• Journal of Chest Surgery
• /
• 제57권1호
• /
• pp.79-86
• /
• 2024

Background: This study investigated the surgical outcomes associated with coronary artery fistulas (CAFs) in children. Methods: We retrospectively reviewed the medical records of 23 pediatric patients who underwent surgical closure of CAFs between 1995 and 2021. At presentation, 7 patients (30.4%) exhibited symptoms. Associated cardiac anomalies were present in 8 patients. Fourteen fistulas originated from the right coronary artery and 9 from the left. The most common drainage site was the right ventricle, followed by the right atrium and the left ventricle. The median follow-up duration was 9.3 years (range, 0.1-25.6 years) Results: The median age and body weight at repair were 3.1 years (range, 0-13.4 years) and 14.4 kg (range, 3.1-42.2 kg), respectively. Cardiopulmonary bypass was used in 17 cases (73.9%), while cardioplegic arrest was employed in 14 (60.9%). Epicardial CAF ligation was utilized in 10 patients (43.5%), the transcoronary approach in 9 (39.1%), the endocardial approach in 2 (8.7%), and other methods in 2 patients (8.7%). The application of cardioplegic arrest during repair did not significantly impact the duration of postoperative intensive care unit stay or overall hospital stay. One in-hospital death and 1 late death were recorded. The overall survival rate was 95.7% at 10 years and 83.7% at 15 years. A residual fistula was detected in 1 patient. During the follow-up period, no surviving patient experienced cardiovascular symptoms or coronary events. Conclusion: Surgical repair of CAF can be performed safely with or without cardioplegic arrest, and it is associated with a favorable prognosis in children.

• Journal of Gastric Cancer
• /
• 제18권1호
• /
• pp.90-98
• /
• 2018

Purpose: We evaluated the learning curve and short-term surgical outcomes of robot-assisted distal gastrectomy (RADG) performed by a single surgeon experienced in open, but not laparoscopic, gastrectomy. We aimed to verify the feasibility of performing RADG without extensive laparoscopic experience. Materials and Methods: Between July 2012 and December 2016, 60 RADG procedures were performed by a single surgeon using the da $Vinci^{(R)}$ Surgical System (Intuitive Surgical). Patient characteristics, the length of the learning curve, surgical parameters, and short-term postoperative outcomes were analyzed and compared before and after the learning curve had been overcome. Results: The duration of surgery rapidly decreased from the first to the fourth case; after 25 procedures, the duration of surgery was stabilized, suggesting that the learning curve had been overcome. Cases were divided into 2 groups: 25 cases before the learning curve had been overcome (early cases) and 35 later cases. The mean duration of surgery was 420.8 minutes for the initial cases and 281.7 minutes for the later cases (P<0.001). The console time was significantly shorter during the later cases (168.6 minutes) than during the early cases (247.1 minutes) (P<0.001). Although the volume of blood loss during surgery declined over time, there was no significant difference between the early and later cases. No other postoperative outcomes differed between the 2 groups. Pathology reports revealed the presence of mucosal invasion in 58 patients and submucosal invasion in 2 patients. Conclusions: RADG can be performed safely with acceptable surgical outcomes by experts in open gastrectomy.

• 대한족부족관절학회지
• /
• 제11권2호
• /
• pp.192-197
• /
• 2007

Purpose: The purpose of this study is to present our clinical results after surgical treatment in tarsal tunnel syndrome due to space occupying lesions. Material and Methods: We performed surgical decompression for tarsal tunnel syndrome in 20 patients from July 2004 to February 2007. Out of them, thirteen cases were due to space occupying lesions around the tarsal tunnel. The average age at operation was 51.3 years old and the duration from symptom onset to surgery was 16.5 months. The operation included removal of space occupying lesions and tarsal tunnel decompression. The clinical parameters were pain visual analogue scale (VAS), AOFAS scale, and subjective satisfaction. Results: The ganglion cysts were the most frequent causes (ten cases) and synovial chondromatosis in 1 case, neurofibroma in 1 case, talocalcaneal coalition in 1 case. The average follow-up duration was 14.5 months. The AOFAS scale showed significant improvement from 77.8 to 92.7. The average VAS decreased from 6.4 to 2.2. Seven out of thirteen patients were satisfied with the results. The excellent results were shown in six patients, the good results in one patient, the fair result in three patients and the unsatisfactory results in three patients. Conclusion: Favorable results could be obtained in patients with known etiology. But not all cases with surgical decompression of space occupying lesions showed satisfactory results. We assume that the clinical results were related to the multiple factors, not only well performed surgery but also age, size lesions and duration of symptoms, ect.

• 대한치과마취과학회지
• /
• 제10권1호
• /
• pp.1-6
• /
• 2010

Background: Articaine, commercially available in South Korea from 2004, is widely being used for dental treatments. In the surgical extraction of impacted mandibular third molars, one of the most common procedures in oral and maxillofacial surgery, the anesthetic efficacy of 4% articaine and 2% lidocaine, both with 1：100,000 epinephrine, was compared. Methods: A randomized double-blind clinical trial was conducted of 80 patients for bilateral surgical extraction of mandibular third molars with informed consents. One operator carried out the routine surgical procedures using local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor. Latency, duration of anesthesia and the amount of anesthetic solution were recorded. A visual analog scale (VAS) was used to evaluate the intraoperative pain. Results: The pain VAS scores reported similar anesthetic effect with both local anesthetics. Not in the latency of anesthesia and the amount of anesthetic solution, statistically significant difference was found in the mean duration of anesthesia. Conclusions: It was concluded that 4% articaine could offer better or at least the same clinical feasibility compared to 2% lidocaine, particularly in terms of the duration of the local anesthesia for common dental treatments.

