수 있다. 지금까지는 흉골 절개술 후 발생한 창상 감염의 치료로서 창상세척과 변연 절개술 후 직접 상처 부위를 봉합하거나 근육 파판을 사용하여 왔다. 흉골 절개술 후 발생한 창상 감염의 새로운 치료로서 VAC(Vacuum-assisted closure) 술기에 대해 기술 하고자 한다. 이 술기를 흉골 절개술 후 발생한 창상감염 띤 종격동염 환자 3명에게 성공적으로 적용하였고, 이러한 새로운 방식으로 흉골 부위 상처를 치유할 수 있었다.

• Journal of Gastric Cancer
• /
• 제21권2호
• /
• pp.132-141
• /
• 2021

Purpose: Intracorporeal esophagojejunostomy during reduced-port gastrectomy for proximal gastric cancer is a technically challenging technique. No study has yet reported a robotic technique for anastomosis. Therefore, to address this gap, we describe our reduced-port technique and the short-term outcomes of intracorporeal esophagojejunostomy. Materials and Methods: We conducted a retrospective review of patients who underwent a totally robotic reduced-port total or proximal gastrectomy between August 2016 and March 2020. We used an infra-umbilical Single-Site^® port with two additional ports on both sides of the abdomen. To transect the esophagus, a 45-mm endolinear stapler was inserted via the right abdominal port. The common channel of the esophagojejunostomy was created between the apertures in the esophagus and proximal jejunum using a 45-mm linear stapler. The entry hole was closed with a 45-mm linear stapler or robot-sewn continuous suture. All anastomoses were performed without the aid of an assistant or placement of stay sutures. Results: Among the 40 patients, there were no conversions to open, laparoscopic, or conventional 5-port robotic surgery. The median operation time and blood loss were 254 min and 50 mL, respectively. The median number of retrieved lymph nodes was 40.5. The median time to first flatus, soft diet intake, and length of hospital stay were 3, 5, and 7 days, respectively. Three (7.5%) major complications, including two anastomosis-related complications and a case of small bowel obstruction, were treated with an endoscopic procedure and re-operation, respectively. No mortality occurred during the study period. Conclusions: Intracorporeal esophagojejunostomy during reduced-port gastrectomy can be safely performed and is feasible with acceptable surgical outcomes.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.81-81
• /
• 2008

• Archives of Plastic Surgery
• /
• 제44권4호
• /
• pp.351-352
• /
• 2017

• Archives of Plastic Surgery
• /
• 제43권1호
• /
• pp.88-92
• /
• 2016

There are two general categories of lateral osteotomy techniques-the external perforating method and the internal continuous method. Regardless of which technique is used, procedural effectiveness is hampered by limited visualization in the surgical field. Considering this point, we devised a new technique that involves using a wide subperiosteal dissection and internal perforation under direct visualization. Using an intranasal approach, whereby the visibility of the intended fracture line was maintained, enabled a greater degree of control, and in turn, results that were more precise, and thus predictable and reproducible. Traditionally, it has been taken as dogma that the periosteum must be preserved, considering the potential for dead space and bony instability; however, under sufficient visualization of the surgical field with an internal perforating method, complete osteotomy with fully preserved intranasal mucosa could be conducted exactly as intended. This intact mucosal lining compensates for the elevated periosteum. Compressive dressing and drainage through a Silastic angio-needle catheter enabled the elimination of dead space. Therefore, precise, reproducible, and predictable osteotomy minimizing the potential for associated complications such as ecchymosis, that is, bruising owing to hemorrhage, could be performed. In this article, we introduce a novel technique for lateral osteotomy with improved visualization.

• Journal of International Society for Simulation Surgery
• /
• 제3권2호
• /
• pp.80-83
• /
• 2016

A 37-year-old male was assaulted and complained of severe periorbital swelling. Physical examination revealed that there were limitation of eyeball movement on upper gaze, diplopia, and hypoesthesia on the infraorbital nerve innervating region. Three-dimensional (3D) computed tomography (CT) of facial bone exhibited the fracture of orbital floor accompanying the significant amount of orbital contents' herniation extending to the far posterior part. To recover the orbital volume and restore orbital floor without threatening the optic nerve, preoperative simplified simulation was applied. The posterior margin of the fractured orbit was delineated with simulation technique using cross-linkage between the coronal and sagittal sections based on the referential axial view of the CT scans. Dissection, reduction of orbital contents, and insertion of the absorbable mesh plate molded after the prefabricated template by the simulation technique was performed. Extensive orbital floor defect was successfully reconstructed and there were no serious complications. The purpose of this report is to emphasize the necessity of preoperative simulation in case of restoring the extensive orbital floor defect.

