• Archives of Plastic Surgery
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• v.37 no.4
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• pp.499-530
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• 2010

Purpose: Lateral osteotomy is an essential step in the correction of nasal bony asymmetry. Direct visualization allows accurate repositioning of the nasal bones compared to blind techniques, which require precision and manual dexterity. We propose direct visualization procedures in open corrective rhinoplasty. Methods: The technique was used on 16 patients. All patients underwent open rhinoplasty with a columellar incision. The marginal incisions were extended on either side to allow access to the piriform aperture. A double hook was used to caudally retract the lower lateral cartilages and the fibrous connections between the upper and lower lateral cartilages were released until the piriform aperture was visualized. Through the incision, lateral osteotomy was performed using a reciprocating saw at that time with direct visualization. Additional procedures including augmentation rhinoplasty, hump resection, septoplasty and tip plasty were performed simultaneously. Results: This method provided excellent exposure to the lateral nasal bones and allowed the lateral osteotomy to be carried out precisely using the reciprocating saw. Conclusion: This extended open rhinoplasty method is suitable for most individuals, allowing a wide surgical field.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4295-4299
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• 2014

Background: Surgery offers the only potential for cure and long-term survival of recurrence of rectal cancer. Few studies about laparoscopic recurrent lesion resection have been reported. This study was designed to evaluate the safety and feasibility of laparoscopic abdomino-perineal resection for anastomotic recurrence of rectal cancer. Materials and Methods: Data for 42 patients with recurrence of rectal cancer were collected retrospectively. Of the 42 patients, 22 underwent laparoscopic surgery (LR group) and 20 received open surgery (OR group). Outcomes between the two groups were compared. Results: Operation time in LR group was shorter compared with the OR group ($164.6{\pm}27.7min$ vs $203.0{\pm}45.3min$); intra-operative blood loss was $119.7{\pm}44.4ml$ and $185.0{\cdot}94.0ml$ in LR group and OR group, respectively (p<0.001); time to first flatus in LR group was shorter than in OR group, and the difference was statistically significant ($2.6{\pm}0.8$ days vs $3.1{\pm}0.8$ days, p=0.013); hospital stay in the LR and OR groups was $8.6{\pm}1.3$ days and $9.8{\pm}2.2$ days; 3-year survival rates in the LR and OR groups were 44.4% and 42.8% (p=0.915) and the 3-year disease-free survival rates were 36.4% and 30.0%, respectively (p=0.737). Conclusions: Laparoscopic abdomino-perineal resection is safe and feasible for anastomotic recurrence of rectal cancer.

• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.38-41
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• 2000

Purpose : We report a result of arthroscopic resection after inner-wall staining for treatment of prepatellar bursitis which was not treated conservatively. Materials and Methods : Between January 1996 and October 1998, We treated arthroscopically 11 patients with prepatellar bursitis. Arthroscopic resection was performed with shaver after inner-wall staining using Methylene Blue and then placed continuous suction drainage and compressive dressing. Results : All patients had no tender scars and were able to walk immediately after procedure. We found one case of late infection during follow-up. Conclusion : Arthroscopic bursectomy minimizes the complication of open bursectomy such as pain or large scar. Skin perforation would be prevented by inner-wall staining.

• Journal of Gastric Cancer
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• v.15 no.4
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• pp.278-285
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• 2015

Purpose: Gastric submucosal tumors (SMTs) located very close to the esophagogastric junction (EGJ) are a challenge for gastric surgeons. Therefore, this study reports on the experience of using endoscopic and laparoscopic full-thickness resection (ELFR) with laparoscopic two-layer suturing in such tumors. Materials and Methods: Six patients with gastric SMTs very close to the EGJ underwent ELFR with laparoscopic two-layer suturing at Kyungpook National University Medical Center. With the patient under general anesthesia, the lesser curvature and posterior aspect adjacent to the EGJ were meticulously dissected and visualized using a laparoscopic approach. A partially circumferential full-thickness incision at the distal margin of the tumor was then made using an endoscopic approach under laparoscopic guidance. The SMT was resected using laparoscopic ultrasonic shears, and the gastric wall was closed using two-layer suturing. Thereafter, the patency and any leakage were checked through endoscopy. Results: All the ELFR procedures with laparoscopic two-layer suturing were performed successfully without an open conversion. The mean operation time was $139.2{\pm}30.9$ minutes and the blood loss was too minimal to be measured. The tumors from four patients were leiomyomas, while the tumors from the other two patients were gastrointestinal stromal tumors with clear resection margins. All the patients started oral intake on the third postoperative day. There was no morbidity or mortality. The mean hospital stay was $7.7{\pm}0.8$ days. Conclusions: ELFR with laparoscopic two-layer suturing is a safe treatment option for patients with an SMT close to the EGJ, as major resection of the stomach is avoided.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.225-231
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• 2008

