• Title/Summary/Keyword: 복강경 수술

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Diagnosis and Treatment of Gastric Cancer (위암의 진단과 치료)

  • Song, S.K.
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.173-181
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    • 1996
  • 위암 환자의 수술후 5년 생존율은 조기암의 경우 90%이상으로 매우 좋으나 진행암의 경우 20~30%를 넘지 못한다. 위암의 예후에 영향을 주는 요인 중 조기 발견보다 더 중요한 것은 없으며, 조기암의 진단율에 노력을 기울이는 것이 현실적 타개책이라 하겠다. 현재 우리나라의 조기암 진단율은 16~22%로 일본의 40~45%보다 극히 저조하므로 소화기계 증상이 있는 경우 위내시경 검사를 적극 권고함이 바람직하다. 위암은 외과적 절제술이 유일한 근치치료법임은 주지의 사실이며 근래에는 위내시경 및 복강경을 이용하여 위장관 기능을 보존하는 술식도 시도되고 있어 바람직한 발전이라 사료되나, 림프절 곽청의 원칙을 훼손하지 않는 범위내에서 이루어져야할 것이다. 근치적 절제술의 정의에 합당한 외과적 치료법만이 5년 생존율 향상을 기대할 수 있으며, 보조적 항암화학요법과 면역요법은 대상 환자의 엄선으로 부분적 치료효과를 기대할 수 있다. 절제불능 위암이나 국소진행암에서 절제율을 높이기 위한 술전치료방법들의 적극적 도입이 바람직하다. 그러나 대상 환자의 선정에 있어 객관적 타당성이 있는 병기 결정 방법과 치료효과를 판정하는 방법의 혁신이 있어야 할 것으로 사료되며 현재의 부정확한 검사방법들의 대안으로 복강경의 이용이 바람직하리라 사료된다.

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Effects of PCA (Patient Controlled Analgesics) Education Program including Practicum on Post-op Pain of Gynecologic Laparoscopic Surgery Patients (실물실습을 이용한 통증자가조절기 교육 프로그램이 부인과 복강경 수술환자의 수술 후 통증에 미치는 효과)

  • Hwang, Mi Sook;Kim, Joo Hyun
    • Journal of Korean Biological Nursing Science
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    • v.17 no.3
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    • pp.253-261
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    • 2015
  • Purpose: The purpose of this study was to identify the effects of the patient controlled analgesics (PCA) education program (including practicum) on post-op pain suffered by patients who have undergone gynecologic laparoscopic surgery. Methods: The research was designed for a nonequivalent control group before and after the test design. The subjects of this study were 54 in all and were divided into an experimental group and a control group. The program consisted of a brochure for PCA use and a practicum with an actual PCA instrument. Data were collected with questionnaires and observations and were analyzed on the basis of frequency, percentage, mean, standard deviation, ${\chi}^2$ and t-test. Results: Complaints regarding pain by the experimental group were significantly less than those of the control group in both post-op 24-hour and post-op 48-hour reporting. The experimental group pressed the PCA button much less frequently than the control group in post-op 24 hours. However, there were no significant differences in side effects between the two groups. Conclusion: Based on the results of this study, this PCA education program can be useful in the clinical nursing field and helpful for patients who use PCA.

Surgical Treatment of Gastric Cancer

  • Kim, Sang-Woon
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.105-116
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    • 2003
  • Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

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da Vinci Robot-Assisted Esophagectomy for Esophageal Cancer: A Case of Esophago-gastrostomy through the Retrosternal Route - A case report - (식도암 환자에서 da Vinci 로봇을 이용한 식도암 수술 (흉골하 통로를 통한 식도-위 문합술) - 1예 보고 -)

  • Jeong, Sang-Seok;Choi, Pill-Jo;Woo, Jong-Soo;Kim, Si-Ho;Bang, Jung-Hee;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.396-400
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    • 2009
  • Operations using the da Vinci robot have performed in for many surgeries, but the adoption of robotics to general thoracic surgery has been slow. The patient (age 74, male) visited our hospital complaining of hiccups and dysphagia. The CT scan and endoscopic biopsy revealed esophageal cancer (squamous cell carcinoma). We performed transthoracic esophagectomy using a da Vinci robot and this was followed by gastric tube mobilization via laparoscopy. Cervical esophago-gastric anastomosis was done using the hand-sewn method. The gastric tube was brought into the neck through the retrosternal route. The patient was discharged without any complications. We report here on a case of successful da Vinci robotic esophgagectomy.