• 대한치과의사협회지
• /
• 제50권2호
• /
• pp.64-71
• /
• 2012

Recently, the presurgical orthodontic duration tends to be shortened by virtue of the advancement of surgical and orthodontic techniques in class III orthognathic surgery cases. But the predictability of the surgical results should be secured by removing several uncertain factors in presurgical orthodontic treatment. The purpose of this study is to investigate the influence of immediate postsurgical occlusal stability on postsurgical mandibular change. The study includes 40 patients who underwent orthognathic surgery to correct skeletal class III malocclusion. The patients were divided into two groups based on the numbers of occlusal contact in surgical setup occlusion: group 1 (stable surgical occlusion, n=24) and group 2(unstable surgical occlusion, n=16). Changes of horizontal and vertical mandibular measurements during postsurgical follow up period(from 1 week postsurgery to 12month after debonding) were compared to examine the differences between two groups. The stability of surgical occlusion is one of the factors influencing postsurgical mandibular changes in class III malocclusion. The various class III malocclusion cases have specific prerequisites for the orthognathic surgery according to the skeletal patterns. The prerequisites should be obtained by minimum presurgical orthodontics to increase the predictability of the surgical results.

• 간호행정학회지
• /
• 제13권2호
• /
• pp.199-207
• /
• 2007

Purpose: Clinical characteristics and medical cost were analyzed according to the surgical procedures for intertrochanteric fracture in aged patients to assess the appropriateness of treatment expense and to find possibility of reducing the medical cost. Method: Variable for the statistical analysis were; the clinical characteristics, medical cost according to the surgical procedures, the treatment success rate, the total medical expense, and the average expense per case. SAS Package Version 8.02. was used to analyze the relevant data. Results: Operative procedures differ significantly according to the gender and by the location of institution. Only significant clinical variables according to the operative procedure were duration of general anesthesia and amount of blood transfusion. Average cost per treatment was the highest in the bipolar hemiarthroplasty followed by the gamma nail and hip compressing screw. Average cost for bipolar hemiarthroplasty was significantly higher than other surgical procedures. Conclusions: The difference in hospital costs for treatment of intertrochanteric fracture originates from the utilized surgical procedures, mostly by the materials used. The method of surgical treatment should be carefully determined by the purpose of the surgery, in order to improve the quality of medical care and also to reduce the hospital cost.

• Journal of Yeungnam Medical Science
• /
• 제7권1호
• /
• pp.215-219
• /
• 1990

자동코딩 방식을 이용함으로써 업무 수행능력이 배가되고 용이하게 호출이 가능하며 디스켓에 따로 저장하는 보완장치가 있으므로 상당히 안전하리라 생각된다. 대형컴퓨터에 비해 그 소요경비가 무척 절감되었으며 언제든지 프로그램 보완이 가능하여 앞으로의 이용이 주목된다 하겠다.

• Journal of Chest Surgery
• /
• 제27권3호
• /
• pp.251-254
• /
• 1994

Esophageal leiomyosarcoma is a rare lesion. [0.5 % of all esophageal malignancy] The patient was 74 year old female and complained postprandial vomiting of 4 years, duration & hematemasis of 2 months` duration. On gastrofiberscopy, huge exophytic mass nearly occluding esophageal lumen located 30∼38 cm from upper incisor was found. Endoscopic biopsy was squamous cell carcinoma. Transthoracic esophagectomy and esophagogastrotomy was carried out. Result of biopsy was esophageal leiomyosarcoma.

• Journal of Korean Neurosurgical Society
• /
• 제52권4호
• /
• pp.306-311
• /
• 2012

Objective : A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. Methods : The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. Results : In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean${\pm}$standard deviation, $6.6{\pm}2.3$ mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.

• Archives of Plastic Surgery
• /
• 제38권6호
• /
• pp.798-802
• /
• 2011

Purpose: A wart is caused by epidermal infection with the human papilloma virus. Although wart naturally disappears in some cases, it require treatment because of pain, aesthetic problem, and the possibility of malignant change. Conventional non-surgical treatment cannot be a fundamental solution for the pain and has such disadvantages as frequent recurrence and difficulties in achieving a satisfactory outcome. A surgical procedure was performed on patients with wart and the procedure had a good outcome. Methods: We investigated the gender, age, lesion site, mean treatment duration, and presence or absence of recurrence in 21 patients with a wart within the period of January 2007 to July 2011. For local lesions, primary closure, including subcuticular suture after the excision, was performed. If the defect size was too big to do primary closure, we performed rotation flap. For wide multiple lesions, a split thickness skin graft was performed. Results: Among the 21 patients, 12 patients were male and 9 patients were female, and their mean age was 42 years (SD=17.38, range: 11~75 years). The lesion site was the foot in 10 patients, the hand in 8 patients, the face in 2 patients, and the scalp in 1 patient. The mean treatment duration was 13.5 days (SD=4.36, range: 6~15 days) for the primary closure or rotation flap, and 18.5 days (SD=2.12, range: 17~20 days) for the skin graft. 20 patients were cured without recurrence. No recurrence was observed in the patients who underwent primary closure or rotation flap. One of the two patients who underwent a skin graft of their wart that had covered their entire palm had local recurrence in part of her finger tips. Conclusion: We performed surgical procedure on recalcitrant wart. As a results, we can treat it with short treatment duration, low recurrence rate and less scarring and get high patient satisfaction.