• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.608-618
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• 2021

Objective : The endoscopic endonasal transsphenoidal approach is a widely-used method for the surgical treatment of pituitary adenomas. We aimed to evaluate the results of endoscopic surgery by comparing preoperative classification methods and investigating their relationship with postoperative resection and remission rates and complications. Methods : We retrospectively reviewed the medical records of 236 patients (118 males) who underwent surgery for pituitary adenomas. Preoperative Knosp classification, tumor size (TS), suprasellar extension (SSE), postoperative resection and remission rates, and complications were evaluated. Results : The follow-up period was 3 months to 6 years. The patients' ages ranged between 16 and 84 years. Endocrinologically, 114 patients (48.3%) had functional adenoma (FA), and 122 patients (51.7%) had non-functional adenoma (NFA). Among the FA group, 92 (80.7%) showed remission. A statistically significant difference was found between patients with and without remission in terms of the Knosp, TS, and SSE classifications (p<0.01). Knosp, TS, and SSE classification grades were found to be correlated with the resection rates (p<0.01). Meningitis was seen in seven patients (3.0%), diabetes insipidus in 16 (6.9%; permanently in two [0.9%]), and rhinorrhea in 19 (8.1%). Thirty-six patients (15.3%) developed pituitary insufficiency and received hormone replacement therapy. Conclusion : The resection categories and remission rates of FAs were directly proportional to the adenoma sizes and Knosp grades, while the degree of suprasellar growth further complicated resection and remission rates. Adenoma sizes less than 2 cm and SSEs less than 1 cm are associated with favorable remission and resection rates.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.741-745
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• 1996

AVMs is not a neoplasm, but a congenital developmental anomalies.$^{5)}$ In oral and maxillofacial area, the high recurrence rate and more facial disfigurement give a difficult problem to surgen and patient.$^{8)}$ Conventional treatment modality nowadays is presurgical embolization and surgical resection. In treatment planning, we consider the possibility of complete surgical resection and the esthetics of soft tissue reconstruction. But, two things are very difficult to achieve. We present a patient with AVMs in left upper lip, he had presurgical embolization with Ivalon and Bucrylate, and conservative surgical procedure. So we present this possible treatment modality.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.793-811
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• 2020

Surgical resection remains the primary choice of treatment and the only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Gastric resection represents a challenging procedure, with a significant morbidity and non-negligible postoperative mortality. The interpretation of imaging after gastric surgery can be challenging due to significant modifications of the normal anatomy. After the surgery, the familiarity with expected imaging appearances is crucial for diagnosis and appropriate management of potentially life-threatening complications in patients who underwent gastric surgery. We review various surgical techniques used in gastric surgery and describe fluoroscopic and cross-sectional imaging appearances of normal postoperative anatomic changes as well as early and late complications after gastric surgery.

• Journal of Gastric Cancer
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• v.11 no.2
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• pp.116-121
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• 2011

Purpose: Gastric cancer surgery is a common operation in East Asia, such as Korea and Japan, and there has been a significant increase in the need for this procedure due to the aging population. As a result, surgery for the treatment of gastric cancer for elderly patients is expected to increase. This study examined the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients. Materials and Methods: From November 2008 to August 2010, 590 patients, who underwent a curative resection for gastric cancers, were enrolled. Patients who underwent palliative or emergency surgery were excluded. A retrospective analysis of the correlation between surgical outcomes and age was performed. The elderly were defined as patients who were over the age of 65 years. Results: The mean age of all patients was 58.3 years, and complications occurred in 87 cases (14.7%). The most common complication was wound infection and severe complications requiring surgical, endoscopic, or radiologic intervention developed in 52 cases (8.8%). The rate of complications increased with increasing age of the patients. Univariate analysis revealed age, comorbidity, extent of resection, operation time, and combined resection to be associated with surgical complications. In particular, age over 75 years old, operation time, and comorbidity were predictive factors in multivariate analysis. In the elderly, only comorbidity was associated with surgical complications Conclusions: The patients' age is the most important factor for predicting surgical complications. Surgeons should pay an attention to the performance of gastric cancer surgery on elderly patients. In particular, it must be performed carefully for elderly patients with a comorbidity.