The Effect of Preoperative Dexamethasone Administration, according to Age and Gender on Postoperative Pain in Patients who Undergo Laparoscopic Choelecystectomy (복강경 담낭절제술에서 연령과 성별이 고려될 때 수술 전 Dexamethasone의 투여가 수술 후 통증에 미치는 영향)

  • Lee, Cheol;Kim, Tai-Yo
    • The Korean Journal of Pain
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    • v.21 no.1
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    • pp.51-56
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    • 2008
  • Background: Preoperative dexamethasone improves the surgical outcome after laparoscopic cholecystectomy(LC). The purpose of this study was to determine the effect of preoperative dexamethasone on the postoperativepain according to age and gender in patients who undergo LC.Methods: In this double blind prospective study, 400 patients, males or females :< 45 yr and males or femaless 65 yr (n = 50 in each of eight groups) who undergoing LC were randomized to receive dexamethasone 8mg (5 ml) or saline 5 ml intravenously 100 minutes before their operation, Postoperative pain was assessedon a visual analog scale (VAS) at 1, 6, 12, and 24 hour, and the time to administering the first postoperativeanalgesics was recorded.Results: Dexamethasone was administered without consideration for age and gender, and it reduced thepostoperative pain VAS score at 1, 6, and 12 hours, and the opioid analgesic requirement, but there was nosignificant difference between administering saline or dexamethasone in the same gender and age groups.Females U 45 yr who were administered saline had the most pain sensitivity and males S 65 yr who wereadministered dexamethasone had the least pain sensitivity.Conclusions: Preoperative dexamethasone reduces the pain intensity and opioid consumption, but does notreduce the pain intensity, according to age and gender in the patients undergoing LC. As a result, Preoperativedexamethasone should be considered for routine use for patients who are undergoing laparoscopic cho-lecystectomy. (Korean J Pain 2008; 21: 51 56)

Ilioinguinal and Iliohypogastric Nerve Block for Neuropathic Pain Following the Laparoscopic Surgery -A case report- (복강경 수술후 발생한 신경병증성 통증 치료를 위한 장골서혜신경 및 장골하복신경 차단 -증례 보고-)

  • Choy, Yoon-Keun;Kim, Myoung-Hee;Jo, Dae-Hyun;Kim, In-Hyun
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.124-126
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    • 1998
  • As laparoscopic surgery becomes more popular, various complications following the laparoscope are also increasing. Nerve injury following the laparoscope is an infrequent but serious complication for both the doctor and patient. A 30-year old female patient suffered severe burning pain of the left buttock, inguinal area, external genitalia and inner side of vagina following laparoscopic surgery for ovarian mass. We successfully treated this patient with ilioinguinal, iliohypogastric nerve block in combination with epidural blocks.

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Laparoscopic Surgery for Intussusception in Children (소아 장중첩증에 대한 복강경 수술의 경험)

  • Yoon, Doo Hwan;Nam, So-Hyun
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.66-72
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    • 2013
  • Intussusception is common cause of intestinal obstruction in children. Most of intussusceptions can be treated with non-operative reduction using air or barium. However, about 10% patients need operative treatment due to failure of reduction, peritonitis, and recurrence after reduction. We introduce our experience of laparoscopic surgery for intussusception. From April 2010 to March 2013, we reviewed 57 children who diagnosed intussusception. Twelve patients underwent an operation. The cause of operation was 7 of failure of air reduction and 5 of recurrence after air reduction. Median age was 21.5 months (range: 5.0~57.7 months) and 11 children (91.7%) underwent successful laparoscopic reduction. Median operating time was 50 minutes (range: 30~20 minutes) and median hospital days was 4.5 days (range: 3~8 days). One patient had a leading point as a heterotopic pancreas and underwent bowel resection through conversion. There was neither intra-operative nor postoperative complication. Laparoscopic reduction for intussusception can bring an excellent cosmetic effect with high success rate.

