• 제목/요약/키워드: Surgical adhesion

검색결과 128건 처리시간 0.022초

Patient-reported satisfaction after robot-assisted hysterectomy among Korean patients with benign uterine disease

  • Park, Suyeon;Lee, Young-eun;Cho, Seong-Sik;Park, Sung-ho;Park, Sung Taek
    • Obstetrics & gynecology science
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    • 제61권6호
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    • pp.675-683
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    • 2018
  • Objective This study aimed to evaluate patient-reported satisfaction following robot-assisted hysterectomy due to benign uterine disease, and to identify the factors associated. Methods We used a questionnaire to evaluate patients' satisfaction with robot-assisted hysterectomy. The questions concerned overall patient-reported satisfaction and specific factors affecting satisfaction, including postoperative pain, return to daily life, the hospital experience, wounds, cost, the doctor-patient relationship, whether expectations were met, and whether detailed information was provided. We also collected data from patient records, such as uterine weight, rate of pelvic adhesion, operation time, rate of transfusion, delayed discharge, and readmission. One hundred patients who underwent robot-assisted hysterectomy participated in the study. Seventy-three fully completed questionnaires were returned. Results The majority of patients (95.9%) were satisfied with robot-assisted hysterectomy. The doctor-patient relationship, whether expectations were met, the hospital experience, wounds, and whether detailed information was provided were statistically significant factors influencing patients' overall satisfaction. Payment of fees and clinical and surgical outcomes did not significantly influence patients' overall satisfaction. Conclusion Our findings show that most patients reported high levels of satisfaction following robot-assisted hysterectomy, regardless of cost or clinical and surgical outcomes. Therefore, if gynecologists consider robot-assisted hysterectomy suitable for patients they need not hesitate based on potential costs; they should feel confident in recommending the procedure to patients.

동연동성 좌측결장을 이용한 식도재건술 (Esophageal Reconstruction with Isoperistaltic Interposition of Left Colon)

  • 성시찬
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.895-902
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    • 1991
  • The surgical experience on 18 patients with benign or malignant stricture of the esophagus who underwent isoperistaltic interposition of left colon from April 1989 to July 1991 was reviewed. During same period 22 esophageal reconstructions with colon were performed, but 3 patients who had intraabdominal adhesion in the left upper quadrant and one patient who had uncertainty of blood supply of left colic artery could not undergo iso-peristaltic interposition of left colon. There were 12 male and 6 female patients ranging from 16 to 65 years of age. 12 patients had corrosive esophageal stricture, two had cancer of esophagus, and another two had hypopharyngeal cancer. The postoperative complications developed in 7 patients [38.8%] and most frequently encountered complication was cervical anastomotic leakage, which was successfully managed with simple drainage in all cases but one malignant patient. There was no operative mortality. The esophageal reconstruction with isoperistaltic left colon resulted in good function in 14 patients[77.8%], fair in 3 patients[16.7], and poor in 1 patient[5.6%]. In this experience esophageal reconstruction using isoperistaltic left colon is a satisfactory method that can be accomplished with acceptable morbidity and mortality.

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Two Cases of Laparoscopic Adhesiolysis for Chronic Abdominal Pain without Intestinal Obstruction after Total Gastrectomy

  • Choi, Hyun Jung;Yoon, Sang Chul;Kim, Yong Jin
    • Journal of Gastric Cancer
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    • 제12권4호
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    • pp.249-253
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    • 2012
  • Chronic abdominal pain remains a challenge to all known diagnostic and treatment methods with patients undergoing numerous diagnostic work-ups including surgery. However, the surgical treatment of patients with chronic intractable abdominal pain is controversial. There has been no discussion of the indications for adhesiolysis in cases of obstruction or strangulation of the bowel, and adhesiolysis by laparotomy has never gained acceptance as a treatment modality for chronic abdominal pain. One of the reasons for this lack of acceptance is the high complication rate during and after adhesiolysis. Laparoscopic surgery has been accepted as a technique for diagnostic and therapeutic procedures in general surgery. Laparoscopy allows surgeons to see and treat many abdominal changes that could not otherwise be diagnosed. Here we report two cases of successful symptomatic improvement through laparoscopic adhesiolysis for chronic abdominal pain without intestinal obstruction after total gastrectomy.

