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Anterolateral Thigh Free Flap for Reconstruction after Wide Resection of Soft Tissue Sarcoma (악성 연부조직 종양의 광범위 절제 후 전외측 대퇴부 유리 피판을 이용한 재건술)

  • Park, Jong-Hyuk;Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.119-124
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    • 2008
  • Purpose: To present our experience with soft tissue reconstruction using anterolateral thigh free flap after resection of soft tissue sarcoma. Materials and Methods: Between January of 2003 and June of 2007, we treated 7 patients with soft tissue reconstruction using anterolateral thigh free flap after wide resection for soft tissue sarcoma. We retrospectively analyzed type and size of tumors, resection margin, size of defect after resection, time of operation, flap survival and complication. Results: The type of sarcoma was 3 synovial sarcoma, 2 malignant fibrous histiocytoma, 1 leimyosarcoma and 1 fibrosarcoma. The size of tumor varied from $3{\times}5\;cm$ to $7{\times}8\;cm$. The resection margins of tumors were negative in all cases. The size of soft tissue defect after resection varied from $6{\times}8\;cm$ to $15{\times}10\;cm$. The mean time of operation was 3.6 hours. All flaps were survived. Conclusion: Anterolateral thigh free flap appear to be ideal for reconstruction after wide resection of soft tissue sarcoma.

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Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes (연부 조직 육종에 대한 무계획적 절제술: 환자의 임상적 특징 및 치료 결과)

  • Lee, Jae Hoo;Cho, Yong Jin;Kim, Seung Hyun;Shin, Kyoo Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.72-77
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    • 2012
  • Purpose: Unplanned excision of a soft tissue sarcoma is defined as the operation performed for gross removal of a soft tissue sarcoma without regard for preoperative imaging or the necessity to removal a margin of normal tissue covering the cancer. We report our experience of treating primary soft tissue sarcoma after an unplanned excision. Materials and Methods: We retrospectively reviewed 31 patients referred to our hospital after unplanned excision at other hospitals for treatment of a STS. The clinical information was reviewed with a focus on the patient's age, gender, tumor location, tumor size, tumor depth, presumptive diagnoses at the previous surgery, refer hospital, definitive diagnosis, interval between the initial and additional surgery and local recurrence. Results: There were 19 males and 12 females with a median age of 48 years (range, 17-75 years) at the time of referral. Seventeen patients (54.8%) had tumors in their lower limb, 6 (19.4%) had tumors in their upper limb, and 8 (25.8%) had tumors in their trunk. Tumor depth could be determined for 8 patients (25.8%), with superficial and 22 deep tumors (71%). The medial interval between unplanned excision to re-excision ranged from 2 weeks to 1 year (median, 5 weeks). Local recurrence was detected in 2 patients. All patients were alive without metastasis at last follow up. Conclusion: Even in upper class general hospital, many unplanned excision had been performed, which is considered to be avoided. When the relatively huge mass located in deeper layer it requires enough preoperative imaging studies and biopsy.

Short-term Surgical Outcomes after Laparoscopic D2 Lymphadenectomy in Patients with Distal Gastric Cancer (원위부 위암에서 복강경 D2 림프절 절제술의 수술 성적)

  • Cheong, Oh;Park, Young Kyu;Yook, Jeong Hwan;Kim, Byung Sik
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.79-84
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    • 2008
  • Purpose: With advancements in laparoscopic surgery, there have been efforts to expand the indication for laparoscopic surgery up to advanced gastric cancer. However, scant data are available regarding the feasibility and advantages of laparoscopy-assisted distal gastrectomy (LADG) with standard radical D2 lymph node dissection. Materials and Methods: Twenty-two patients who were preoperatively diagnosed with cT1N0M0 gastric cancer underwent LADG with standard D2 lymphadenectomy between February and August 2007. They were compared with patients who underwent conventional open D2 lymphadenectomy with respect to clinicopathologic features, surgical outcomes, and postoperative course. Results: The mean operative time was significantly longer in the LADG group than in the open group ($160{\pm}25min$ vs. $135{\pm}21min$, P<0.001). However, surgical outcomes, such as surgical margin and number of retrieved lymph nodes ($25.7{\pm}11.1$ vs. $26.9{\pm}9.2$, P=ns) were comparable between the groups. The LADG group exhibited quicker postoperative recovery, and both groups exhibited similar postoperative morbidity and mortality. Conclusion: LADG with D2 lymphadenectomy is feasible and safe, with short-term surgical outcomes comparable to those seen in open D2 lymphadenectomy. Further prospective clinical investigation will be needed to better evaluate the advantages of LADG with D2 lymphadenectomy.

