• 제목/요약/키워드: surgical ablation

검색결과 116건 처리시간 0.026초

Outcomes of Surgical Atrial Fibrillation Ablation: The Port Access Approach vs. Median Sternotomy

  • Park, Won-Kyoun;Lee, Jae-Won;Kim, Joon-Bum;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • 제45권1호
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    • pp.11-18
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    • 2012
  • Background: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases. Materials and Methods: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups' baseline characteristics, a propensity score analysis was performed. Results: After adjustment, there were no significant differences in the two groups' baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group ($176.0{\pm}49.5$ minutes) than the sternotomy group ($150.0{\pm}51.9$ minutes). There were no significant differences (p=0.31) in the two groups' rate of reoperation for bleeding (MICS=6 vs. sternotomy=2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were $87.4{\pm}8.1%$ in the MICS group and $89.6{\pm}5.8%$ in the sternotomy group (p=0.92). Freedom from late AF at 2 years was $86.8{\pm}6.2%$ in the MICS group and $85.0{\pm}6.9%$ in the sternotomy group (p=0.86). Conclusion: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.

협부피부를 침범한 상악암에서 광범위 절제술 후 광배근 이중도서형 유리피판을 이용한 재건술 1예 (Reconstruction of the Maxillary and Cheek Skin Defect with Folded Latissimus Dorsi Free Flap : A Report of One Case)

  • 권윤환;서규환;이승훈;동은상;권순영
    • 대한두경부종양학회지
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    • 제20권1호
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    • pp.41-43
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    • 2004
  • An advanced maxillary sinus cancer requires an extensive ablation that results an extensive facial deformity, including a skin defect. Reconstruction has to be considered in a radical maxillectomy, especially with skin defect may be accomplished in one stage with a microsurgical free transfer of a latissimus dorsi flap. A man of right maxillary sinus cancer, squamous cell carcinoma, 47 years old of age, had soft tissue invasion of the cheek region. He underwent a radical maxillectomy with extensive skin excision. The maxillectomy and skin defects were reconstructed with the double skin island latissimus dorsi myocutaneous free flap. The cosmetic result and the functional outcome of the nose were thought to be considerably satisfied.

Surgical Management of a Coronary-Bronchial Artery Fistula Combined with Myocardial Ischemia Revealed by 13N-Ammonia Positron Emission Tomography

  • Choi, Hang Jun;Kim, Hwan Wook;Kim, Do Yeon;Choi, Kuk Bin;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.220-223
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    • 2017
  • A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. R adiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.

피판을 이용한 구강악안면 결손부의 재건 (REVIEW OF RECONSTRUCTION OF ORAL AND MAXILLOFACIAL DEFECT WITH FLAP)

  • 이동근;정호용;이재은
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제16권3호
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    • pp.359-370
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    • 1994
  • The reconstruction of major head and neck defects must be an integral part of the overall cancer treatment plan. The priorities of surgical treatment of head and neck tumor are 1) local tumor control, 2) relief of pain, 3) avoidance of difficult dressing, 4) provision of oral continence, and 5) ability to swallow and manage saliva. The recent advances in reconstructive surgery including the development of musculocutaneous flaps and microvascular free tissue transfer have allowed the surgical restoration of head and neck tumor defects that previously were not possible. These techniques have provided the opportunity to undertake larger, more aggressive resection while at the same time permitting functional rehabilitation. The timing of reconstruction demands on the nature of the resection, the ability of the ablative and reconstructive teams to coordinate efforts, the overall health of the patients, the patient's needs and wishes. So, we report to emphasize current methods for restoring major head and neck tumor defects after tumor ablation, reviewing for the reconstructive operations, postoperative complications, and postoperative sequelae etc, of patients from Jan, 1990 to Dec, 1993.

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The supraclavicular artery island flap: a salvage option for head and neck reconstruction

  • Lee, Sanghoon;Cho, Hye-Min;Kim, Jin-kyu;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.25.1-25.4
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    • 2018
  • Background: Some of head and neck cancer patients are in compromised general condition after ablation surgery and chemoradiation therapy, which makes secondary free tissue transfer quite challenging. Elderly cancer patients also have some risk for microvascular surgery with lengthened general anesthesia. In those cases, the pedicled flap vascularized by supraclavicular artery could be considered as an alternative to free flap. Despite several authors have demonstrated the clinical reliability of supraclavicular artery island flap (SCAIF), to date, SCAIF has not been widely used among reconstructive surgeon. In this article, we clarified vascular flow pattern and introduce simple surgical technique of SCAIF with a literature review. Case presentation: Three patients who had underwent previous neck surgery and adjuvant therapy received maxillofacial reconstruction using SCAIF. It required only a few landmarks, flap harvesting was carried out, and the elapsed time gradually decreased to 15 min with experiences. There were no remarkable morbidities in both donor and recipient sites. Conclusion: SCAIF exhibited minimal anatomic variations and short learning curve of surgical techniques, which might be valuable reconstruction modality for beginning surgeon. And it can be beneficial option for the patients with vessel-depleted neck, medically compromised status for lengthened general anesthesia and failed free tissue transfer.