Vestibular Schwannoma Atypically Invading Temporal Bone

  • Park, Soo Jeong;Yang, Na-Rae;Seo, Eui Kyo
    • Journal of Korean Neurosurgical Society
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    • 제57권4호
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    • pp.292-294
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    • 2015
  • Vestibular schwannoma (VS) usually present the widening of internal auditory canal (IAC), and these bony changes are typically limited to IAC, not extend to temporal bone. Temporal bone invasion by VS is extremely rare. We report 51-year-old man who revealed temporal bone destruction beyond IAC by unilateral VS. The bony destruction extended anteriorly to the carotid canal and inferiorly to the jugular foramen. On histopathologic examination, the tumor showed typical benign schwannoma and did not show any unusual vascularity or malignant feature. Facial nerve was severely compressed and distorted by tumor, which unevenly eroded temporal bone in surgical field. Vestibular schwannoma with atypical invasion of temporal bone can be successfully treated with combined translabyrinthine and lateral suboccipiral approach without facial nerve dysfunction. Early detection and careful dissection of facial nerve with intraoperative monitoring should be considered during operation due to severe adhesion and distortion of facial nerve by tumor and eroded temporal bone.

심근 경색후 발생한 좌심실 파열을 동반한 심실중격 결손의 외과적 치료 -1례 보고- (Surgical Treatment of Post-Infarction Ventricular Septal Defect with Left Ventricular Rupture -A Case Report-)

  • 김현조;김두성;안혁
    • Journal of Chest Surgery
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    • 제28권9호
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    • pp.857-860
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    • 1995
  • In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

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원발성 종격동 활막육종- 1례 보고- (Primary Synovial Sarcoma in the Mediastinum- A case report-)

  • 배지훈;권오춘;이섭;조창호
    • Journal of Chest Surgery
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    • 제34권5호
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    • pp.437-440
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    • 2001
  • Synovial sarcoma is a malignant soft tissue tumor that primarily occurs in the praarticular regions, especially in the knee. They are composed of keratin-positive epithelial cells and vimentin-positive spindle cells. We report a 76 year old woman with a primary synovial sarcoma in the mediastinum that had severe adhesion to the right side of pericardium. Primary synovial in the midiastinum is extremely rare and this is the first case reported in the Korean literature. The mass including the pericardium was resected and the defect was closed with Gore-Tex patch. The patient is well and free of disease 6 months after the operation.

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Acquired synechia of the tongue to the mouth floor

  • Sodnom-Ish, Buyanbileg;Nguyen, Truc Thi Hoang;Eo, Mi Young;Cho, Yun Ju;Kim, Soung Min;Lee, Jong Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권5호
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    • pp.394-397
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    • 2021
  • Sodium hydroxide or caustic soda is a corrosive agent that can cause extensive damage to the oral mucosa, lips, and tongue when ingested either accidentally or intentionally. These injuries include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment in facial expression. In the present article, we report a unique case of tongue adhesion to the mouth floor and its surgical management in a 66-year-old female patient, who had a history of caustic soda ingestion.

Application of superficial keratectomy and soft contact lens for the treatment of symblepharon in a cat: a case report

  • Kim, Youngsam;Kang, Seonmi;Seo, Kangmoon
    • Journal of Veterinary Science
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    • 제22권2호
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    • pp.19.1-19.5
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    • 2021
  • A 7-month-old intact female Persian cat was diagnosed with symblepharon accompanied by epiphora, brownish ocular discharge, and ocular discomfort in the left eye. Superficial keratectomy (SK) was performed to remove adhesions between the conjunctiva and cornea. To prevent re-adhesion after SK, the detached conjunctival tissue was sutured to the corneal limbus, and a soft contact lens (SCL) was inserted and a partial temporary tarsorrhaphy was performed. The SCL and tarsorrhaphy sutures were maintained for 22 days, and symblepharon did not recur 347 days postoperatively. SK combined with SCL is a relatively easy and cost-effective surgical option for feline symblepharon.

