• Title/Summary/Keyword: Surgical approaches

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Fabrication and application of post surgical anti-adhesion barrier using bio-compatible materials (생체 적합성 재료를 이용한 수술후 유착 방지막의 제작과 응용)

  • Park S.H.;Kim H.C.;Yang D.Y.;Kim T.K.;Park T.K.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.203-204
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    • 2006
  • Studies on some biodegradable polymers and other materials such as hydrogels have shown the promising potential for a variety of surgical applications. Postoperative adhesion caused by the natural consequence of surgical wound healing results in problems of the repeated surgery. Recently, scientists have developed absorbable anti-adhesion barriers that can protect a tissue from adhesion in case they are in use; however, they are dissolved when no longer needed. Although these approaches have been attempted to fulfill the criteria for adhesion prevention, none can perfectly prevent adhesions in all situations. Overall of this work, a new method to fabricate an anti-adhesion membrane using biodegradable polymer and hydrogel has been developed. The ideal barrier for preventing postoperative adhesion would have the following properties; it should be (i) resorbable (ii) non-reactive (iii) easy to apply (iv) capable of being fixed in position. In order to fulfill these properties, we adopted solid freeform fabrication method combined with surface modification which includes the hydrogel coating, therefore, inner or outer structure can be controlled and the property of anti adhesion can be improved.

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Surgical Approach to the Oral Cavity and Oropharyngeal Cancer; Visor Flap Approach (구강 및 구인두암의 수술적 접근방법 ; 면갑피판(Visor Flap)의 임상적 평가)

  • Choi Eun-Chang;Choi Yoon-Suk;Kim Dong-Young
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.226-231
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    • 1999
  • Objectives: Visor flap is one of the useful surgical approach to the oral cavity cancer, but the report on its specific indications, advantages and disadvantages is lacking. Material and Methods: Seven patients treated with visor flap for oral cavity and oropharyngeal cancer were reviewed. Result: Visor flap provided excellent visual field to anterior oral cavity without splitting the lip and chin skin. Postoperative cosmesis was satisfactory. One complication associating with this flap was salivary leak through gingivo-labial and gingivo-buccal suture which was successfully repaired. Conclusion: Visor flap is an excellent approach on extirpation of the oral cavity and oropharyngeal cancer in case of combining with segmental mandibulectomy. Especially it was useful for the approach to the anterior floor of the mouth and oral tongue lesion. But, it has no actual advantage over the other approaches in cases without mandibulectomy.

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Evaluation and management of facial granuloma caused by various injection materials

  • Jang, Jin Woo;Kang, Sang Yoon
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.26-32
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    • 2021
  • Background: Various substances are currently being used for cosmetic or postsurgical reconstruction reasons. Injecting of various materials into the face may provoke inflammatory or granulomatous reactions, infection and tissue necrosis. Among these reactions are foreign body granulomas. This study aims to describe the clinical characteristics of and therapeutic approaches used in patients with facial foreign body granulomas caused by the injection of various substances. Methods: From 2007 to 2020, a total of 64 patients visited our hospital due to inflammatory signs, palpable masses or surface irregularities. We reviewed patient characteristics, type of injected material, medical history and treatment outcomes. The treatment results were scored with patient satisfaction and statistical analysis of the treatment period was performed. Results: Most patients underwent conservative treatment followed by surgical treatment because of persistent symptoms; one patient did not require surgery. All patients reported good treatment results and satisfaction. The earlier the surgical treatment was performed, the shorter the treatment period and the higher patient satisfaction scoring. Conclusion: Granulomatous changes to the face are an emerging concern in various cosmetic procedures and surgeries, including fillers, silicone implants and autologous fat injections. Our findings strongly suggest that patient symptoms require accurate diagnosis and surgical treatment.

Thoracic Fetiform Teratoma: A Case Report of a Very Rare Entity in a Peruvian Hospital

  • Ludwig Caceres-Farfan;Wildor Samir Cubas;Franco Alban;Jorge Mantilla-Vasquez;Johny Mayta-Rodriguez;Karen Mendoza-Guerra
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.282-285
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    • 2023
  • Mature fetiform teratoma, or homunculus, is a term coined for a rare variant of teratoma with a prevalence of 0.01% of teratomas. There have been very few cases reported in the world, and its thoracic presentation is extremely unusual. We present the case of a 31-year-old female patient with a history of progressive chest pain in the left hemithorax, associated with dyspnea on moderate exertion and cough. Imaging studies revealed a large intrathoracic tumor visually compatible with a teratoma. Surgical resection by a clamshell approach was successful, and subsequent anatomopathological studies of the operative specimen concluded that the mass was a mature fetiform thoracic teratoma. The treatment of this entity is generally surgical and includes wide resection due to its large adhesive component to surrounding tissues. Thus, the cardiothoracic surgeon must know approaches that allow wide resection, making these cases true surgical challenges.