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Resection and Reconstruction for Liposarcoma Involving Popliteal Fossa and Antero-lateral Compartment of Lower Leg - A Case Report - (하퇴 슬와부 및 전외측 구획을 침범한 지방육종 환자의 절제 및 재건술 - 증례보고 -)

  • Won, Ho-Hyun;Hong, Youn-Seok;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.69-74
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    • 2009
  • Soft tissue sarcomas of popliteal fossa are rare, accounting for less than 5% of all soft tissue sarcomas of the extremities. In an extracompartmental space such as the popliteal, cubital fossa and inguinal space, where major vessels and nerves traverse, performing resections with wide margin is difficult and sometimes marginal margin is inevitable for limb salvage. For popliteal tumor resection, posterior approach would be a classic method. For tumors with small size and not adherent to surrounding structures, tumor is easily resected by this approach and dissection of nerve sheath or adventitia of vessel. On the contrary, tumors of large size and infiltrating the posterior structure of knee joint may show difficulty in en-bloc resection itself. These cases were candidates for amputation. Furthermore, tumors involving both popliteal fossa and anterior compartment usually had no choice but to have an amputation to prevent local recurrence. We regarded soft tissue sarcoma showing this kind of presentation as bone tumor having extraosseous mass. We performed wide en-bloc resection of proximal tibia and fibula along with sarcoma involving both compartment on liposarcoma of 47-year old man.

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Effects of Dietary Calcium and Soy Isoflavones Supplementation on Bone Metabolism in the Ovariectomized Rats (난소절제 흰쥐의 골격대사에 대한 식이 칼슘과 대두 이소플라본의 섭취효과)

  • Kim, Min-Sun;Lee, Yeon-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.6
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    • pp.833-839
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    • 2005
  • This study was conducted to demonstrate whether dietary Ca and the soy isoflavones supplementation could reduce the bone loss associated with estrogen deficiency. Nine week-old female rats (SD) were ovariectomized and then fed on diet of low $(0.1\%)$ or normal $(0.5\%)$ Ca supplemented with soy isoflavones (80 and 160 ppm) for 6 weeks. The ovariectomized and sham-operated rats showed normal serum Ca and P levels, and dietary Ca and soy isoflavones did not changed them. The serum alkaline phosphatase activity was increased in all ovariectomized rats, especially in the rats fed low Ca diet regardless of isoflavone supplementation. The serum tartrate-resistance acid phosphatase was not significantly different among the ovariectomized rats and were not changed by dietary Ca and isoflavones. Breaking force of femur was higher in the rats fed the nomral Ca diets and not statistically changed by soy isoflavone supplementation. Femoral and lumbar Ca and P contents decreased in the ovariectomized rats and the soy isoflavones-80 ppm supplementation significantly enhanced bone minerals, but the soy isoflavones-160 ppm supplementation did not. Dietary Ca increased lumbar Ca and P contents. The results of this study have suggested that the soy isoflavones 80 ppm supplementation could be sufficient to prevent bone loss in ovariectomized rats and normal Ca supplementation could enhance the effect of soy isoflavones on bone protection.

Result of Complete Resection of T3 Non-Small Cell Lung Cancer Invading the Chest Wall (흉벽침습이 있던 T3 비소세포암환자의 완전절제후의 결과)

