• Title/Summary/Keyword: Surgical blood loss

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Laser Frenotomy (레이저를 이용한 설소대절단술)

  • 김정은;김명원;백승훈;박종태;이종환;장백암
    • Korean Journal of Bronchoesophagology
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    • v.2 no.1
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    • pp.125-128
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    • 1996
  • Tongue tie is the congenital anomaly which is manifested by an abnormally short and thick lingual frenulum so that a condition outside of the range of normal anatomic or functional capability. In general, the surgical correction is the treatment of choice: release of tongue tie and closure. We compared the traditional frenotomy with laser frenotomy using Nd:YAG laser to treat 67 cases of tongue tie during a period of JAN. 1993 through Feb. 1996. The advantages of laser frenotomy were decreased blood loss and operation time. So we had a conclusion as the adequate use of laser frenotomy with suture was a good surgical procedure for correction of tongue tie.

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A Case of External Skeletal Fixation for Treatment of Bilateral Mandibular Fracture in a Dog (개에서 외부고정법을 이용한 양측성 하악골절의 치유 일례)

  • 구자민;김현희;박대식;장홍희;이효종;이후장;송해룡;이용훈;정종태
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.134-137
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    • 2003
  • A 5-year-old, male mixed breed dog was presented to Gyeongsang National University Animal Hospital for bilateral mandibular open fracture by bite. The dog had loss of the teeth and injury of the oral mucosa. Radio-graphic and blood examinations were conducted. Fracture lines were observed between first premolar and second premolar, but temporomandibular luxation was not observed on radiographs. In serum analysis, elevated levels of CPK and LDH were found. The dog was anesthetized and prepared for aseptic surgery. Acrylic external skeletal fixator with Kirschiner wire was applied. Pin loosening and malalignment of the right fracture line was observed at 7 weeks after surgery. We applied Kirschner-Ehmer fixator and half pins during the second surgical procedure. At 4 weeks after a second surgical procedure, the fixator and pins were removed from mandible. The fractures were healed with no complications.

A treatment of atreiovenous malformation on mandible

  • Jung, Mi-Sun;Ryu, Dong-Mok;Kim, Eui-Jong;Oh, Jeong-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.1
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    • pp.69-75
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    • 2007
  • The treatment of intraosseous ateriovenous malformation in the jaw is difficult because of life threatening frequent bleeding tendency. The surgical resection of AVM may be mortal due to massive blood loss. In the growing pediatric patient, surgery may cause facial deformity and growth disturbance. So currently, the treatment of AVM is only embolization using various material through endovascular access, direct-puncture or embolization in conjunction with surgical resection. We report a case of combined techniques.

Single-Stage Posterior Subtotal Corpectomy and Circumferential Reconstruction for the Treatment of Unstable Thoracolumbar Burst Fractures

  • Jo, Dae-Jean;Kim, Ki-Tack;Kim, Sung-Min;Lee, Sang-Hun;Cho, Myung-Guk;Seo, Eun-Min
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.122-128
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    • 2016
  • Objective : To illustrate the technique of single-stage posterior subtotal corpectomy and circumferential reconstruction for the treatment of unstable thoracolumbar burst fractures and to evaluate the radiographical and clinical outcomes of patients treated using this technique. Methods : 16 consecutive patients with unstable thoracolumbar burst fractures were treated with single-stage posterior subtotal corpectomy and circumferential reconstruction. The mean patient age was 54.8 years. The mean follower up period was 25 months. Five patients suffered from T12 fractures, 10 from L1, 1 from L2. The segmental kyphosis, neurologic status, visual analogue scale for back pain was evaluated before surgery and at follow up. Results : The segmental kyphotic angle improved from 18.5 degrees before surgery to -9.2 degrees at the last follow up. The mean correction angle was 28.9 degrees. The mean surgical time was 255 minutes, and a mean intraoperative blood loss was 1073 mL. Intraoperative complications included two dural tears, and a superficial wound infection. There were no other severe complications. The mean visual analog scale of back pain decreased from a mean value of 6.6 to 2 at the last follow up. Conclusion : The single-stage posterior subtotal corpectomy and circumferential reconstruction achieved satisfactory kyphosis correction with direct visualization of the circumferentially decompressed spinal cord, as well as good fusion with less blood loss and complications. It is a safe and reliable surgical treatment option for unstable thoracolumbar burst fractures.

Is There any Role of Visceral Fat Area for Predicting Difficulty of Laparoscopic Gastrectomy for Gastric Cancer?

