• Title/Summary/Keyword: Surgical management

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Application of Virtual Surgical Planning with Computer Assisted Design and Manufacturing Technology to Cranio-Maxillofacial Surgery

  • Zhao, Linping;Patel, Pravin K.;Cohen, Mimis
    • Archives of Plastic Surgery
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    • v.39 no.4
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    • pp.309-316
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    • 2012
  • Computer aided design and manufacturing (CAD/CAM) technology today is the standard in manufacturing industry. The application of the CAD/CAM technology, together with the emerging 3D medical images based virtual surgical planning (VSP) technology, to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD/CAM technology including: data acquisition, virtual surgical and treatment planning, individual implant design and fabrication, and outcome assessment. It focuses primarily on the technical aspects of the VSP and CAD/CAM system to improve the predictability of the planning and outcome.

Surgical Treatment of Post-Infarction Left Ventricular Free Wall Rupture: Three Cases Review

  • Lee, Hee Moon;Lee, Young Tak;Kim, Wook Sung;Jeong, Dong Seop;Park, Pyo Won;Sung, Kiick
    • Journal of Chest Surgery
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    • v.46 no.5
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    • pp.357-361
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    • 2013
  • Left ventricular free wall rupture (LFWR) is rare, but is one of the most serious complications of myocardial infarction and is associated with high mortality. Several operative techniques have been attempted, but early diagnosis and prompt surgical management are crucial for a positive patient outcome. We report three cases of LFWR successfully treated with surgical methods.

Surgical Treatment and Postoperative Management of Third-degree Perineal Laceration Occurring at the Time of Foaling in a Thoroughbred Horse (더러브렛 말에서 분만중에 발생한 3도 회음부 열상의 치료 및 술 후 관리)

  • Lee, Sang-Kyu;Lee, Dong-Hoon;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.286-289
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    • 2009
  • Perineal laceration commonly occurs due to dilation of the birth canal at the time of foaling in primiparous mares. A 7-year-old Thoroughbred mare was presented with faecal contamination of the external genitalia. She was having history of constant straining three days after the mare's first foaling. Physical examination revealed the tearing extended from the deep part of vagina through muscles of the perineal body involved rectal floor and anal sphincter. Tentative diagnosed was third-degree perineal laceration therefore one-stage surgical procedure and a modified surgical procedure at three-week intervals was performed. During postoperative care for 3 weeks, soft faces was a key factor in success. After 3 weeks, the patient was recovered to normal condition completely.

Femoral Periprosthetic Fractures after Total Knee Arthroplasty: New Surgically Oriented Classification with a Review of Current Treatments

  • Rhee, Seung Joon;Cho, Jae Young;Choi, Yoon Young;Sawaguchi, Takeshi;Suh, Jeung Tak
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.284-292
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    • 2018
  • Purpose: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures. Methods: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature. Results: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment. Conclusions: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.

Radiation segmentectomy for gastric leiomyosarcoma hepatic metastasis

  • Roh, Simon
    • Korean Journal of Clinical Oncology
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    • v.14 no.2
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    • pp.142-145
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    • 2018
  • Metastases to the liver can be found in various malignancies, most commonly originating from the colon, rectum, pancreas, stomach, esophagus, breast, lung, and melanoma. Surgical resection of liver metastasis is generally considered to be the definitive therapy fore cure. However, many patients are unable to undergo surgical resection due to medical comorbidities or multifocal extent of malignant disease affecting the liver. Among patients not eligible for surgery, other therapies exist for treatment in order to down stage the disease for surgical resection or for palliation. Radioembolization of hepatic metastases has shown to improve outcomes among patients with variety of malignancies including more common malignancies such as colorectal cancer. Yttrium-90 (Y-90) radioembolization has been successfully used in the management of hepatic metastases. A small series of metastatic sarcoma to the liver treated with radioembolization showed a promising response. We report a case of metastatic gastric leiomyosarcoma to the liver treated with Y-90 glass microspheres therapy using the radiation segmentectomy approach, previously described for hepatocellular carcinoma.