• 대한족부족관절학회지
• /
• 제8권2호
• /
• pp.166-170
• /
• 2004

Purpose: To evaluate the results of MIPPO (minimal invasive percutaneous plate osteosynthesis) technique for distal tibial metaphyseal fractures. Materials and Methods: It is a retrospective study of 13 patients who were treated by MIPPO technique for distal tibial metaphyseal fractures from Jan. 2001 to Jan. 2003. The average age was 46.7 years and mean follow-up period was 13.3 months. According to AO classification, there were 8 cases of A1, 3 cases of A2, 1 case of B1 and 1 case of C2. One case of A1 was a Gustilo-Anderson type I open fracture and fibular fractures were combined in 12 cases. We applied anatomical reduction and internal fixation for the fibular fractures and internal fixation on the medial side of the tibia by MIPPO technique for distal tibial metaphyseal fractures. Clinical results were evaluated using radiographic results, Neer score, the starting time of postoperative exercise and clinical complications. Results: According to the Neer score, all cases showed satisfactory results. Active ankle ROM was started at average 2.4 weeks ($2{\sim}4$ weeks) and full weight bearing ambulation at average 5.2 weeks ($4{\sim}8$ weeks) postoperatively. Union of fractures was obtained by average 14.4 weeks ($8{\sim}18$ weeks) postoperatively. Two cases showed $5^{\circ}$ limitation of motion without functional deficits and other cases showed satisfactory ROM results. One case had $6^{\circ}$ valgus deformity without functional deficits. There were not any other complications like soft tissue problems and delayed-or non-union. Conclusion: MIPPO technique for the treatment of distal tibial metaphyseal fractures is a feasible technique with a good clinical outcomes.

• Journal of Chest Surgery
• /
• 제23권4호
• /
• pp.820-824
• /
• 1990

A very early and effective technique of sternal closure by plastic plates was successfully applied to a 7-months-old infant of tetralogy of Fallot in whom the standard closure of sternum was not possible due to massive generalized edema after cardiopulmonary bypass for total correction. This technique provides not only solid but also permanent closure of the sternum so that any early reoperation for closure of sternum and its accompanying risk of infection in many other known methods can be avoided.

• Archives of Plastic Surgery
• /
• 제41권6호
• /
• pp.693-701
• /
• 2014

Background A thin perforator flap is one of the best methods for covering defects. This study aimed to revisit and further test the rapidly advancing field of flap thinning techniques. Methods We performed two cadaveric studies to test the known flap thinning methods, and then applied these methods to a clinical series. In the first study, five cadavers were used to observe the anatomical relation of the perforator with the subdermal plexuses and the subcutaneous fat layer by injecting a colored latex solution. The second study was done on four cadavers independently from the first study. Last, a clinical series was performed on 15 patients. Results The areolar fat lobules of 10 anterolateral thigh perforator (ALT), seven deep inferior epigastric artery perforator (DIEAP), and six thoracodorsal artery perforator (TAP) flaps were dissected to reduce the flap thickness guided by the colored vascular pattern. On average, the ALT, DIEAP, and TAP flaps were reduced to $32.76%{\pm}9.76%$, $37.01%{\pm}9.21%$, and $35.42%{\pm}9.41%$, respectively. In the second study, the areolar fat lobules were directly dissected in six ALT, six TAP, and four MSAP flaps, and an average reduction in flap thickness of $53.41%{\pm}5.64%$, $52.30%{\pm}2.88%$, and $47.87%{\pm}6.41%$, respectively, was found. In the clinical series, 13 out of the 15 cases yielded satisfactory outcomes with an average thickness reduction of $37.91%{\pm}7.15%$. Conclusions These multiple studies showed that the deep fat layer could be safely removed to obtain a thin yet viable perforator flap. This evidence suggests that the macroscopic flap thinning technique can achieve thin flaps. Surgeons should consider this technique before embracing the latest technique of supermicrosurgery.