• Journal of Gastric Cancer
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• v.17 no.3
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• pp.193-203
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• 2017

The implementation of national cancer screening has increased the detection rates of early gastric cancer (EGC) in Korea. Since the successful introduction of laparoscopic gastrectomy for gastric cancer in the early 1990s, this technique has demonstrated improved short-term outcomes without compromising long-term oncologic results. It is associated with reduced pain, shorter hospitalization, reduced morbidity rates, better cosmetic outcomes, and equivalent mortality rates as those for open surgery. Laparoscopic gastrectomy improves patients' quality of life (QOL) and provides favorable prognosis. Single-incision laparoscopic gastrectomy (SILG) is one extremely minimally invasive method, theoretically offering improved cosmetic results, less postoperative pain, and earlier recovery after surgery than conventional multiport laparoscopic gastrectomy. In this context, SILG is thought to be an optimal method to promote and maximize patients' QOL in the acute postoperative phase. However, the technical difficulties of this procedure have limited its use. Since the first report describing single-incision distal gastrectomy in 2011, only 16 studies to date have evaluated SILG. Most of these studies have focused on the technical feasibility and safety of SILG because its long-term outcomes have not been reported. This article reviews the advantages and limitations of SILG.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.77-81
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• 2016

Background: Asymmetry of the infraorbital rim can be caused by trauma, congenital or acquired disease, or insufficient reduction during a previous operation. Such asymmetry needs to be corrected because the shape of the infraorbital rim or midfacial skeleton defines the overall midfacial contour. Methods: The study included 5 cases of retruded infraorbital rim. All of the patient underwent restoration of the deficient volume using polyethylene implants between June 2005 and June 2011. The infraorbital rim was accessed through a subciliary approach, and the implants were placed in subperiosteal space. Surgical outcomes were evaluated using preoperative and postoperative computed tomography studies. Results: Implant based augmentation was associated with a mean projection of 4.6 mm enhancement. No postoperative complications were noted during the 30-month follow-up period. Conclusion: Because of the safeness, short recovery time, effectiveness, reliability, and potential application to a wide range of facial disproportion problems, this surgical technique can be applied to midfacial retrusion from a variety of etiologies, such as fracture involving infraorbital rim, congenital midfacial hypoplasia, lid malposition after blepharoplasty, and skeletal changes due to aging.

• Advances in pediatric surgery
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• v.2 no.1
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• pp.72-76
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• 1996

Annular pancreas is a rare congenital anomaly with the descending duodenum encircled by a ring of pancreatic tissue, which may cause partial or complete obstruction of the duodenum. In newborn, the symptoms can be those of duodenal stasis resulting from partial intestinal obstruction secondary to some degree of duodenal stenosis. A male newborn weighing 2.0 Kg was born by C-section delivery at 37 weeks' gestation to a 27-year-old mother who had a hydramnios. He was in relatively good condition at birth except regurgitation of saliva and intermittent apnea. A plain film of the abdomen showed the double-bubble of gas filled stomach and proximal duodenum, and upper gastrointestinal series showed a dilated proximal duodenum, with a complete obstruction of the descending duodenum. Intraoperative finding revealed encirclement of the duodenal second portion by pancreatic tissue. Duodenojejunostomy was performed. After the operation, he had developed two serious complications, neonatal septicemia by Enterobacter cloacae on postoperative day 12 and systemic candidiasis on postoperative day 19, and been managed with ventilatory support, antibiotics, and antifungal agents with recovery.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.396-399
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• 2021

A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventilation, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid administration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while communication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous immunoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.152-156
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• 2021

Diplopia is a rare complication of spine surgery. The abducens nerve is one of the cranial nerves most commonly related to diplopia caused by traction injury. We report a case of a 71-year-old woman who presented with diplopia developing from abducens nerve palsy after C1-C2 fixation and fusion due to atlantoaxial subluxation with cord compression. As soon as we discovered the symptoms, we suspected excessive traction by the instrument and subsequently performed reoperation. Subsequently, the patient's symptoms improved. In other reported cases we reviewed, most were transient. However, we thought that our rapid response also helped the patient's fast recovery in this case. The mechanisms by which postoperative diplopia develops vary and, thus, remain unclear. We should pay attention to the fact that the condition is sometimes an indicator of an underlying, life-threatening condition. Therefore, all patients with postoperative diplopia should undergo thorough ophthalmological and neurological evaluations as well as careful observation by a multidisciplinary team.

• Journal of Korean Dental Science
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• v.13 no.2
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• pp.73-80
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• 2020

Purpose: The purpose of this case study series was to introduce successful implant cases that used the palatal bone in patients with severe maxillary alveolar bone atrophy or defects. Case Presentation: In this case series study, a total of four patients underwent implant placement in the palatal bone of the maxilla. A total of 6 implants were installed using the palatine bone. The patients' ages ranged from 40 to 73 years with an average age of 63.5 years. The patients had maxillary sinus-related diseases, such as maxillary sinusitis, oroantral fistula, and dentigerous cysts, prior to implantation. To achieve initial stability, the implants were placed on the palatal side, and buccally tilted. The average postoperative recovery period was 8 months. No postoperative complications occurred in any of the cases, and the approach was used without reported issues. Conclusion: Implant treatment by securing the initial fixation in the palatal bone is a good alternative when an implant must be installed in a patient who requires extensive and invasive bone graft.

• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.99-106
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• 2016

Minimally invasive surgery for gastric cancer has increased in popularity during the last two decades mainly in the Asia for patients with early-stage cancer. Nevertheless, the development of laparoscopic surgery for gastric cancers in the Western world has been slow because of the advanced stage at diagnosis for which LG is not yet considered an acceptable alternative to standard open surgery. RAG has been reported as a safe alternative to conventional surgery for treating of early gastric carcinoma. We assess the current status of robotic surgery in the treatment of gastric cancer focusing on the technical details, postoperative outcome, oncological considerations and future perspectives. In gastrectomy the biggest advantage of the robotic approach is the ease and reproducibility of lymphadenectomy. Reports also show that even the intra corporeal digestive restoration is facilitated by use of the robotic approach, particularly following TG. Additionally, the accuracy of robotic dissection is confirmed by decreased blood loss in comparison to conventional laparoscopy. The learning curve and technical reproducibility also appear to be shorter with robotic surgery and, consequently, robotics can help to standardize and diffuse minimally invasive surgery in the treatment of gastric cancer. While published reports have shown no significant differences in surgical morbidity, mortality, or oncological adequacy between robot-assisted and conventional gastrectomy. There are some advantages in terms of postoperative recovery of patients after robotic surgery. More studies are needed to assess the true indications and oncological effectiveness of robotic use in the treatment of gastric carcinoma.

• Journal of Gastric Cancer
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• v.15 no.3
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• pp.159-166
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• 2015

Purpose: Laparoscopic total gastrectomy (LTG) is more complicated than laparoscopic distal gastrectomy, especially during a surgeon's initial experience with the technique. In this study, we evaluated the short-term outcomes of and learning curve for LTG during the initial cases of a single surgeon compared with those of open total gastrectomy (OTG). Materials and Methods: Between 2009 and 2013, 134 OTG and 74 LTG procedures were performed by a single surgeon who was experienced with OTG but new to performing LTG. Clinical characteristics, operative parameters, and short-term postoperative outcomes were compared between groups. Results: Advanced gastric cancer and D2 lymph node dissection were more common in the OTG than LTG group. Although the operation time was significantly longer for LTG than for OTG ($175.7{\pm}43.1$ minutes vs. $217.5{\pm}63.4$ minutes), LTG seems to be slightly superior or similar to OTG in terms of postoperative recovery measures. The operation time moving average of 15 cases in the LTG group decreased gradually, and the curve flattened at 54 cases. The postoperative complication rate was similar for the two groups (11.9% vs. 13.5%). No anastomotic or stump leaks occurred. Conclusions: Although LTG is technically difficult and operation time is longer for surgeons experienced in open surgery, it can be performed safely, even during a surgeon's early experience with the technique. Considering the benefits of minimally invasive surgery, LTG is recommended for early gastric cancer.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.253-257
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• 1998

Background: The purpose of this study was to examine the extent and evaluation of pain after total abdominal hysterectomy (TAH) and to establish correlation between three types of pain; pain at rest, pain with movement and pain with coughing (maximum pain). Methods: The present study compared quality of pain during pain management in 48 patients undergoing TAH. Patients received i.v. meperidine as loading dose in the recovery room and PCA with nalbuphine 90 mg, ketorolac 180 mg, buprenorphine 0.9 mg, droperidol 5 mg, plasma solution A 28 ml for 3 days. The PCA device used was the Baxter infusor$^{(R)}$ (PCA module PC-19-55, 0.5 ml/hr basal rate, 15 minute lockout interval). Patients were then interviewed on Operative Day (OPD), Postoperative Day 1, 2, and 3 (POD 1, 2 and 3) to assess their pain on a visual analogue scale (VAS) of 0 (none) to 10 (worst imaginable). Results: The mean pain score at rest was 2.0 on OPD and decreased to 0.7 on POD 3. The mean pain score with movement was 3.2 on OPD and decreased to 1.6 on POD 3. The mean pain score with coughing was 4.2 on OPD and decreased to 2.2 on POD 3. Conclusions: Patients' experience of three types of postoperative pain emphasizes the need for more effective pain management.

• Journal of Korean Neurosurgical Society
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• v.38 no.4
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• pp.273-280
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• 2005

Objective : There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. Methods : The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. Results : There were 16boys and 9girls whose median age was 6months[range $2{\sim}120months$]. The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness[y] could be expressed with the factor of month[x]: $y\;=\;-1.32\;{\times}\;+11.8$ in subdural drainage, and $y\;=\;-1.52\;{\times}\;+14.9$ in subduroperitoneal shunts. Of the 25patients, 2 [50%] were successfully treated by aspiration, 13 [59%] by subdural drainage, and 9 [69%] by subduroperitoneal shunt. Conclusion : It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.