• Title/Summary/Keyword: 복부 절개술

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Off-pump Reoperative Coronary Artery Bypass by Thoracotomy and Laparotomy -A case report - (개흉술과 복부 절개술을 통한 심폐바이패스를 이용하지 않은 관상동맥 재수술 - 1예 보고 -)

  • Kim Jeong-Won;Hahm Shee-Young;Je Hyoung-Gon;Cho Won-Chul;Song Meong-Gun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.710-713
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    • 2006
  • The incidence of reoperative coronary artery bypass grafting (CABG) has increased because of the rise in the number of patients who have undergone initial CABG. In addition, recent technological advances have resulted in widespread application of off pump coronary artery bypass (OPCAB). We report a case of redo OPCAB through thoracotomy and small laparotomy in 76-year-old man with recurrent unstable angina.

Hand-assisted Laparoscopic Abdominal Aortic Aneurysm Repair Through a 6 cm Incision (6 cm 절개선을 통한 수기 보조 복강경 복부 대동맥류의 수술)

  • Choi, Hyung-Yoon;Song, Suk-Won;Yi, Gi-Jong
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.645-648
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    • 2009
  • We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal. aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the $4^{th}$ postoperative day.

A case report of Successful Laparascopic Myotomy for Achalasia (식도이완불능증의 복강경 수술)

  • 황성욱;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.157-160
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    • 2002
  • Recently, video-assisted surgical approaches for achalasia have been adopted by many surgeons. Many reports showed that the minimal invasive video-assisted operations for Ihe achalasia revealed such good results as the conventional operations via thoracotomy. In some studies, among the minimal invasive video assisted surgeries for achalasia, the laparascopic assisted operations have some advantages mainly in respect to patient satisfaction over the thoracoscopic assisted surgeries. In this case, the patient had not responded to repeated balloon dilatation, and we made 5 small incisions over the abdominal wall and performed an esophageal myotomy and partial anterior fundoplication by laparascopic guide. The patient's symptoms were almost relieved, and the postoperative radiologic findings were satisfactory.

Total Aortic Replacement - A Case Report - (대동맥 전장 치환 치험 1례)

  • Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.173-177
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    • 1998
  • A 28 years old pregnant woman(Gestational age 35 weeks) had been operated emergency Cesarian section for delivery and emergency graft replacement of ascending aorta and total arch for acute type A aortic dissection. 1 year and 6 months later, she underwent aortic graft replacement from descending thoracic aorta to both common iliac arteries because of further progression of aortic dissection. So far she has a complete artificial graft aorta.

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The Thracoabdominal Aortic Replacement Using Deep Hypothermic Circulatory Arrest Technique (흉복부대동맥치환술에서 극저체온하순환정지법의 효과)

  • Woo, Jong-Su;Bang, Jung-Hee;Kim, Si-Ho;Choi, Pil-Jo;Cho, Kwang-Jo
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.194-200
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    • 2006
  • Background: Thoracoabdominal aortic replacement is an extensive operation that opens both the pleural cavity and abdominal cavity, which has high mortality and morbidity rate. The authors have reported 9 cases of the thoracoabdominal aortic replacement in 2001. Since 2003 we have applied the deep hypothermic circulatory arrest to the Crawford type I and II thoracoabdominal aortic replacement. Therefore, we analysed the effect of the changes in operative techniques. Material and Method: Between 1996 and 2005, we have performed 20 cases of thoracoabdominal aortic replacement. The underlying diseases were 8 cases of atherosclerotic aneurysm with 4 cases of ruptured aneurysm and 12 cases of aortic dissection with 10 cases of a previous operations. According to Crawford classification, there were 2 cases of type I, 7 cases of type II, 1 case of type III, 7 cases of type IV, and 3 cases of type V. We compaired the results of the patients who underwent thoracoabdmoninal replacement before 2001 which already has been reported and after then. Result: Before 2001 we have performed 9 cases of thoracoabdominal replacement and 5 patients were died of the operation. All three patients with type I and II were died. There was no case of thoracoabdominal replacement between 2001 and 2002, but after 2003 we have performed 11 cases of thoracoabdominal replacement which involved 1 case of type I, 5 cases of type II, 1 case of type III, 2 cases of type IV and 2 cases of type V. There was no mortality and no fetal complications. Conclusion: The deep hypothermic circulatory arrest is a safe method of extended thoracoabdominal aortic replacement.

