• Archives of Plastic Surgery
• /
• v.38 no.1
• /
• pp.19-26
• /
• 2011

Purpose: This is the report on the results of 150 consecutive cases of delayed postmastectomy reconstruction with TRAM flap performed by single surgeon. The purpose of this study is to review the merits, demerits and other considerations of this method by analyzing the results. Methods: 150 patients were reviewed retrospectively who had breast reconstruction by a single surgeon from July 2001 to July 2008. Reviewed factors include demographic factors, mastectomy method, adjuvant therapies (such as radiation, chemotherapy) complication rate, simultaneous contralateral breast procedure rate, secondary touch-up procedure rate, and patients' satisfaction. Results: Ovarall TRAM flap complication rate was 22.6%. Among them, donor site complication rate was 36%, simultaneous contralateral breast procedure rate was 44.6%, secondary touch-up procedure rate was 40%. All rates were higher compared to immediate reconstruction with TRAM flap. But the patients' satisfaction was about the same as immediate reconstruction. Conclusion: Delayed postmastectomy reconstruction with TRAM flap can yield satisfactory results despite of relatively high complication rate and concomitant procedure rate when it is performed by a experienced surgeon.

• Journal of Chest Surgery
• /
• v.33 no.1
• /
• pp.73-78
• /
• 2000

Background: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inf-lammatory lung disease. Material and Method: Eighty-five patients underwent pneumon-ectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergio- losis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, Result: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneu-monectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pl- eural spillage due to cavity or lesion perforation(p=.003) which is as the same results as gen-eral complication rate. Conclusion: The postoperative complication rate of pneumone-ctomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra- pleural spillage.

• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.62-66
• /
• 2008

Purpose: Although nasal fractures are often discussed as minor injuries but the incidence of post-traumatic nasal deformity remains high. For decrease the incidence of post-traumatic nasal deformity which require the guideline to optimize the management of acute nasal bone fracture. The aim of this study is analysis of post-traumatic nasal deformity according to Stranc classification. Method: We reviewed 310 patients with nasal bone fracture treated at our hospital from January of 2005 to December of 2006. Result: Post-traumatic complication were divided septal deviation, nasal bone deformity, temporary hyposmia and synechia. Nasal bone deformity include nasal bone deviation, hump, flat nose and minimal nasal bone irregularity. The incidence of total complication rate was 36.4%. The most common complication was nasal deformity(22.9%) followed by septal deviation(19.7%). The most common complication was septal deviation(20%) in frontal impact. The most common complication was nasal deformity(19.5%) in lateral impact. In frontal impact, the incidence of complication rate was plane II(68.8%) followed by plane I(29.9%) and plane III(16.7%). In lateral impact, the incidence of complication rate was plane II (78.8%) followed by plane III(61.5%) and plane I(42.7%). Conclusion: This result can be used to improve longterm results and to reduce the incidence of post-traumatic nasal deformity by predict complication of nasal bone fracture according to Stranc classification.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.143-148
• /
• 1993

From September 1985 through September 1989,56 patients with stage IIIB carcinoma of the cervix were treated with radiation therapy with curative aim. The overall survival at 5 year was $38{\%}$. The survival rate was better for patients treated with combined external radiotherapy and high dose rate intracavitary radiotherapy than with external radiotherapy alone. No significant survival difference was observed between the unilateral and bilateral parametrial extension of the tumor Seventeen patients experienced recurrence within the irradiated field with a loco-regional recurrence rate of $30{\%}$. Ten patients had complications ($18{\%}$). The complications were mild in three, moderate in four, and severe in three patients. A study was made on the relationship between the fraction numbers of intracavitary radiotherapy, vaginal packing and the complication rate, respectively. In this analysis author observed that the significant treatment factor influencing the survival of cervical cancer was the use of intracavitary radiation, and meticulous vaginal packing could decrease the late complication rate of radiotherapy of cervical cancer.

• Radiation Oncology Journal
• /
• v.14 no.3
• /
• pp.201-209
• /
• 1996

Purpose : To assess the efficacy of high dose rate - intracavitary radio-therapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination scheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Materials and Methods : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy) Summation of external dose Plus ICR dose to the point A range were 64.20-95.00 Gy. and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Rusults : Initial complete response rate was $99.4\%$ for all patients. Overall 5-year survival rate was $91.1\%$ and 5-year disease free survival rate was $90.9\%$. Local failure rate was $4.9\%$ and distant failure rate was $4.3\%$. Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-rear survival rate was $92.6\%$ and less than 3cm, that was $79.6\%$. Late complication rate was $23.5\%$ with $18.5\%$ of rectal complication and $4.9\%$ of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gr) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.4
• /
• pp.255-263
• /
• 2011

Introduction: Maxillomandibular fixation (MMF) is essential before surgery under general anesthesia in maxillofacial trauma patients. MMF is used basically to reconstruct the occlusion and occlusal stability to recover the facial shape and oral functions. The arch bar and wire is a traditional method for MMF, but it can not only bring pressure to the periodontal ligaments and teeth but also cause a penetrating injury to the surgeons. Materials and Methods: In this study, 198 patients with an open reduction using a manual reduction without MMF from September 2005 to May 2010 in Dankook University Dental Hospital were subjected to a follow-up evaluation during the postoperative 4 months periods. This study evaluated the incidence of complications according to the condition of the patient (gender, age), the state of bony union of the fracture sites and a numeric rating scale evaluation for postoperative pain scoring. Results: 1. The complications were classified into major and minor according to the seriousness, and the major complication rate was as low as 2.02%. Only 2 cases of re-operations (1.01%) were encountered. In the classification according to the fracture line, plate fracture was observed in both cases of mandibular symphysis fracture, and angle fractures and loosening of two screws were noted in the case of mandibular angle fracture. 2. The complication rate was similar regardless of gender and age. 3. The degree of bony union was satisfactory, and the complication rate was reduced as the bony union improved. 4. More patients complained of pain as the operation time was increased. Conclusion: The use of MMF is not always necessary if a skilled assistant is provided to help manually reduce the fracture site. Compared to other studies of mandibular fracture surgery using MMF, the complication rate was similar using only manual reduction and the patients' discomfort was reduced without MMF.