  • Shin, Ho-Jung;Son, Sang-Yong;Cui, Long-Hai;Byun, Cheulsu;Hur, Hoon;Lee, Jei Hee;Kim, Young Chul;Han, Sang-Uk;Cho, Yong Kwan
    • Journal of Gastric Cancer
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    • v.15 no.3
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    • pp.151-158
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    • 2015
  • Purpose: Obesity is associated with morbidity following gastric cancer surgery, but whether obesity influences morbidity after laparoscopic gastrectomy (LG) remains controversial. The present study evaluated whether body mass index (BMI) and visceral fat area (VFA) predict postoperative complications. Materials and Methods: A total of 217 consecutive patients who had undergone LG for gastric cancer between May 2003 and December 2005 were included in the present study. We divided the patients into two groups ('before learning curve' and 'after learning curve') based on the learning curve effect of the surgeon. Each of these groups was sub-classified according to BMI (<$25kg/m^2$ and ${\geq}25kg/m^2$) and VFA (<$100cm^2$ and ${\geq}100cm^2$). Surgical outcomes, including operative time, quantity of blood loss, and postoperative complications, were compared between BMI and VFA subgroups. Results: The mean operative time, length of hospital stay, and complication rate were significantly higher in the before learning curve group than in the after learning curve group. In the subgroup analysis, complication rate and length of hospital stay did not differ according to BMI or VFA; however, for the before learning curve group, mean operative time and blood loss were significantly higher in the high VFA subgroup than in the low VFA subgroup (P=0.047 and P=0.028, respectively). Conclusions: VFA may be a better predictive marker than BMI for selecting candidates for LG, which may help to get a better surgical outcome for inexperienced surgeons.

Predictors of Mortality after Surgery for Empyema Thoracis in Chronic Kidney Disease Patients

  • Pulle, Mohan Venkatesh;Puri, Harsh Vardhan;Asaf, Belal Bin;Bishnoi, Sukhram;Malik, Manish;Kumar, Arvind
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.392-399
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    • 2020
  • Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials

  • Vishnu Baburaj;Sandeep Patel;Vishal Kumar;Siddhartha Sharma;Mandeep Singh Dhillon
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.72-78
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    • 2024
  • Background: Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. Methods: A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. Results: Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. Conclusions: Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes.

Video-assisted Thoracic Surgery Versus Thoracotomy for Non-small-cell Lung Cancer

  • Pan, Tie-Wen;Wu, Bin;Xu, Zhi-Fei;Zhao, Xue-Wei;Zhong, Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.447-450
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    • 2012
  • Video-assisted thoracic surgery (VATS) has been recommended as more optimal surgical technique than traditional thoracotomy for lobectomy in lung cancer, but it is not well defined. Here, we compared VATS and traditional thoracotomy based on clinical data. From November 2008 to November 2010, 180 patients underwent lobectomy for non-small-cell lung cancer (NSCL) identified by computerized tomography. Of them, 83 cases were performed with VATS and 97 by thoracotomy. Clinical parameters, consisting of blood loss, operating time, number of lymph node dissection, days of pleural cavity drainage, and length of stay were recorded and evaluated with t test. No significant difference was observed between the VATS and thoracotomy groups in the average intraoperative blood loss, number of lymph node dissections, and days of pleural cavity drainage. While the average operating time in the VATS group was significantly longer than that in thoracotomy group, recurrence was only present in one case, as opposed to 7 cases in the thoracotomy group In conclusion, similar therapeutic effects were demonstrated in VATS and thoracotomy for NSCL. However, VATS lobectomy was associated with fewer complications, recurrence and shorter length of stay.

ASSESSMENT OF INFERIOR ALVEOLAR NERVE DAMAGE USING DIGITAL INFRARED THERMOGRAPHIC IMAGING (디지털 적외선 체열 검사를 사용한 하치조 신경 손상의 평가)

  • Lee, Ji-Yeon;Lee, Jae-Hoon;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.488-496
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    • 2004
  • Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

Is central pancreatectomy an effective alternative to distal pancreatectomy for low-grade pancreatic neck and body tumors: A 20-year single-center propensity score-matched case-control study

  • Ashish Kumar Bansal;Bheerappa Nagari;Phani Kumar Nekarakanti;Amith Kumar Pakkala;Venu Madhav Thumma;Surya Ramachandra Varma Gunturi;Madhur Pardasani
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.87-94
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    • 2023
  • Backgrounds/Aims: Central pancreatectomy (CP) is associated with a higher rate of postoperative pancreatic fistula (POPF), and it is less preferred over distal pancreatectomy (DP). We compared the short- and long-term outcomes between CP and DP for low-grade pancreatic neck and body tumors. Methods: This was a propensity score-matched case-control study of patients who underwent either CP or DP for low-grade pancreatic neck and body tumors from 2003 to 2020 in a tertiary care unit in southern India. Patients with a tumor >10 cm or a distal residual stump length of <4 cm were excluded. Demographics, clinical profile, intraoperative and postoperative parameters, and the long-term postoperative outcomes for exocrine and endocrine insufficiency, weight gain, and the 36-Item Short Form Survey (SF-36) quality of life questionnaire were compared. Results: Eighty-eight patients (CP: n=37 [cases], DP: n=51 [control]) were included in the unmatched group after excluding 21 patients (meeting exclusion criteria). After matching, both groups had 37 patients. The clinical and demographic profiles were comparable between the two groups. Blood loss and POPF rates were significantly higher in the CP group. However, Clavien-Dindo grades of complications were similar between the two groups (p = 0.27). At a median follow-up of 38 months (range = 187 months), exocrine sufficiency was similar between the two groups. Endocrine sufficiency, weight gain, SF-36 pain control score, and general health score were significantly better in the CP group. Conclusions: Despite equivalent clinically significant morbidities, long-term outcomes are better after CP compared to DP in low-grade pancreatic body tumors.