성인병 뉴스 제322호

  • The Korea Association of Chronic Disease
    • The Korean Chronic Disease News
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    • no.322
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    • pp.1-18
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    • 2007
  • 은퇴의사 보건소 봉사체계 도입/내년부터 병원 등 전면파업 금지/노인요양병원 30곳 종합실사/한국인 혈당 기준 대폭 강화/흡연이 40대 발기부전 직접 원인/노인 성병 감염자 대책 절실/복강경 대장수술 97%가 대장암/이화의료원, 여성전문대학병원 재도약/베트남에 한양대 류마마티스 센타 설립/김안과, 범태평양 안과병원 네트워크 구축/약제비절감 의사에 인센티브 제공/의약품 표준코드 시행 1년 유예 요청/전 국민 살빼기 캠페인/자궁경부암 백신, 45세까지 접종 확대/제약협회와 긴밀한 관계 유지/만성폐쇄성폐질환(COPD) 환자 급증/흡연, 음주가 대사증후군 2배 높여/골다공증에 대한 이해 여전히 부족/표준체중 성인도 '복부비만' 주의/녹차, 충치 예방과 치아 착색의 양면성/마음을 여는 Heart행정 실현-충주시보건소/'열심, 합심, 양심', 三心행정 지향/만성질환관리의 정책적 추진 방향/

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Traditional Korean Medicine(TKM) Management for the Recovery after Laparoscopic Gynecological Surgery (부인과 복강경 수술 후 한의진료 방향에 대한 고찰)

  • Jeong, Jae-Cheol;Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.4
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    • pp.218-227
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    • 2008
  • Purpose: The purpose of this study is to report the TKM Management for the recovery after laparoscopic gynecological surgery. Methods: The basic informations about laparoscopy and report 3 laparoscopic postoperative patients were managed with TKM. Patients had taken the surgery for the different gynecologic diseases. Results: The 3 patients' symptoms were improved gradually. TKM management is good for the recovery of laparoscopic surgery. And the management need to reflect postoperative complications. the cause and part of operation. and postoperative common symptoms. Conclusion: The TKM managements are effective in the postoperative recovery after laparoscopic gynecological surgery. And more study is needed for developing the model.

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Development of Multi-Organ Segmentation Model for Support Abdominal Disease Diagnosis (복부질환 진단 지원을 위한 다중 장기 분할 모델 개발)

  • Si-Hyeong Noh;Dong-Wook Lim;Chungsub Lee;Tae-Hoon Kim;Chul Park;Chang-Won Jeong
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.05a
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    • pp.546-548
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    • 2023
  • 인공지능 기술을 도입한 의료분야에서 진단 및 예측을 위한 관련 연구가 활발하게 진행되고 있다. 특히, 인공지능 기술 적용에 가장 많이 활용되고 있는 의료영상을 기반으로 하는 질환에 관한 진단 연구는 매우 복잡한 과정이 필요한 질환의 진단에 큰 영향을 미치고 있다. 복부 장기들의 분할은 환자의 질환 진단 지원 및 복강경등의 수술 지원에 매우 중요한 부분을 차지한다. 본 논문에서는 의료영상을 통해 13가지 복부 장기들을 분할하는 모델을 만들고 그 결과를 보인다. 본 논문에서 제안한 모델을 통해 13가지 복부 장기에 대한 분할로 영상분석을 통해 진단 지원이 가능할 것으로 기대한다.