• 제목/요약/키워드: Surgery first approach

검색결과 234건 처리시간 0.029초

안장 색전증을 유발한 좌심방 점액종 -수술 치험 1례- (Saddle Embolism Caused by Left Atrial Myxoma -A Case Report-)

  • 송정근
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.316-319
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    • 1995
  • Systemic emboli occur in approximately one-third of patients with cardiac myxoma. Embolization is common because of the friability of the tumor and intracardiac location. Embolic episodes in young patients with normal sinus rhythm should arouse suspicions of cardiac myxoma in the absence of active endocarditis. We present one case of 17 years old girl having saddle embolism combined with left atrial myxoma. We planned staged operation. First, the emergency thromboembolectomy of aortic bifurcation was performed through bilateral transfemoral approach with use of Forgaty catheter. One week later, the extirpation of myxoma was successfully done with ECC.

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성인 전폐정맥 연결이상 [TAPVR] 교정 1례 보고 (TAPVC)

  • 유회성
    • Journal of Chest Surgery
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    • 제11권2호
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    • pp.123-128
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    • 1978
  • This 18 year old girl with total anomalous venous connection, which was corrected surgically for the first time in Korea, is presented here. This patient has mild cyanosis, ejection systolic murmur with splitting of $S_2$ ,identical $O_2$ saturation of bleed samples from right and left chambers of the heart. The type was supracardiac TAPVC. On conventional cardiopulmonary by pass was used, and an right sided approach was employed. Post-op. course was smooth except for transient arrhythmia, low blood pressure and jaundice. She left hospital in a good general conditions.

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일란성 쌍둥이에서 발생한 항문관 중복증 (A Set of Monozygotic Female Twins With Anal Canal Duplication)

  • 최순옥
    • Advances in pediatric surgery
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    • 제9권2호
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    • pp.117-120
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    • 2003
  • Anal canal duplications occurring in a pair of 4 month-old healthy female twins are presented. The openings were located in the posterior midline of the anus since birth without a history of perianal abscess or swelling. Excision of the duplicated anal canals was performed using posterior sagittal approach. Although the anal canal duplication occurs predominantly in female, to our knowledge, this is the first case of anal duplication in a monozygotic female twins reported.

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좌측 폐동맥 형성 부전증 : 수술치험 1례 (Left pulmonary artery agenesis - One Case Report -)

  • 김용환
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.83-87
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    • 1991
  • A unilateral pulmonary artery agenesis, which develops occasionally as one of the associated anomalies in congenital cardiovascular defect like as tetralogy of Fallot, is very rare anomaly as an isolated congenital defect. The diagnostic approach for the pulmonary artery agenesis is first suggested by the unique appearance of the involved lung on a routinely checked chest roentgenogram, because most patients are asymptomatic unless pulmonary infection had been superimposed. We have recently experienced a case of left pulmonary artery agenesis, which was diagnosed by perfusion scan, digital subtraction angiogram and then treated by left pneumonectomy in a 9 year-old boy, and presented hereby with the review of relevant literature.

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흉곽 출구 증후군 수술치험 1례 (Surgical Treatment of Thoracic Outlet Syndrome)

  • 서정욱
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.506-508
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    • 1994
  • Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. A 35-year old female was evaluated for right hand numbness. This patient had a history of headache, right shoulder pain, and right hand numbness during 10 months.Preoperative angiography, EMG, and NCV was performed. First rib and cervical rib resection was done with transaxillary approach. After operation, right hand numbness and right shoulder pain were disappeared. Postoperative course was uneventful.

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Biomarkers Screening Between Preoperative and Postoperative Patients in Pancreatic Cancer

  • Li, Pei;Yang, Juan;Ma, Qing-Yong;Wu, Zheng;Huang, Chen;Li, Xu-Qi;Wang, Zheng
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4161-4165
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    • 2013
  • Objective: To investigate discriminating protein patterns and potential biomarkers in serum samples between pre/postoperative pancreatic cancer patients and healthy controls. Methods: 23 serum samples from PC patients (12 preoperative and 11 postoperative) and 76 from healthy controls were analyzed using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry (MALDI-TOF MS) technique combined with magnetic beads-based weak cation-exchange chromatography (MB-WCX). ClinProTools software selected several markers that made a distinction between pancreatic cancer patients and healthy controls. Results: 49 m/z distinctive peaks were found among the three groups, of which 33 significant peaks with a P < 0.001 were detected. Two proteins could distinguish the preoperative pancreatic cancer patients from the healthy controls. About 15 proteins may be potential biomarkers in assessment of pancreatic cancer resection. Conclusion: MB-MALDI-TOF-MS method could generate serum peptidome profiles of pancreatic cancer and provide a new approach to identify potential biomarkers for diagnosis and prognosis of this malignancy.

