• Title/Summary/Keyword: 위 절개술

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Surgical Treatment of Ventricular Tachycardia After Total Correction of Tetralogy of Fallot- Report of a case (TOF 완전교정술후 발생한 심실빈맥의 외과적 절제술 -치험1례보고-)

  • 장병철;김정택
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.639-645
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    • 1996
  • A 14-year-old male patient with previous surgical repair of tetralogy of Fallot was admitted with hemodynamically significant ventricular tachycardia (VT). On preoperative electrophysiologic study (EPS), the morphology of documented VT was RBBB of vertical axis with 320 msec cycle length. The endocardial mapping during VT delineated the origin of VT at right ventricular outflow tract (RVOT), where the patch was attached. The clinical VT had a clockwise reentry circuit around the patch with the earliest activation at the same site seen during the preoperative EPS. The previously placed right ventricular outflow patch and fibrous tissue were removed. During a postoperative EPS, it was no longer possible to induce the VT. Ventricular tachycardia following repair of tetralogy of Fallot seen in this patient was caused by a macro-reentry around the right ventricular outflow patch. We were able to ablate the VT with the aid of a detailed mapping of its epicardial activation sequence.

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Characterization of Porcine Tissue Perforation Using High-Power Near-Infrared Laser at 808-nm Wavelength (808 nm 파장의 고출력 근적외선 레이저 조사 시 돼지 조직의 천공 특성 연구)

  • Kim, Seongjun;Cho, Jiyong;Choi, Jaesoon;Lee, Don Haeng;Kim, Jung Kyung
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.9
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    • pp.807-814
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    • 2013
  • A fundamental study on laser-tissue interaction was conducted with the aim of developing a therapeutic medical device that can remove lesions on the intestinal wall by irradiating a high-power 808-nm infrared laser light incorporated in an endoscopic system. The perforation depth was linearly increased in the range of 1~4 mm in proportional to laser output (3~12 W) and irradiation time (5~20 s). We demonstrated that the perforation depth during laser irradiation was varied according to the tissue property of each extracted porcine organ. The measurement of the temperature distribution suggests that the energy is localized in the irradiation spot and transferred to deep tissue, which protects the surrounding tissue from thermal injury. These results can be used to set the driving parameters for a laser incision technique as an alternative to conventional surgical interventions.

Posterolateral Thoracotomy versus Muscle-sparing Vertical Thoracotomy (후측개흉술과 근육보존수직개흉술의 임상고찰)

  • Kim, Kwang-Ho;Kim, Hyun-Tae;Kim, Jung-Taek;Sun, Kyung
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.509-512
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    • 1998
  • Although posterolateral thoracotomy(PLT) has been a standard thoracic incision in resection surgery of the lung for surgeons to achieve a good surgical field, there remains concern about severing a group of thoracic muscles remains. Muscle-sparing vertical thoracotomy (MVT) is an alternative to PLT, which gives cosmetic result and may preserve motion of the shoulder girdle as well as respiratory function of the patient in the early postoperative period. However, surgeons tend not to perfer it because of limited surgical field from the vertical wound made on the lateral thoracic wall. The purpose of this study is to compare the surgical outcomes of PLT versus MVT. We retrospectively reviewed 29 patients(15 who had PLT and 14 who had MVT, organized into those two groups) who had undergone lung resection surgery in our institute. There were no clinical differences between the two groups in terms of operation time, estimated amount of blood loss during the operation, amount of chest drainage on the first and the second postoperative day, duration of chest tube placement, incidence and amount of transfusion, and postoperative complications. We conclude that, from our limited experience, MVT can be applied to lung resection surgery as safely as PLT and that it may have a beneficial role for the patient with compromised lung function in addition to cosmetic effect.

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The Risk Factors Influencing the Postoperative Mortality of the Patients with an Abdominal Aortic Aneurysm (복부대동맥류 환자에서의 수술 후 사망의 위험인자 분석)

  • Lee, Seong-Kwang;Jun, Hee-Jae;Park, Kyung-Taek;Yoon, Young-Chul;Han, IL-Yong;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.655-662
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    • 2010
  • Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.