• Title/Summary/Keyword: 수술 후 감염

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Anatrophic Nephrolithotomy; Experience in 55 Cases (비위축성 신절석술 55례)

  • Kim, Tae-Jin;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.149-155
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    • 1992
  • 55 consecutive anatrophic nephrolithotomies on 53 patients performed between July, 1983 and June, 1990 were reviewed. The patients(36 male and 19 female) ranged in age from 3 to 72years. The operation time averaged 219.8 minutes with a range of 120-330 minutes, and the ischemic time ranged between 20 and 90 minutes, with a mean of 43.5 minutes. Postoperative complications developed in 18 patients, which were such as persistent urinary tract infection in 5cases(9.4%), atelectasis in 4(7.5%), transient urine leak in 2(3.8%), delayed bleeding in 2(3.8%) and urinary retention in 2(3.8%), Postoperative residual stones were identified in 15(27.3%), but in 8 of these 15patients stones were delivered spontaneously and thus 48 of 55 cases(87.3%) became stone free, The recurrence of stone was noted in 2 out of 48 patients during the short followup period. Anatrophic nephrolithotomy seems to be an effective method compared to other procedure because of decreasing recurrence of stone by complete stone removal and reconstruction of abnormal collecting system.

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Surgical Correction of Total Anomalous Pulmonary Venous Connection without Total Circulatory Arrest (완전 순환 정지 없이 시행한 총 폐정맥 환류 이상의 수술 교정)

  • Han Won Kyung;Cho Joon Yong;Lee Jong Tae;Kim Kyu Tae;Chang Bong Hyun;Lee Eung Bae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.12-17
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    • 2006
  • Background: Circulatory arrest under deep hypothermia is an important auxiliary means for surgical correction of total anomalous pulmonary venous connection (TAPVC), However, cardiac operations under deep hypothermic circulatory arrest are associated with the risk of post-arrest neurologic abnormalities. The purpose of this study is to evaluate the results of the surgical correction of total anomalous pulmonary venous connection without the total circulatory arrest. Materiai and Method: Between April 2000 and October 2004, hospital records of 10 patients were reviewed retrospectively. Result: The locations for abnormal anatomical connections were supracardiac in 7 cases, cardiac in 1 case, and infracardiac in 2 cases. The mean cardiopulmonary bypass time and aorta cross clamp time were 116.8$\pm$40.7 and 69.5$\pm$24.1 minutes. There was no surgical mortality. Postoperative complications were post-repair pulmonary venous stenosis in 1 case, pneumonia in 1, pneumothorax in 1, wound infection in 1,and diaphragmatic paralysis in 1. All patients without pulmonary venous stenosis were in NYHA class I at mean follow-up of 16.6 months (3$\∼$49 months) Conclusion: We could obtain excellent results by repair without the total circulatory arrest for total anomalous pulmonary venous connection.

Biportal Endoscopic Spinal Surgery for Lumbar Intervertebral Disc Herniation (두 개의 입구를 통한 내시경 척추 수술: 요추부 추간판 탈출증에의 적용)

  • Lee, Ho-Jin;Choi, Dae-Jung;Park, Eugene J.
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.211-218
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    • 2019
  • Herniation of the intervertebral disc is a medical disease manifesting as a bulging out of the nucleus pulposus or annulus fibrosis beyond the normal position. Most lumbar disc herniation cases have a favorable natural course. On the other hand, surgical intervention is reserved for patients with severe neurological symptoms or signs, progressive neurological symptoms, cauda equina syndrome, and those who are non-responsive to conservative treatment. Numerous surgical methods have been introduced, ranging from conventional open, microscope assisted, tubular retractor assisted, and endoscopic surgery. Among them, microscopic discectomy is currently the standard method. Biportal endoscopic spinal surgery (BESS) has several merits over other surgical techniques, including separate and free handling of endoscopy and surgical instruments, wide view of the surgical field with small skin incisions, absence of the procedure of removing fog from the endoscope, and lower infection rate by continuous saline irrigation. In addition, existing arthroscopic instruments for the extremities and conventional spinal instruments can be used for this technique and surgery for recurred disc herniation is applicable because delicate surgical procedures are performed under a brightness of 2,700 to 6,700 lux and a magnification of 28 to 35 times. Therefore, due to such advantages, BESS is a novel technique for the surgical treatment of lumbar disc herniation.