Iatrogenic Vertebral Artery Injury During Anterior Cervical Spine Surgery : Report of Two Cases

  • Lee, Jae-Hyun;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제40권6호
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    • pp.450-454
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    • 2006
  • The incidence of vertebral artery injury during the anterior approach to the cervical spine is rare, but potentially lethal. The authors describe two cases of vertebral artery injury during anterior cervical decompression surgery. In the first case, infection was the cause of the vertebral artery injury. During aggressive irrigation and pus drainage, massive bleeding was encountered, and intraoperative direct packing with hemostatic agents provided effective control of hemorrhage. Ten days after surgery, sudden neck swelling and mental deterioration occurred because of rebleeding from a pseudoaneurysm. In the second case, the vertebral artery was injured during decompression of cervical spondylosis while drilling the neural foramen. After intraoperative control of bleeding, the patient was referred to our hospital, and a pseudoaneurysm was detected by angiography four days after surgery. Both pseudoaneurysms were successfully occluded by an endovascular technique without any neurological sequelae. Urgent vertebral angiography, following intraoperative control of bleeding by hemostatic compression in cases of vertebral artery injury during anterior cervical decompression, should be performed to avoid life-threatening complications. Prompt recognition of pseudoaneurysm is mandatory, and endovascular treatment can be life saving.

DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report

  • Young Hwii Ko;Jong Gyun Ha;Jae Yoon Jang;Yeung Uk Kim
    • Journal of Yeungnam Medical Science
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    • 제41권1호
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    • pp.48-52
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    • 2024
  • While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Robot-Assisted Thoracoscopic Esophagectomy with Total Mediastinal Lymphadenectomy: A Guide to a Systematic Approach Using the Concept of Fascial Plane Dissection

  • Park, Byung Jo;Kim, Dae Joon
    • Journal of Chest Surgery
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    • 제54권4호
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    • pp.294-301
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    • 2021
  • Recent case series and meta-analyses have suggested that robot-assisted minimally invasive esophagectomy (RAMIE) could be a useful alternative to video-assisted thoracic surgery esophagectomy. The advantages of RAMIE are a 3-dimensional view, 7 degrees of freedom, and tremor filtering, which enable more meticulous lymph node dissection with a lower incidence of complications. However, in radical esophagectomy, understanding the concepts of the fascia and compartment is crucial for successful and reliable dissection. The first RAMIE in Korea was performed by our team in July 2006, and since then, we have developed related techniques to achieve better short- and long-term outcomes. The key step in RAMIE for esophageal squamous cell carcinoma is dissection of the upper mediastinum due to the difficulty of lymph node dissection and the high incidence of nodal metastasis in the area. Herein, we describe the technique of fascial plane dissection with esophageal suspension during RAMIE.

Brace Compression for Treatment of Pectus Carinatum

  • Jung, Joonho;Chung, Sang Ho;Cho, Jin Kyoung;Park, Soo-Jin;Choi, Ho;Lee, Sungsoo
    • Journal of Chest Surgery
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    • 제45권6호
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    • pp.396-400
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    • 2012
  • Background: Surgery has been the classical treatment of pectus carinatum (PC), though compressive orthotic braces have shown successful results in recent years. We propose a non-operative approach using a lightweight, patient-controlled dynamic chest-bracing device. Materials and Methods: Eighteen patients with PC were treated between July 2008 and June 2009. The treatment involved fitting of the brace, which was worn for at least 20 hours per day for 6 months. Their degree of satisfaction (1, no correction; 4, remarkable correction) was measured at 12 months after the initiation of the treatment. Results: Thirteen (72.2%) patients completed the treatment (mean time, $4.9{\pm}1.4$ months). In patients who completed the treatment, the mean overall satisfaction score was $3.73{\pm}0.39$. The mean satisfaction score was 4, and there was no recurrence of pectus carinatum in patients who underwent the treatment for at least 6 months. Minimal recurrence of pectus carinatum after removal of the compressive brace occurred in 5 (38.5%) patients who stopped wearing the compressive brace at 4 months. Conclusion: Compressive bracing results in a significant improvement in PC appearance in patients with an immature skeleton. However, patient compliance and diligent follow-up appear to be paramount for the success of this method of treatment. We currently offer this approach as a first-line treatment for PC.