Ultrasound-Guided Posterolateral Approach for Midline Calcified Thoracic Disc Herniation

  • Tan, Lee A.;Lopes, Demetrius K.;Fontes, Ricardo B.V.
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.383-386
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    • 2014
  • Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

Surgery of the Tumors in the Ventricular System

  • Hong, Sang-Won;Choi, Ha-Young;Koh, Eun-Jeong
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.26-31
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    • 2006
  • Objective : The authors study on the clinical presentations and the surgical outcomes of the tumors in the ventricular system. Methods : 15 patients with ventricular tumor were studied. The clinical presentation, radiological findings, different surgical approaches, and outcome were analyzed. Tumors were classified into three groups based on their locations in MRI : lateral, third and fourth ventricle. Surgical methods were transcortical approach in eight patients, transcallosal approach in four, median suboccipital approach in two, and subfrontal approach in one. Gross total removal was achieved in 10 patients. Subtotal resections were performed in the rest. Glasgow outcome scale was used for evaluation of the surgical outcome. Results : Main clinical presentations were chronic headache in patients with the tumor in the lateral ventricular tumor and sudden onset of headache and consciousness change in patients with the tumor in the third and fourth ventricular tumor Development of hydrocephalus was more predominant in patients with the tumors in the third ventricle. Postoperatively, good outcome [Glasgow outcome scale IV, V] were in 73%, and better results was observed in patients with the tumors in the lateral ventricular tumor. The differences of outcome according to surgical approach were not recognized, even though it was not reliable statistically. Conclusion : In ventricular tumor, postoperative outcome is not good in patients with sudden development of headache, hydrocephalus, high grade tumor. Outcome is good in patients with the tumor in the lateral ventricle relatively. There is no difference in outcome according to the approach method to the tumors. And it is necessary to be aware of various approach methods to the tumors and anatomy surrounding the ventricle for avoidance of neurological complications.

The Surgical Treatment of Choice for Patients with Differentiated Thyroid Cancer(DTC) (분화성 갑상선암 환자에서 수술범위의 선택)

  • Cha Seong-Jae;Park Sung-Jun;Lim Hyen-Muck
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.200-205
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    • 1997
  • Background: There is considerable controversy concerning the most appropriate surgical treatment of patients with DTC. Objectives: In order to selection of the appropriate surgical treatment for DTC, we have analyzed the outcome of the different types of surgical treatment in low and high risk groups of DTC. Materials and Methods: From January 1968 through december 1980, a total of 71 patients with DTC were treated surgically at our institution. According to Cady and Rossi's scoring system, the patients were divided into low risk and high risk groups. Results: Seventy percent of patients were defined as low risk group with a 4% death rate whereas 30% of patients at high risk with a death caused by thyroid cancer in 38%(p<0.05). There was no difference in mortality between ipsilateral lobectomy and total thyroidectomy in both low and high risk groups(p>0.1). Conclusion: In our study, total thyroidectomy was not benefit in high risk group. These results suggested that total thyroidectomy must be selected carefully and based on clear evidence of major improvement in outcome or absence of other suitable surgical approaches. However, follow up study of more cases will be needed for accurate determination of the efficacy of total thyroidectomy in high risk group.

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Transitioning from the Posterior Approach to the Direct Anterior Approach for Total Hip Arthroplasty

  • Cameron M. Metzger;Hassan Farooq;Jacqueline O. Hur;John Hur
    • Hip & pelvis
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    • v.34 no.4
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    • pp.203-210
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    • 2022
  • Purpose: Total hip arthroplasty (THA) using the direct anterior approach (DAA) is known to have a learning curve. The purpose of this study was to review cases where surgery was performed by an arthroplasty surgeon transitioning from the posterior approach (PA) to the DAA. We hypothesized similar complication rates and improvements in surgical duration over time. Materials and Methods: A review of 2,452 consecutive primary THAs was conducted. Surgical duration, length of stay (LOS), surgical complications, decrease in postoperative day (POD) 1 hemoglobin, transfusion rates, POD 0 and POD 1 pain scores, incision length, leg length discrepancy (LLD), and radiographic cup position were recorded. Results: No differences in surgical duration were observed after the first 50 DAA cases. A shorter LOS was observed for the DAA, and statistical difference was appreciated after the first 100 DAA cases. There were no differences in periprosthetic fractures. A higher rate of infections and hip dislocations were observed with the PA. The PA showed an association with higher transfusion rates without significant difference in POD 1 decrease in hemoglobin over the first 100 DAA cases. Similar POD 0 and POD 1 pain scores with a smaller incision were observed for the first 100 DAA cases. The DAA cohort showed less variation in cup inclination, version, and LLD. Conclusion: DAA is safe and non-inferior in terms of reduced LOS, smaller incision, and less variation in cup position. Fifty DAA cases was noted to be the learning curve required before no differences in duration between approaches were observed.

Irreducible Ankle Fractures by Locked Posterior Malleolar Fragment: Case Report (포착된 후과 골편에 의한 비정복성 족관절 골절: 증례 보고)

  • Kang, Jong-Hoon;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.125-130
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    • 2005
  • Irreducible fracture dislocation of the ankle associated with comminuted displaced fracture of posterior malleolus is rare. Locked posterior malleolar fragments interfere with reduction of fibula or talus in ankle fractures. Prompt recognition and appropriate surgical approaches are necessary to achieve anatomical reduction of the ankle fractures.

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Gene Therapy for Oral Cancer

  • Chung, In-Jae
    • Biomolecules & Therapeutics
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    • v.15 no.4
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    • pp.273-280
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    • 2007
  • New treatment approaches are needed to improve the effectiveness of oral cancer treatment, since surgical resection of the tumor in oral region causes various oral dysfunctions. The molecular biology of oral cancer has been progressively delineated. Concurrently, gene therapy techniques have been developed that allow targeting or replacement of dysfunctional genes in cancer cells, offering the potential to treat a wide range of cancer. Oral carcinoma is attractive target for gene therapy because of its accessibility. In this article, we review the current status of gene therapy as applied to oral carcinoma.