• 제목/요약/키워드: Surgical operation

검색결과 2,188건 처리시간 0.036초

Visual Outcome after Surgical Removal of Craniopharyngiomas

  • Kim, Yeon-Seong;Jung, Shin;Cheon, Hyo-Cheol;Jung, Tae-Young;Kang, Sam-Suk;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제39권3호
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    • pp.171-175
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    • 2006
  • Objective : In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. Methods : This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function [visual acuity and field] of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. Results : Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved [38.0%], and 7 patients were worse [33.3%]. However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation [44.4%]. The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection : Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. Conclusion : After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.

Single-incision laparoscopic ileostomy is a safe and feasible method of fecal diversion for anastomotic leakage following laparoscopic low anterior resection

  • Hwang, Duk Yeon;Lee, Gyeo Ra;Kim, Ji Hoon;Lee, Yoon Suk
    • Annals of Surgical Treatment and Research
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    • 제95권6호
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    • pp.319-323
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    • 2018
  • Purpose: Currently, many operations are performed using the single-incision laparoscopic method. Although there have been recent reports on single-incision laparoscopic ileostomy, none have compared this method to conventional laparoscopic ileostomy. This study aimed to assess the safety and feasibility of single-incision laparoscopic ileostomy for anastomotic leakage following laparoscopic low anterior resections. Methods: From April 2012 to April 2017, 38 patients underwent laparoscopic ileostomy (single-incision; 19 patients referred to as group A, conventional laparoscopy; 19 patients referred to as group B) for anastomotic leakage following laparoscopic low anterior resection. We analyzed surgical and clinical outcomes between the 2 groups. Patients in whom a protective ileostomy was carried out during the initial laparoscopic low anterior resection were excluded from this study. Results: No significant differences were observed between the 2 groups in terms of patient demographics and initial operation details. Incisional surgical site infections occurred less in group A than in group B (2 of 19 vs. 9 of 19, P = 0.029). The median ileostomy operation time, amount of intraoperative bleeding, parastomal hernia ratio, hospital stay duration after ileostomy, postoperative pain score were not significantly different between the 2 groups. Conclusion: Single-incision laparoscopic ileostomy is safe and feasible method of fecal diversion for anastomotic leakage following laparoscopic low anterior resection.

Robotic lower pelvic port placement for optimal upper paraaortic lymph node dissection

  • Paek, Jiheum;Kang, Elizabeth;Lim, Peter C.
    • Journal of Gynecologic Oncology
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    • 제29권6호
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    • pp.87.1-87.4
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    • 2018
  • Objective: Upper paraaortic lymph node dissection (UPALD) to the infrarenal level is one of the most challenging robotic procedures. Because robotic system has the limitation in robotic arm mobility. This surgical video introduces a novel robotic approach, lower pelvic port placement (LP3), to perform optimally and simultaneously both UPALD and pelvic procedures in gynecologic cancer patients using da Vinci Xi system. Methods: The patient presented with high-grade endometrial cancer. She underwent robotic surgical staging operation. For the setup of the LP3, a line was drown between both anterior superior iliac spines. At 3 cm below this line, another line was drown and four robotic ports were placed on this line. Results: After paraaortic lymph node dissection (PALD) was completed, the boom of robotic system was rotated $180^{\circ}$ to retarget for the pelvic lateral displacement. Robotic ports were placed and docked again. The operation was completed robotically without any complication. Conclusion: The LP3 was feasible for performing simultaneously optimal PALD as well as procedures in pelvic cavity in gynecologic cancer patients. The advantage of LP3 technique is the robotic port placement that affords for multi-quadrant surgery, abdominal and pelvic dissection. The LP3 is facilitated by utilizing advanced technology of Xi system, including the patient clearance function, the rotating boom, and 'port hopping' that allows using every ports for a camera. The LP3 will enable surgeons to extend the surgical indication of robotic surgical system in the gynecologic oncologic field.

하악골 재건을 위한 가상수술계획 시스템 (Virtual Surgical Planning System for Mandible Reconstruction)

  • 김한나;김영준;조현철;심응준;이득희;김래현;박세형;이정우
    • 한국CDE학회논문집
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    • 제21권2호
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    • pp.196-203
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    • 2016
  • In this paper, we propose a virtual surgical planning system specialized to mandible reconstruction surgery. Mandible reconstruction surgery is one of the most difficult surgeries, even for experienced surgeons. Compared to the traditional surgical procedures, virtual surgical planning can reduce the operation time in operating room while expecting better surgical outcome with optimized planning. However, with existing software systems, it requires much time and manual operations in virtual surgical planning. To reduce preparation time and improve accuracy of virtual surgical planning, we have developed optimized functions for virtual surgical simulation of mandible reconstruction with user-friendly interface. We found that the proposed system shortened the preparation time by half compared to the existing system from the experiments. The proposed system supports surgeons to make accurate plan faster and easier. The virtually planned results are used to make surgical cutting guide by 3D printing, and this will enhance surgical performance in operating room.