Surgical Treatment in Locally Advanced Thyroid Cancer - Trachea, Larynx, Esophagus Invasion Management (국소 진행된 갑상선암의 수술 - 기관 및 후두, 식도 침범의 치료)

  • Lee, Guk Haeng;Kang, Ju Yong
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.99-108
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    • 2018
  • Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

Conservative Management and Postoperative Rehabilitation of Chronic Lateral Ankle Instability (만성 외측 족관절 불안정성의 보존적 치료와 수술적 치료 후의 재활운동)

  • Park, Young Hwan;Kim, Hak Jun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.6-11
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    • 2019
  • As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

Surgical Management of an Isolated Huge Innominate Artery Aneurysm Causing Tracheal Compression: A Case Report

  • Young Kwang, Hong;Won Ho, Chang;Hong Chul, Oh;Young Woo, Park
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.478-481
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    • 2022
  • The innominate artery is an uncommon site for an aneurysm, and tracheal compression caused by an innominate artery aneurysm is a very rare occurrence. An innominate artery aneurysm can cause catastrophic complications, such as rupture or thromboembolism. The most common surgical approach for open repair is median sternotomy with cardiopulmonary bypass, but cerebral ischemic injury and thromboembolism can occur during surgery. We present the case of a male patient who had an isolated giant innominate artery aneurysm causing tracheal compression, which was successfully managed by surgical repair.

Symptomatic Post-Discectomy Pseudocyst after Endoscopic Lumbar Discectomy

  • Kang, Suk-Hyung;Park, Seung-Won
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.31-36
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    • 2011
  • Objective: The objectives of this study were to determine the frequency of symptomatic postdiscectomy pseudocyst (PP) after endoscopic discectomy and to compare the results of surgical and conservative management of them. Methods: Initial study participants were 1,503 cases (1,406 patients) receiving endoscopic lumbar discectomy by 23-member board of neurosurgeons from March 2003 to October 2008. All patients' postoperative magnetic resonance imaging (MRI) scans were evaluated. On the postoperative MRI, cystic lesion of T2W high and T1W low at discectomy site was regarded as PP. Reviews of medical records and radiological findings were done. The PP patients were divided into two groups, surgical and conservative management by treatment modality after PP detection. We compared the results of the two groups using the visual analogue scale (VAS) for low back pain (LBP), VAS for leg pain (LP) and the Oswestry disability index (ODI). Results: Among 1,503 cases of all male soldiers, the MRls showed that pseudocysts formed in 15 patients, about 1.0% of the initial cases. The mean postoperative interval from surgery to PP detection was 53.7 days. Interlaminar approach was correlated with PP formation compared with transforaminal approach. (p=0.001).The mean VAS for LBP and LP in the surgical group improved from 6.5 and 4.8 to 2.0 and 2.3, respectively. The mean VAS for LBP and LP in the conservative group improved from 4.4 and 4.4 to 3.9 and 2.3, respectively. There was no difference in treatment outcome between surgical and conservative management of symptomatic PP. Conclusion: Although this study was done in limited environment, symptomatic PP was detected at two months' postoperative period in about 1% of cases. Interlaminar approach seems to be more related with PP compared with transforaminal approach.

Surgical Management of Pseudoaneurysm (가성동맥류의 수술적 가료)

  • Kim, Jae Hong;Yim, Man Bin;Lee, Chang Young;Kim, Ill Man
    • Journal of Korean Neurosurgical Society
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    • v.30 no.3
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    • pp.307-318
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    • 2001
  • Objective : Surgical experiences of pseudoaneurysms such as traumatic, mycotic and ill-defined unknown causes of aneurysms are rare. The authors have studied the results of surgical management from such cases in our series. Patients and Method : In the last 17 years, 1320 patients with cerebrovascular aneurysms were managed surgically. Among these, 16 patients showed the pseudoaneurysms. The authors analyzed retrospectively the clinical characteristics, treatment methods, management outcomes and problems in the managements. Results : There were 6 patients with traumatic aneurysm, 4 mycotic aneurysms and 6 ill-defined unknown causes of aneurysm. The sites of traumatic aneurysms were cavernous portion of the internal carotid artery(n=3), distal portion of the anterior cerebral artery (n=2) and vertebral artery(VA : n=1). Good outcomes in 5 cases could be obtained by extracranial - intracranial bypass followed by parent vessel occlusion or resection of aneurysm followed by re-anastomosis of parent vessel. The sites of mycotic aneurysm were peripheral portions of middle cerebral artery(MCA : n=3) and posterior cerebral artery(PCA : n=1). The outcomes of the patients with a mycotic aneurysm were relatively poor. It was partially due to the development of new aneurysm after treatment in one. The sites of ill-defined unknown causes of aneurysm were extracranial carotid artery(n=3), V2 portion of the VA(n=1), peripheral portion of the PCA (n=1) and MCA(n=1). Good outcome in all cases could be obtained by resection of aneurysm with or without saphenous vein graft. Conclusion : For the treatments of cerebrovascular pseudoaneurysm, combinations of aggressive medical, endovascular and surgical managements seem mandatory. Insertion of stent for a extracranial carotid artery aneurysm and coiling for a peripheral mycotic aneurysm can be option in future.

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