• Radiation Oncology Journal
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• v.29 no.4
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• pp.277-282
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• 2011

Purpose: This study was performed to evaluate the change in the lumpectomy cavity volumes before and after whole breast radiation therapy (WBRT) and to identify factors associated with the change of volume. Materials and Methods: From September 2009 to April 2010, the computed tomography (CT) simulation data from 70 patients obtained before and after WBRT was evaluated. The lumpectomy cavity volumes were contoured based on surgical clips, seroma, and postoperative changes. Significant differences in the data from pre-WBRT CT and post-WBRT CT were assessed. Multiple variables were examined for correlation with volume reduction in the lumpectomy cavity. Results: The mean and median volume reduction in the lumpectomy cavity after WBRT were 17.6 $cm^3$ and 16.1 $cm^3$, respectively with the statistical significance (p < 0.001). The volume reduction in the lumpectomy cavity was inversely correlated with time from surgery to radiation therapy (R = 0.390). The presence of seroma was significantly associated with a volumetric change in the lumpectomy cavity after WBRT (p = 0.011). Conclusion: The volume of lumpectomy cavity reduced significantly after WBRT. As the time from surgery to the start ot WBRT increased, the volume reduction in the lumpectomy cavity during WBRT decreased. A strong correlation was observed between the presence of seroma and the reduced volume. To ensure appropriate coverage and to limit normal tissue exposure during boost irradiation in patients who has seroma at the time of starting WBRT, repeating CT simulation at boost planning is suggested.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.676-679
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• 2006

Purpose: Breast volume is one of the crucial measurements in preoperative planning and postoperative evaluation of the results in mammoplasty. There are several methods suggested by different authors, but there is still no commonly accepted standard methods for measuring breast volume. To help the surgeons to base their estimation on an objective evaluation, we developed a simple method using Polyethylene bag and plaster molding. Methods: After Polyethylene bags were put in suitable size on both breasts of the patient in upright position, silk plaster was molded on the surface evenly. Then molds can be obtained after marking boundaries of breasts with a pen. Breast volume measurement can be done by filling water in the molds and measuring it. Moreover, postoperative design for natural skin brassier was possible using the molds. Results: This method was applied to 2 patients for reduction mammoplasty and the breast volume measurement was simple, hygienic and accurate, done within 10 minutes. Conclusion: This method using Polyethylene bag and plaster molding has several advantages. 1. It is comparatively accurate regardless of the size and shape of patient's breasts in upright position. 2. Measurement time is short and inconvenience and shame of patients can be reduced by making molds after putting on Polyethylene bags. 3. It is relatively economical and uses easily available hygienic materials. 4. The postoperative shape and volume of breasts can be predicted by using molds preoperatively.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.20-27
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• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.234-240
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• 2010

Purpose: Most gastric cancer patients undergo operations at large tertiary hospitals in Korea. However, some patients are treated at low volume hospitals. We investigated patient outcomes after gastric surgery at a secondary hospital and compared with outcomes of large volume centers. Materials and Methods: We included 184 patients who underwent gastric surgery for gastric cancer at our hospital from January 2003 to December 2008. We conducted a retrospective study and evaluated the clinicopathological characteristics, clinical outcomes and survival rate of patients. Results: Mean age was 61.7 years old. Male to female ratio was 2.2 : 1. Proportion of early gastric cancer was 38.6% and that of advanced gastric cancer was 61.4%. The 5 year overall survival rate of 184 patients was 66.3%. The overall survival rate was significantly lower for people over 62 years old. The morbidity rate and mortality at our hospital were 10.3% and 0.5%, respectively. Conclusions: The overall survival rate, morbidity and mortality were similar to those of the previous reports from Korea. Treatment of gastric cancer at a secondary hospital is feasible and safe. Standardization of operations and management of gastric cancer patients of the Korean Gastric Cancer Association is the most important factor to achieve these outcomes.

• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.53-57
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• 2015

Background: Surgical outcomes after orbital wall decompression have focused on the degree of exophthalmos and intraocular pressure. The aim of this research was to evaluate intraorbital volume using computed tomography (CT) images following two-wall decompression using a combined subcilliary and endoscopic approaches. Methods: A retrospective review was performed for all patients who had undergone the two-wall decompression method. The pre/postoperative CT images were used to evaluate changes in intraocular volume. Intraocular pressure was evaluated using applanation tonometry. Surgical details are discussed within the body of text. Results: Two-wall decompression thru the medial wall and floor was associated with an average intraorbital volume change of $7.3cm^3$, with maximal accommodation up to $13cm^3$. Changes in intraocular pressures were not statistically significant. Conclusion: Two-wall decompression was effective in accommodation of up to $13cm^3$ of soft tissue herniation. There was no statistically significant association between changes in volume to pressure.

• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.630-635
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• 1998

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.453-456
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• 2017

Patients are increasingly seeking repair of their earlobes following ear gauging. Research has shown that current repair techniques either excessively reduce the lobular volume or leave an obvious scar along the free edge of the earlobe. In our case series, we describe the use of a novel technique for repairing earlobes following ear gauging using a rolling earlobe flap that preserves the lobular volume and avoids leaving a scar on the free edge of the lobule. The procedure was performed on 3 patients (6 earlobes) who had defects from ear gauging that ranged from 3.0 to 6.5 cm. There were no postoperative complications of infection, wound dehiscence, flap necrosis, hypertrophic scars, or keloids, and all patients were highly satisfied with the postoperative results. This versatile technique allows for an aesthetically pleasing reconstruction of the lobule with the advantages of: the absence of a surgical scar on the free edge of the lobule, preserving the lobule volume, and presenting a highly customizable technique that allows lobules to be created with various shapes and volumes.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.502-508
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• 2017

Background Breast-conserving therapy is defined as a breast-conserving wide local excision (WLE) of a mammary tumour combined with postoperative radiotherapy. Immediate restoration of the mammary shape by use of breast reduction techniques (volume displacement) or tissue replacement techniques (volume replacement) is gaining popularity to prevent breast malformation. Methods To date, using the internal mammary artery perforator (IMAP) flap has been suggested for immediate volume replacement after WLE, but has never been evaluated in a published study. Results We applied this flap in 12 women (mean age, 56.1 years) after WLE (mean specimen weight, 46.5 g) of the medial aspect of the breast. Over a median follow-up of 35.3 months (standard deviation, 1.2 months), 4 women needed repeated surgery for dog-ear correction of the donor site. Conclusions In our experience, the use of an IMAP flap was a reliable technique with good cosmetic outcomes after oncoplastic reconstruction. In this series, donor site revision often proved necessary initially, but we showed that this may easily be prevented.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.370-375
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• 2019

Background: Some parts of a maxillary fracture-for example, the medial and posterior walls-may remain unreduced because they are unapproachable or hard to deal with. This study aimed to investigate the self-healing process of unreduced maxillary membranous parts of fractures through a longitudinal computed tomography (CT) analysis of cases of unilateral facial bone injuries involving the maxillary sinus walls. Methods: Thirty-two patients who had undergone unilateral facial bone reduction surgery involving the maxillary sinus walls without reduction of the medial and posterior walls were analyzed in this retrospective chart review. Preoperative, immediate postoperative, and 3-month postoperative CT scans were analyzed. The maxillary sinus volume was calculated and improvements in bone continuity and alignment were evaluated. Results: The volume of the traumatized maxillary sinuses increased after surgery, and expanded significantly by 3 months postoperatively (p< 0.05). The significant preoperative volume difference between the normal and traumatized sides (p= 0.024) resolved after surgery (p> 0.05), and this resolution was maintained at 3 months postoperatively (p > 0.05). The unreduced parts of the maxillary bone showed improved alignment and continuity (in 75.0% and 90.6% of cases, respectively), and improvements in bone alignment and bone continuity were found to be correlated using the Pearson chi-square test (p= 0.002). Conclusion: Maxillary wall remodeling through self-healing occurred concomitantly with an increase in sinus volume and simultaneous improvements in bone alignment and continuity. Midfacial surgeons should be aware of the natural course of unreduced fractured medial and posterior maxillary walls in complex maxillary fractures.

• Archives of Plastic Surgery
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• v.44 no.4
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• pp.308-312
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• 2017

Background Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. Methods In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated. Results In the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P =0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05). Conclusions This study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.