개에서 컴퓨터 단층촬영상을 통한 중이염의 진단 (Radiographic and CT Diagnosis Of Otitis Media In a Dog)

  • 이기창;서은정;권정국;송경진;윤정희;최민철
    • 한국임상수의학회지
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    • 제21권2호
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    • pp.184-186
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    • 2004
  • A castrated male, 6 year-old Shih-Tzu, weighing 4.6 kg with a discharge from the external ear canal and a mal-odor was referred to Verterinary Medical Teaching Hospital, Seoul National University. Radiographic findings were narrowing and focal loss of an air density in the left ear canal and bilateral thickening of the osseous bullae. For more detail examination, computed tomography was used. In computed tomographic findings, bilateral thickening of the bulla wall and increased opacity of the bulla space were observed. Thus this dog was diagnosed as bilateral otitis media. Then surgical correction, total ear canal ablation, was performed successfully and the patient showed a good prognosis thereafter. It is considered that computed tomography might serve as an useful imaging tool for otitis media and that it supplies information not obtained with a conventional radiography.

분화된 갑상선암의 치료 (Treatment of Differentiated Thyroid Cancer)

  • 송영기
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2002년도 제23차 연수교육
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    • pp.77-95
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    • 2002
  • During the last several decades, prognosis of differentiated thvroid cancers improved markedly, mainly due to refinement of surgical techniques and routine use of radioactive iodine. Total or neat-total thyroidectomy is to be performed as the first line of treatment. Routine remnant ablation just after surgery decreases recurrence and increases survival. After then patients are maintained on suppressive dose of thyroid hormone to keep endogenous TSH below normal. Regular follow-up of the patients with serum thyroglobulin measurement and iodine whole body scan after thyroid hormone withdrawal or under recombinant human thyrotropin stimulation select high risk patients with recurrence or metastatic disease and treatment with therapeutic dose of radioactive iodine prolongs survival and sometimes leads cure. Currently recommended diagnostic and therapeutic strategies, present controversies and future directions are discussed.

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Pulsed Radiofrequency Ablation Under Ultrasound Guidance for Huge Neuroma

  • Kim, Young Ki;Jung, Il;Lee, Chang Hee;Kim, Se Hun;Kim, Jin Sun;Yoo, Byoung Woo
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.290-293
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    • 2014
  • Amputation neuroma can cause very serious, intractable pain. Many treatment modalities are suggested for painful neuroma. Pharmacologic treatment shows a limited effect on eliminating the pain, and surgical treatment has a high recurrence rate. We applied pulsed radiofrequency treatment at the neuroma stalk under ultrasonography guidance. The long-term outcome was very successful, prompting us to report this case.

갑상샘암의 방사성요오드 치료의 최신 지견 (Recent Advances in Radioiodine Therapy for Thyroid Cancer)

  • 배상균
    • Nuclear Medicine and Molecular Imaging
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    • 제40권2호
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    • pp.132-140
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    • 2006
  • Well-differentiated thyroid cancer is the most common endocrine malignancy with an increasing incidence. Most patients with well-differentiated thyroid caner have a favorable prognosis with high survival rate. While surgery and radioiodine therapy is sufficient treatment for the majority of patients with differentiated thyroid cancer, a minority of these patients experiences progressive, life-threatening growth and metastatic spread of the disease. Because there is no prospective controlled study to evaluate the differences of management of thyroid cancer, it is hard to choose the best treatment option. And there are still lots of controversies about the management of this disease, such as surgical extent, proper use of radioiodine for remnant ablation and therapy, use of rhTSH instead of withdrawal of thyroid hormone, long-term follow-up strategy, thyroglobulin as a tumor marker, etc. In this review, recent data related to these conflicting issues and recent advances in diagnosis, radioiodine therapy and long-term monitoring of well-differentiated thyroid cancer are summarized.

Percutaneous Cryoablation of Multiple Pulmonary Endometriosis

  • Kim, Chong Hoon;Lee, Doo Yun;Moon, Duk Hwan;Lee, Sungsoo
    • Journal of Chest Surgery
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    • 제54권1호
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    • pp.75-78
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    • 2021
  • Minimally invasive cryoablation is often considered for lung tumor patients with high surgical risk or inoperable metastatic lung tumors. Cryoablation is a type of thermal percutaneous ablation in which argon and helium gases are delivered via a cryoprobe to induce tissue freezing and necrosis. We report the case of a 23-year-old woman who had suffered from multiple pulmonary endometriosis with frequent intermittent hemoptysis during menstruation for 6 years prior to her visit. She was treated with cryoablation at our hospital, and since her treatment, she has been doing well with no hemoptysis for at least 6 months. Although endometriosis is a benign lung disease, cryoablation is an ideal and effective treatment option for patients with multiple endometriosis.