The Effects of the Decortication on Pulmonary Function in Tuberculous Empyema (결핵성 농흉 환자에게 시행한 흉막박피술의 폐기능 개선 효과)

  • Lee, Seok-Young;Kwon, Sung-Youn;Kim, Deog-Kyeom;Yoo, Chul-Gyoo;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Yong-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.30-36
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    • 2000
  • Background : The purpose of decortication is to eliminate the infection focus and to improve the decreased lung function due to chronic empyema. However, lung function is not improved in all cases. It would be clinically useful if we could predict prepoperatively whether lung function would improve after decortication. The purpose of this study is to find useful indices for predicting the possible improvement of lung function after decortication. Method : The medical records of 37 tuberculous empyema patients who underwent pleural decortication were analyzed retrospectively from 1990 to 1996. The measurements of preoperative and postoperative foræd vital capacity(FVC) were used for evaluating the effects of decortication. Results : The sex ratio was 29:8 (male to female), and the median age was 34 years. The time interval between the formation of empyema and operation was 1 month to 30 years. Postoperative pulmonary function test was performed 5.4$\pm$2.6 months later. FVC(forced vital capacity) was significantly increased from 2.77$\pm$0.67(L) to 2.95$\pm$0.81(L). Interestingly, postoperative pulmonary function was significantly improved in patients who were less than 40 years old, within 4 months after diagnosis of tuberculous empyema, in the group with FVC of less than 60% of the predicted value and in the absence of calcification. Conclusion : The improvement of lung function after decortication was expected in patients younger than 40 years old, within 4 months after diagnosis of tuberculous empyema, in the group having less than 60% of the predicted FVC, without calcification.

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Surgical Treatment of Persistent Ductus Arteriosus Complicated by Bacterial Endocarditis with Pulmonary Artery Embolism 1 case report (세균성 심내막염에 의한 폐색전증이 동반된 동맥관 개존증의 수술치험 -1례 보고-)

  • Oh, Jeong-Woo;Oh, Bong-Suk;Lee, Dong-Joon
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.209-212
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    • 1997
  • A fifteen-year-old boy was transported to our hospital emmergency room due to sudden onset of chest pain, hemoptysis and dyspnea. He was diagnosed as persistent ductus arteriosus that had developed acute bacterial endocarditis with pulmonic valve vegetation and pulmonary embolism with pulmonary infarction. After conservative antibiotic therapy (vancomycin + aminoglycoside), we operated this patient successfully - patch closer of the ductus and pulmonary valve valvuloplasty - under the cardiopulmonary bypass.

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Chest Wall Hamartoma in Infancy A case report (흉벽의 간엽세포종(과오종)수술치험 1예 보고)

  • Jo, Hyeon-Min;Kim, Hae-Gyun;Mun, Dong-Seok
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1170-1172
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    • 1996
  • Chest wall hamartoma Is a very rare disease. The female infant was suffered from frequent upper respiratory infection. The chest AP revealed destruction of the ribs and widening of the intercostal space Chest CT demonstrated well-defined solid and cystic extrapleural mass. Chest M Rl revealed high signal and low signal intensities In the mass. In December, 1995, she underwent excision of the mass with partial resection of the ribs and ch st wall reconstruction with thick Cortex patch. The chest wall hamartoma was confirmed with histopathological examination. The postop course was smooth and uneventful.

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A Surgical Idea for Wide Communicated Wound on Laryngopharynx (인후두의 개방적 외상에 대한 수술적 고찰)

  • 이종원;국태진;이정헌;염시경
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.7.4-8
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    • 1982
  • The common causes of neck closed injuries are automobile accidents and sports troubles; open injuries are gun-shot wounds and stab wounds. Generally, the treatment of wide laryngopharyngeal injuries consists of tracheostomy for adequate airway, simple repair and, later, surgical intervention for chronic laryngeal stenosis and hypopharyngeal reconstruction. Recently, authors experienced a case of extensive communicated wound with large defect on the layngopharyngeal structures and anterior neck skin. This large defect was reconstructed with horizontal cervical skin flap after total laryngectomy.

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Submental Intubation for Maxillofacial Surgery -A Case Report - (구강악안면수술을 위한 악하 기관 삽관 -증례보고-)

  • Kim, Soung-Min;Kwon, Kwang-Jun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.4 no.2 s.7
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    • pp.96-99
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    • 2004
  • 구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

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Chondrosarcoma of Proximal Tibia Trated by Allograft - A Case Report - (동종골 이식술로 치료한 경골 근위부에 발생한 연골 육종 - 증례 보고 -)

  • Jung, Gu-Hee;Kim, Jae-Do;Chung, So-Hak;Cha, Sang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.165-170
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    • 2006
  • We reported a case of chondrosarcoma in proximal tibia in a 44-year-old man. MR images demonstrated a $3.5{\times}20$ cm sized bone tumor. In reconstruction of resected proximal tibia, we used the allograft bone and soft tissue defects were covered by medial gastrocnemius rotation flap and skin graft. There were no local recurrence and distant metastasis and any complication such as secondary infection, nonunion, metal failure at the time of the last follow-up. There was no limitation of knee motion through the appropriate rehabilitaion programs.

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Chest Wall Implantation of Lung Cancer after Fine Needle Aspiration Biopsy - 2 cases - (세침 흡입생검 후 발생한 폐암의 흉벽전이 -2례 보고-)

  • 강정신;조현민;윤용한;이두연
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.629-633
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    • 1998
  • Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

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