• Korean Journal of Head & Neck Oncology
• /
• v.11 no.1
• /
• pp.9-17
• /
• 1995

This study was retrospectively reviewed and analysis of postoperative local complication on all patient undergoing thyroid operation of 242 cases of thyroid disease, at Department of General Surgery, Chosun University Hospital from January 1988 to December 1992. The result were follow: Postoperative local complication are as follow; 52 cases of transient hypocalcemia, 7 cases of thansient hoarseness, 3 cases of permanent hypocalcemia, 2 cases of permanent hoarseness, and other local complication were postoperative bleeding with airway obstraction, hematoma, infection. In pathologic classification according to complicative patients; The most common frequency of complication in benign disease was Graves' disease with 13 cases(54.2%), and the most frequency of complication in malignance disease was follicalar adenocarcinoma with 7 cases(53.9%). The frequency of complication according to operation procedure were unilateral lobectomy in 31 cases(19.9%), subtotal thyroidectomy in 15 cases(39.5%), near total thyroidectomy in 12 cases (44.4%), and total thyroidectomy in 10 cases(55.6%). There was a significant relationship between extent of operative procedure and frequency of complication. The incidence of local complication after thyroid resection was 57 of 196(29.1%) in the benign disease that was 15 of 26(57.7 %) in the intrathyroidal carcinoma and 13 of 20(65.0%) in the extrathyroidal carcinoma. There was significant different in frequency of local complication according to invasion and malignance of pathologic lesion. The most frequent complication after thyroid resection is transient hypocalcemia ; 39 of 196(19.9%) in the benign disease, 7 of 26(26.9%) in the intrathyroida1 carcinoma, and 6 of 10(30.0%) in the extrathyroidal carcinoma. Their complication rate increased in direct relationship to the invasion and malignance of pathologic lesion, but there was no statistically significant. Transient hypocalcemia was encountered in 52 cases of the total 242 patient(21.9%) ; 29 of 156(18.6%) after unilateral lobectomy, 9 of 38(23.7%) after subtotal thyroidectomy, and 5 of 18(27.8 %) after total thyroidectomy. The relation ship between temporal hypocalcemia and the extent of surgery was not statistically significant.

• Korean Journal of Head & Neck Oncology
• /
• v.14 no.1
• /
• pp.61-69
• /
• 1998

Objectives: The response rate of the radioactive iodine(RI) therapy with low dose was variable. Only a few studies reported the response and complication rate with high dose. The goal of this study was to access the ablation and complication rate after high dose of RI therapy (more than 100mCi) and to evaluate the factors affect the results. Material and Methods: During a period of 12 years, 225 patients received high dose of RI from 100 to 200mCi depending on the RI uptake in the whole body after total thyroidectomy. 100mCi of RI was given to 123 patients for ablation who showed the uptake only in the thyroid bed. 150mCi was given to another 84 patients for ablation who had uptake confined to the neck. The other 21 patients took more than 200mCi of RI because the whole body scan showed distant metastasis. Among these patients, the ablation and the complication rate was investigated. Results: Elevated level of the serum thyroglobulin(Tg) decreased less than 5ng/ml after RI therapy in all patients except two in the first group. The second group showed reduction of the serum Tg in 93%. Eighteen of the 21 patients in the third group are still alive after RI therapy. There were no fatal complications after high dose RI therapy and most of the complications were minimal and transient. The complication rate was not related with the dose of RI, age, sex, DNA flowcytometry, serum thyroglobulin level and the extent of node dissection. Conclusion: We concluded that RI therapy with high dose was very effective for thyroid ablation after operation and it also showed excellent results with minimal complications for treatment of metastatic lesions.

• Journal of Chest Surgery
• /
• v.6 no.2
• /
• pp.219-224
• /
• 1973

82 cases of esophageal stenosis due to lye solution in our hospital, which is surgicallly treated with retrosternal esophagoplasty were reported. female was 2 times more then male and average age is 30 years old. Dyphagia and precordial pain were chief complaint. In this technique, jejunum, right and left colon were substituted for constricted esophagus. Postoperative complication rate 14.6%, mortality rate due to other complication were 21.9% but had not seen in this operative technique.

• Journal of Chest Surgery
• /
• v.28 no.2
• /
• pp.150-155
• /
• 1995

For study the influencing factors to the complication after pneumonectomy, authors performed retrospective analysis in 33 patients managed surgically from February 1985 to February 1994 in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital.Among 33 patients, the underlying diseases were distributed 15 patients[45.5% pulmonary tuberculosis, 14[42.% lung cancer and 4[12.1% bronchiectasis. Numbers of complication according to the underlying disease after pneumonectomy were 8 in pulmonary tuberculosis, 2 in lung cancer and 1 in brochiectasis. Study was analyzed on age, sex distribution, etiology of underlying diseases and operated sides contributing to the complication. The results were characterized that the rate of occurrence of complication after pneumonectomy was not affected by age, sex and operated side differences but affected by the underlying disease.The development of complication after pneumonectomy in patients with pulmonary tuberculosis revealed statistically borderline significance comparing to the others[p=0.07 .