초음파를 이용한 국소마취하 표재비골신경 포착증후군의 치료 (Treatment of Superficial Peroneal Nerve Entrapment Syndrome under Local Anesthesia using Ultrasonogram)

  • 이경찬;곽지훈;황철호;박홍기
    • 대한족부족관절학회지
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    • 제17권3호
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    • pp.215-219
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    • 2013
  • Purpose: To review the outcomes of surgical treatment for superficial peroneal nerve entrapment. Materials and Methods: Ultrasonogram was used for diagnosis and surgical treatment. Seven superficial peroneal nerve entrapment were surgically treated with follow up of average 16 months (range, 6~29 months). Three patients were male and four patients were female with mean age 36.7 years (range, 19~51 years). Four cases developed after repetitive ankle sprain and three cases had no etiology. Results: Operation was performed mini-open and subcutaneous fasciotomy under local anesthesia. The results were excellent in two cases, good in four cases, fair in one case. Conclusion: Ultrasonogram was useful for diagnosis and surgical treatment of superficial peroneal nerve entrapment syndrome.

2 세 이하 유아기의 개심술 (Open heart surgery in the first two years of life)

  • 성숙환
    • Journal of Chest Surgery
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    • 제15권4호
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    • pp.373-380
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    • 1982
  • Experience with intracardiac surgery in infants indicates that for most anomalies the operation and late mortality after primary total correction is lower than the combined mortality after early palliation and delayed correction. In addition, there are secondary benefits of primary total correction in terms of reversal of retarded physical growth and social development and alleviation of parental anxiety. One hundred and fifteen infants under 2 years of age with congenital cardiac anomalies underwent primary surgical intervention at Seoul National University Hospital from Jan. `78 to Sep. `82. There were 70 patients with VSD, 17 patients with TOF, 10 patients with TGA, 4 patients with ASD, 4 patients with TA, 3 patients with TAPVR, and the remainders are Coronary AV Fistula, partial ECD+COA, SV, DORV, PA, Trilogy+PDA. The overall surgical mortality was 18.3%. In acyanotic group 6 patients died among 76 operated patients, and surgical mortality was 6.6%. But in cyanotic group, the mortality was very high as41.0% [16 patients among 39 patients]. This poor surgical result in cyanotic group was due to Improper pre-, intra- and post-operative care, and we are convincing that these factors soon be improved as experiences accumulated.

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기관폐쇄를 동반한 기관 신경초종 환자에 있어 레이져를 이용한 부분절제술후 기관절제술의 경험 (Clinical Experience of Tracheal Resection after Laser Ablation in a Patient having Tracheal Neurilemoma with Tracheal Stenosis.)

  • 박성민;김광택
    • Journal of Chest Surgery
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    • 제32권10호
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    • pp.947-950
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    • 1999
  • Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

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Scalp reconstruction using the reverse temporalis muscle flap: a case report

  • Na, Youngsu;Shin, Donghyeok;Choi, Hyungon;Kim, Jeenam;Lee, Myungchul
    • 대한두개안면성형외과학회지
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    • 제23권3호
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    • pp.134-138
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    • 2022
  • The scalp is the thickest skin in the body and protects the intracranial structures. The coverage of a large scalp defect is a difficult surgical procedure, the full details of which must be considered prior to the procedure, such as defect size and depth, and various factors related to the patient's general condition. Although a free flap is the recommended surgical procedure to cover large scalp defects, it is a high-risk operation that is not appropriate for all patients. As such, other surgical options must be explored. We present the case of a patient with an ulcer on the scalp after wide excision and split-thickness skin graft for squamous cell cancer. We successfully performed a reverse temporalis muscle flap for this patient.

Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

  • Eun Ji Lee;Jihoon T. Kim
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.276-280
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    • 2023
  • Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

Arthroscopic Latarjet procedure: current concepts and surgical techniques

  • Sang-Jin Shin;Jae Hyung Kim;Jonghyun Ahn
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.445-454
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    • 2023
  • The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.