• Hip & pelvis
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• 제35권1호
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• pp.24-31
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• 2023

Purpose: A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. Materials and Methods: A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. Results: The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Conclusion: Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.541-545
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• 2006

Purpose: There are many methods for the reconstruction of the facial defect after an excision of a skin cancer; such as skin graft, local flap, free flap, etc... Skin graft has its' limitations; it could remain in different color with in regards of the recipient to donor, with an unfavorable scar. Free flap can lead to big donor site morbidity with long operation time and uncontrolled scar as a disadvantage factor. Compared to the prior, local flap offers several merits; sufficient blood supply, good tissue quality and short operation time. We revised 'V-Y-S flap' for the facial defect, which proved to have favorable outcomes. Methods: Total 7 V-Y-S flaps were performed to patients with skin cancers(six squamous cell carcinoma and one basal cell carcinoma). Two of these flaps were combined with composite grafts, one with full thickness skin graft. Six patients were female and one male. The average diameter of defects after excision was 2.3 cm. The follow-up period was 18 months maximally. Results: We treated seven facial skin cancers with 'V-Y-S flap'. There were no flap necrosis, cancer recurrence and scar contracture as a result. Furthermore, this method also offers a favorable central scar line that is parallel to the nasolabial fold and the nasojugal groove, especially in the nasolabial area and superomedial side of the cheek. With this method, we could cover a maximum diameter of 4cm facial defect. Conclusion: In conclusion, it is suggested that V-Y-S flap is a useful method to cover facial defects after the excision of a skin cancer.

• 대한골관절종양학회지
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• 제11권1호
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• pp.71-81
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• 2005

목적: 근위 대퇴골의 전이성 종양에서 소파술 후 금속 내고정술 또는 고관절 성형술을 시행했던 환자에게서 종양의 국소 재발로 인한 금속 부전을 경험한 저자들은 광범위 절제술 후 재활용 자가골 이식을 이용한 고관절 성형술을 시행하고, 술 후 국소 재발의 유무와 하지의 기능, 합병증의 발생을 통해 전이성 골종양에서 광범위 절제술 후 재활용 자가골을 이용한 재건술의 타당성에 대해 연구하고자 한다. 대상 및 방법: 2000년 5월부터 2003년 5월까지 근위 대퇴골의 전이성 종양 환자 중 광범위 절제술 후 재활용 자가골을 이용한 재건술을 시행한 6례, 5명의 환자를 대상으로 하였다. 환자의 평균 연령은 60.8세, 남녀 비는 3:2였고 술 후 평균 생존 기간은 23.2개월(7~57개월) 이었다. 원발 병소로는 폐암이 2례였고, 위암, 신장암, 다발성 골수종이 각각 1례였다. 수술은 전례에서 광범위 절제술 후 고관절 재건술을 시행하였으며, 재건술로는 체외 방사선 조사 후 자가골 이식술 및 고관절 반치환술을 4례, 저온 처리한 자가골 이식술 및 고관절 전치환술을 2례에서 시행하였다. 술 후 6개월의 Musculoskeletal Tumor Society(MSTS) 기능 평가 지수(1993년) 및 합병증, 생존 기간 동안의 국소 재발의 유무에 대해 조사하였다. 결과: 술 후 6개월에 조사한 MSTS 기능 평가 지수는 63.3%였고, 술 후 합병증으로는 고관절 탈구가 1례에서 발견되었다. 생존 기간 동안 국소 재발의 소견은 관찰되지 않았다. 결론: 술 후 생존 기간이 6개월 이상으로 추정되는 근위 대퇴골의 전이성 종양에서 소파술 후 금속 내고정술이나 고관절 성형술을 시행하는 것보다 광범위 절제술 후 재활용 자가골을 이용한 고관절 재건술을 시행하는 것이 국소 재발을 방지하여, 환자의 생존 기간동안 사지의 기능을 보존하는데 도움이 될 것으로 사료된다.

• 대한두경부종양학회지
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• 제13권2호
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• pp.256-259
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• 1997

The fibromatoses are defined as a group of non encapsulated, non metastasizing, fibrous tumors that have a tendency for infiltrative growth and local recurrence following surgical excision and can be divided into fascial and musculoaponeurotic fibromatoses. Infantile fibromatosis is childhood counterpart of musculoaponeurotic fibromatosis and is more common in the head and neck, the shoulder and upper arm and the thigh. Treatment includes excision, radiation, steroid and chemotheraphy, etc. Treatment of choice is complete excision but postoperative deformity and sequelae should be considered. Recently, we have experienced a case of infantile fibromatosis originating from infratemporal fossa and report this case with a review of literatures.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.512-515
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• 2007

Purpose: Clear cell hidradenoma, now regarded as an eccrine sweat gland tumor on the basis of its enzyme histochemical and electron microscopic features, occurs as a solitary tumor in most instances. Methods: A 17 year old male presented with asymptomatic nodule, which had developed on nipple with a four years of history and total excision and purse-string suture was then performed. Results: No recurrence was observed 2 months after excision. Histologically, it showed a well circumscribed tumor composed of characteristic clear epithelial cells which are focally arranged in glandular patterns. Conclusion: This case is unique in that the tumor developed on the young male nipple, unusual site and this report emphasizes the benefit of local excision to prevent recurrence of these tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.382-385
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• 2022

Congenital epulis (CE) is an extremely rare benign tumor of the gingiva that is found on the alveolar ridge of newborns, and the main treatment option is simple excision. Postoperative prognosis is very good, and spontaneous regression may occur despite incomplete excision. This report presented a rare case of CE and its healing process after surgery under local anesthesia. The treatment plan was decided upon through consultation between a medical team and the patient's family, with surgical excision for the main lesion, which benefitted from surgery, and follow-up for a very small-sized lesion, which was thought to be appropriate for a newborn. No recurrence was found after its removal, and favorable healing was observed.

• Radiation Oncology Journal
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• 제11권2호
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• pp.411-419
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• 1993

A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.32.1-32.5
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• 2017

Background: Osteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses. Case presentation: This study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period. Conclusions: In local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.376-383
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• 2012

Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.

• 대한골관절종양학회지
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• 제2권1호
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• pp.106-110
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• 1996

A subungual exostosis is an uncommon benign osteochondral lesion that appears as a painful nodule. Histologically, the tumors consist of a proliferating fibrocartilaginous cap that merged into mature trabecular bone at its base. From 1989 through 1991, 5 patients with subungual exostosis were treated. Three of them had exostosis on the great toe. There were three girls and two boys. The average age of the patients was 10.6 years. All of patients were treated by local excision. Two cases of our patients treated with an incomplete excision were recurred within 3 months after the original procedure. Lack of awareness of unusual lesion can cause initial misdiagnosis in many cases. We considered that a complete excision of the lesion is important for preventing the recurrence, and it should be confirmed with intraoperative radiographs.