• Current Optics and Photonics
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• v.3 no.3
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• pp.256-262
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• 2019

Extensive tumor resection accompanied by radiotherapy and chemotherapy is the standard of care for malignant gliomas. However, there is a significant obstacle to the complete resection of the tumor due to the difficulty of distinguishing tumor and normal brain tissue with a conventional surgical microscope. Recently, multiple studies have shown the possibility of fluorescence-guided surgery in malignant gliomas. The most used fluorescence dyes for brain tumor surgery are 5-aminolevulinic acid (5-ALA) and indocyanine green (ICG). In this paper, a new fluorescence guided operation system, which can detect both 5-ALA and ICG fluorescent images simultaneously, is presented. This operation system consists of light emitting diodes (LEDs) which emits 410 nm and 740 nm wavelengths. We have performed experiments on rats in order to verify the operation of the newly developed operation system. Oral administration and imaging were performed to observe the fluorescence of 5-ALA and ICG fluorescence in rats. When LEDs at wavelengths of 410 nm and 740 nm were irradiated on rats, 628 nm wavelength with a violet fluorescence color and 825 nm wavelength with a red fluorescence color were expressed in 5-ALA and ICG fluorescent material, respectively, thus we were able to distinguish the tumor tissues easily. Previously, due to the poor resolution of the conventional surgical microscope and the fact that the color of the vein is similar to that of the tumor, the tumor resection margin was not easy to observe, thus increasing the likelihood for cancer recurrence. However, when the tumor is observed through the fluorescence guided operation system, it is possible to easily distinguish the color with the naked eye and it can be completely removed. Therefore, it is expected that surgical removal of cancerous tumors will be possible and surgical applications and surgical microscopes for cancer tumor removal surgery will be promising in the future.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.217-221
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• 1991

Bronchiectasis is bilateral in approximately 30% of patients. Although the presence of bilateral bronchiectasis was frequently considered a contraindication to surgical resection due to excessive loss of functional pulmonary parenchyma, it is a correct view that the involved broncho-pulmonary segments are functionless and risks to the as yet uninvolved segments and should be removed if the patient`s pulmonary function is tolerable. We report a case of multisegmental bilateral bronchiectasis treated by bilateral simultaneous pulmonary resection through a median sternotomy. Five bronchiectatic segments were resected, which were right middle lobe, anterobasal segment of the right lower lobe, and lingula of the left upper lobe.

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.50-56
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• 2002

Advanced or recurrent thyroid cancer, and metastatic paratracheal lymph nodes may directly invade the trachea and lead to tracheal stenosis. In these cases the stenosis is not circumferential and it would be possible to reconstruct the trachea after partial resection of the stenotic trachea. We experienced five cases of tracheal reconstruction after partial resection of the tracheal wall in four Patients of advanced thyroid cancer, and in one Patient of malignant paratracheal lymphadenopathy.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.1-8
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• 2023

Pancreatic cancer treatment has advanced. In particular, effective chemotherapy regimen development has fundamentally altered the therapeutic concept and strategy for pancreatic cancer treatment. Consequently, the prognosis of patients with pancreatic cancer has gradually improved. Conversion surgery for locally advanced pancreatic cancer may offer long-term survival or even a full recovery in some individuals. In contrast, metastatic pancreatic cancer has long been considered a surgical contraindication because aggressive surgical resection of the metastatic lesions does not prolong patient survival. Unexpectedly positive benefits of anticancer therapy in recent clinical experience were observed even with metastatic pancreatic cancer. To date, little evidence presented the success of surgical resection for metastatic pancreatic cancer treatment in such rare cases. However, hope and concern are growing that surgical intervention, even in patients with metastatic cancer, may result in favorable outcomes. Several studies suggested different surgical intervention effects depending on metastasis sites and patterns. Thus, this review summarizes the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discusses future perspectives.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.156-160
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• 2009

Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.

• Journal of Korean Neurosurgical Society
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• v.65 no.3
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• pp.469-478
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• 2022

Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.