식도섬책에 대한 외과적 치료 (Surgical treatment on the stenosis of the esophagus)

  • 김근호;김영학
    • Journal of Chest Surgery
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    • 제22권1호
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    • pp.134-140
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    • 1989
  • A clinical evaluation was made on total 207 cases of corrosive esophageal stricture after ingestion of various corrosive substances and 173 cases of neoplasms in the esophagus and the cardia. The various complications associated with esophageal corrosion were observed on 28 cases [13.5%] in a total of 207 cases. Pathoanatomic findings of complication may be classified to the five category as follow; [1] stenosis in the pharynx due to adhesion of the epiglottis, [2] esophagobronchial fistula, [3] esophageal perforation with bougienation, [4] necrotic rupture of the esophagus and the stomach, and [5] so-called chronic corrosive gastritis. The comparative studies were done on a total of 165 cases of the various procedures of esophagoplasty to the reconstruction of the esophagus, which consists of antethoracal esophagoplasty with jejunum, retrosternal esophagoplasty with jejunum, retrosternal esophagoplasty with right colon, and retrosternal esophagoplasty with left colon. There is no hard and fast rule in selection of jejunum, right colon or left colon as the transplanting bowel and an operative method either antethoracal or retrosternal approach. When there was no possibility of the complication and no any defect of the anatomical states, one stage retrosternal esophagoplasty using right colon was better in various points of view. The 173 patients of the neoplasm of the esophagus consist of 28 cases of benign tumors and 145 cases of malignant tumors in the esophagus and cardia. 28 cases of benign tumors in the esophagus received the surgical treatment and they obtained with excellent results postoperatively. Of the 145 patients of esophageal carcinoma who received surgical managements, 101 cases [69.6%] were found to be operable and 44 cases [30.3%] were inoperable. Due to the various level of carcinoma in the esophagus, the following different surgical procedure was properly used case by case to get the best results in each case. Esophageal carcinoma in the upper and middle third segment received the total esophagectomy and the reconstruction of the esophagus using right colon by substernal procedure. Esophageal carcinoma in the lower third segment received an esophagojejunostomy in the mediastinum after the resection of lower third segment of the esophagus. Carcinoma in the esophago cardia and the stomach received also an esophagojejunostomy after the resection of the lower third segment of the esophagus and subtotal gastrectomy. For the 44 patients with inoperable carcinoma, the several palliative surgical managements such as gastrostomy or jejunostomy for feeding and esophagojejunostomy for bypass of the lower esophagus and the stomach were properly performed case by case for their maximum improvement.

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Bicluster and Pathway Enrichment Analysis of HCV-induced Cirrhosis and Hepatocellular Carcinoma

  • Cheng, Peng;Cheng, You;Su, Mei X.;Li, Dong;Zhao, Guo Z.;Gao, Hui;Li, Yan;Zhu, Jie Y.;Li, Hua;Zhang, Tao
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3741-3745
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    • 2012
  • Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the most common form of liver cancer. However, while it is associated frequently with hepatitis C virus (HCV) there is only an elementary understanding of its molecular pathogenesis. Methods: To gain insight into the molecular mechanisms of HCV-induced hepatocarcinogenesis, we performed microarray analysis on 75 surgical liver samples from 48 HCV-infected patients. Results: There were 395 differentially expressed geness between cirrhotic samples and HCC samples. Of these, 125 genes were up-regulated and 270 genes were down-regulated. We performed pathway enrichment analysis and screened as described previously. Conclusions: The differentially expressed genes might be involved in hepatocarcinogenesis through upregulating the pathways of ECM-receptor interaction, focal adhesion, cell adhesion molecules and other cancer-related pathways, and downregulating the pathways of "complement and coagulation cascades". We hope our results could aid in seeking of therapeutic targets for HCV-induced hepatocellular carcinoma.