  • 최창휴;임수빈;김재현;조재일;백희종;박종호
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.924-929
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    • 2001
  • Backgroun : The long-term survival after operation of patients with lung cancer invading the chest wall is known to be related to regional nodal involvement, completeness of resection and depth of chest wall involvement. In this study results of complete resection are reviewed to determine survival charateristics. Material and Method: Of 680 consecutive patients who were operated on for primary non-small cell carcinoma between 1988 and 1998, we retrospectively reviewed 55 patients(8.0%) who had complete resection for lung cancer invading the chest wall or parietal pleura. Result: Resection of the chest wall was on bloc in 29 patients(47.3%), and extrapleural in 26(52.7%). In the patients undergoing extrapleural resection, the depth of chest wall invasion was confined to the parietal pleura in all patients(100%). In the patients underging en bloc resection, the pathologic depth of invasion was into the parietal pleura alone in 9(31.0%) and into the chest wall in 20(69.0%). The follow-up rate of these patients was 100%. Hospital mortality was 5.4%(n=3). The actuarial 5-year survival rate was 26% for all hospital survivors(n=52). The actuarial 5-year survival rate of patients with T3N0M0 disease(29%) was better than that of T3N2M0 disease(18%), however, there was no significant(p=0.30) difference. The depth of chest wall invasion had no statistically significant effect on survival in our series, neither for patients with involved lymphatic metastasis nor for those without(p=0.99). Conclusion: These observations indicate that the good five year survival in patients with T3 NSCLC invading the chest wall resulted from complete resection. Survival of patients with lung cancer invading the chest wall after complete resection is dependent on the extent of nodal involvement and much less so on the depth of chest wall invasion.

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Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective (국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망)

  • Hye Shin Ahn;So Lyung Jung;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1009-1016
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    • 2023
  • Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. In Korea, RFA for thyroid nodules was first performed in 2002, and a large population study was published in 2008. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed its first recommendations for RFA in 2009, which were revised in 2012 and 2018. The KSThR guideline was the first guideline for RFA of thyroid nodules worldwide and has become a guideline for physicians to perform thyroid RFA in Korea and other countries around the world. These guidelines have contributed significantly to the establishment and widespread use of RFA worldwide. In addition, since 2015, the KSThR has conducted intensive hands-on courses depending on the level of the participants. In this article, the authors introduce the history of eduction for RFA conducted by the KSThR and describe the learning curve of RFA and current training programs in Korea, along with future directions for training programs.

Esophagectomy with Operating Mediastinoscope (종격동경을 이용한 식도절제수술 -1례-)

  • 윤용한;이두연;이성수
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1110-1115
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    • 1998
  • Esophagectomy has a high morbidity rate, mainly related to pulmonary complications. The respiratory morbidity of open esophagectomy is high, ranging from 6% to 10%. This high morbidity is partially responsible for the 6∼15% mortality rate of esophagectomy. Many techniques of esophagectomy without thoracotomy have been described since the initial report of Orringer and Sloan. Endoscopic microsurgical dissection of the esophagus was clinically introduced in 1989. Endoscopic microsurgical dissection of the esophagus was developed as a minimally invasive procedure that avoids thoracotomy and provides precise vision during the operation in order to reduce mediastinal trauma and to improve the peri- and post-operative situation. A 20 year-old women who accidentally swallowed about 150 cc of glacial acetic acid underwent an esophagectomy using the operating mediastinoscopy, cervical esophagogastric anastomosis, pyloromyotomy, and feeding jejunostomy tube placement for esophageal stricture. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day. Our clinical experience shows that endoscopic microsurgical dissection of esophagus is a safe and feasible method because it offers excellent optical control and enables the surgeon to operate in a minimally invasive manner.

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AN EXPERIMENTAL STUDY ON THE MANDIBULAR GROWTH BY THE PARTIAL GLOSSECTOMY OF THE RATS (백서 부분적 설절제가 하악골 성장에 미치는 영향에 관한 실험적 연구)

  • Hyun, Sug-Hwan;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.567-575
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    • 1995
  • The purpose of this study was to investigate the effect of the partial glossectomy on the mandibular growth of growing rats. Thirty one Sprague-Dawley rats four weeks old were divided into two groupes : the first group served as the control and the second group was partially excised in the tongue of the rats. The experimental animals were sacrificed at 4 and 8 weeks after partial glossectomy. The changes of the rat mandibular growth following partial glossectomy were observed biometrically from dry bone specimens. The findings were as follows : 1. Partial glossectomy of growing rat produced inhibitory effects on the growth of the mandible and did not change the original shape of the mandible. 2. Among the factors affecting mandibular growth, the presence of the proper tongue size was essential. 3. Partial glossectomy of the growing rats could not change general growth of the rats whole bodies.

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Arthroscopic Technique of Partial Meniscectomy for Bucket Handle Tear of Medial Meniscus using Posteromedial Portal (내측 반월상 연골판 양동이형 파열의 후내측 도달법을 이용한 관절경적 부분 절제술 - 수술 수기 -)

  • Ahn, Jin-Hwan;Lee, Jong-Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.71-75
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    • 2000
  • Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

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