Purpose: Laparoscopic gastric resection (LGR) is increasingly being used instead of open gastric resection (OGR) as the standard surgical treatment for gastric submucosal tumors. Yet there are few reports on which technique shows better postoperative outcomes. This study was performed to compare these two treatment modalities for gastric submucosal tumors by evaluating the postoperative outcomes. We also provide an analysis of the learning curve for LGR. Materials and Methods: Between 2003.4 and 2008.8, 103 patients with a gastric submucosal tumor underwent either LGR (N=78) or OGR (n=25). A retrospective review was performed on a prospectively obtained database of 103 patients. We reviewed the data with regard to the operative time, the blood loss during the operation, the time to the first soft diet, the postoperative hospital stay, the tumor size and the tumor location. Results: The clinicopatholgic and tumor characteristics of the patients were similar for both groups. There was no open conversion in the LGR group. The mean operation time and the bleeding loss were not different between the LGR group and the OWR group. The time to first soft diet (3.27 vs. 6.16 days, P<0.001) and the length of the postoperative hospital stay (7.37 vs. 8.88 days, P=0.002) were shorter in the LGR group compared to the OGR group. The tumor size was bigger in the OGR group than that in the LGR group (6.44 vs. 3.65 cm, P<0.001). When performing laparoscopic gastric resection of gastric SMT, the surgeon was able to decrease the operation time and bleeding loss with gaining more experience. We separated the total cases into 3 periods to compare the operation time, the bleeding losses and the complications. The third period showed the shortest operation time, the least bleeding loss and the fewest complications. Conclusion: LGR for treating a gastric submucosal tumor was superior to OGR in terms of the postoperative outcomes. An operator needs some experience to perform a complete laparoscopic gastric resection. Laparoscopic resection could be considered the first-line treatment for gastric submucosal tumors.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.750-757
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• 1990

Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.320-323
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• 2000

This case describes a tracheal stenosis complicated by endobronchial truberculosis. A 50-year-old female with progressive dyspnea was referred to us for the management of long segmental tracheal stenosis. Treatment modalities for tracheal stenosis include open surgical resectin and reconstruction, mechanical dilation, laser resection, and placement of an airway prosthesis. The following is a report of a successful treatment of a long segmental tracheal stenosis through a tracheal augmentation and the use of al Bovine pericardium. This technique may provide a relief from tracheal stenosis.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.689-692
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• 1995

Pulmonary aspergilloma is a rare disease, most commonly presenting as secondary invasion of preexisting cavitary disease. Tuberculosis and bronchieetasis were the commonest pre-existing diseases. Between 1990 and 1994, 11 patients[7 male and 4 female underwent thoracotomy for treatment of pulmonary aspergilloma. The mean age was 45.7 years. The most common indication for operation was hemoptysis. Lobectomy was the m&t frequent operation. Major complication occurred in a patient with bronchopleural fistula and treated with open drainage. There was no operative death. It is concluded that elective pulmonary resection is recommended for all patients with aspergilloma who do not constitute prohibitive operative risks.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.269-271
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• 2011

Pilomatrix carcinoma originates in the matrix cell and is marked by exophytic growing and common local recurrence. There is no established treatment for wide local invasion and metastasis of the pilomatrix besides wide surgical resection. We report a case of rapidly progressive pilomatrix carcinoma, which arose around an Eloesser open window with direct invasion to the adjacent tissue.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1002-1007
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• 1994

The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.