Surgical Correction of Thoracic Aortic Aneurysm Associated with Coronary Artery Disease A Case Report -A Case Report- (관상동맥질환을 동반한 대동맥류 수술치험 1례)

  • 우종수;서정욱
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.724-728
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    • 1997
  • We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

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Klebsiella Pneumonia-Necrotizing Fasciitis followed by Liver Abscess (폐렴 간균-괴사성 근막염에 이어 발생한 간농양)

  • Lee, Seung Hyun;Choi, Jeong Woo;Lee, Myeung Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.427-431
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    • 2018
  • We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

Neonatal Intestinal Pseudo-obstruction Associated with Deficiency of the Interstitial Cells of Cajal in a Premature Infant (카할세포 결핍과 연관된 미숙아 가성 장폐쇄 1례)

  • Lee, Soo-Jung;Lee, Woo-Ryoung
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.196-199
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    • 2008
  • The interstitial cells of Cajal are the pacemakers in the gastrointestinal tract that modulate gastrointestinal motility. A case of a neonate with intestinal pseudo-obstruction caused by a decreased number of the interstitial cells of Cajal is presented. A premature male infant born at 32 weeks of gestation showed progressive abdominal distention beginning 3 days after initiation of enteral feeding at 15 days of life. No etiologic factors were identified on radiologic studies, a gastrographin enema, and an intestinal biopsy other than a markedly decreased number of the intestinal cells of Cajal. An ileostomy, followed by repair of the ileostomy was done, which resulted in but a limited improvement of the abdominal gas pattern. Respiratory distress, pancytopenia, and abdominal distention persisted, and the infant expired on 142 days of life.

Awake OPCAB: Initial Experience (의식 있는 상태에서 경막외 마취를 이용한 심박동하 관상동맥우회술: 초기 경험)

  • Son Kuk-Hui;Cho Kwang-Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.598-603
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    • 2006
  • Background: High thoracic epidural anesthesia allows awake coronary artery bypass grafting, avoiding the drawbacks of mechanical ventilation and general anesthesia. Materian and Method: From April, 2005 to September, 2005, 12 patients were underwent awake coronary artery bypass grafting using high thoracic epidural anesthesia. There were 1 female and 11 male patients, with a mean age of $66{\pm}6$ years. Off pump coronary artery. bypass grafting was performed through a median sternotomy using arterial grafts. Result: There were no mortality. Pneumothorax was developed during surgery in 8 patients. Five patients required secondary intubation because of pneumothorax (n=3), bowel herniation (n=1), and hemothorax after chest tube insertion (n=1). Postoperative coronary angiography was performed before discharge in all patients and all the grafts were patent. Conclusion: Our intial experience demonstrated the feasibility of awake off-pump coronary artery bypass grafting. Further study is required to define the indications, advantages and limitations of this strategy.

A Case of Uterine Adenocarcinoma in A Spayed Female Dog (중성화된 암캐에서 발생한 자궁 선암종 증례)

  • Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.1
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    • pp.53-56
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    • 2013
  • A 10-year-old spayed female Pekinese dog was referred to veterinary medical teaching hospital of Chonbuk National University with signs of dysuria, abdominal distension, and hematuria. Abdominal radiography revealed a large oval soft tissue mass in cranial abdomen, which was a fluid filled cyst containing a round mass by ultrasonography. Exploratory laparatomy found a 4 cm cyst containing reddish brown fluid and a 1.5 cm small round mass attached to the wall. Cytological impression of the imprint smears of the resected mass were highly malignant adenocarcinoma, which was confirmed by histopathology of the mass and the cyst. After the surgery the patient recovered uneventfully and discharged. The tumor recurred about one year after surgery, and second surgery performed at the owner's request. However the tumor recurred in two months with metastatic disease in the lung and the dog survived three more months after surgery.