• Title/Summary/Keyword: 절제 불가능

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Causes of Unresectability in Non-Small Cell Lung Cancer Patients Thought to Be Resectable Preoperatively (수술시 절제가 불가능하였던 비소세포폐암 환자에 대한 분석)

  • Oh, Yeon-Mok;Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Sim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.97-102
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    • 1994
  • Objectives : Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively. The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. Methods : By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, were found to be unresectable at operating room, were selected for this study. Out of 64 patients, 42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. Results : Among 42 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55%(23 patients) and suspicious for unresectable tumors in 45%(19 patients). The causes of unresectability were technically unresectable T3 lesions in 7%(3 patients), T4 lesions in 62%(26 patients), N2 lesions in 17%(7 patients) and N3 lesions in 14%(6 patients). Conclusion : The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT(like MRI) is indicated in selected NSCLC cases.

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Debridement or Tuberoplasty for Massive Rotator Cuff Tear (광범위 회전근 개 파열에 대한 변연절제술 및 결절성형술)

  • Cho, Nam-Su;Oh, Hyun-Sup;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.146-152
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    • 2010
  • Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods: We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than $90^{\circ}$ on flexion and abduction.

경부기관절제 및 단단문합술

  • 김광문;홍원표;최홍식;조정일;최은창;김명상
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.90.1-90
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    • 1995
  • 저자들은 최근 4년간 11례에서 기관절제 및 단단문합술을 사용하였기에 그 치료 결과를 살펴보고 치료적용의 범위를 넓혀보고자 한다. 대상은 후두-기관협착증 2례, 기관협착증 8례, 갑상선암 1례로 총 11례였으며 이중 3례에서 기관-식도누공이 동반되어 있었다. 술후 발거가 가능했던 경우는 8례였으며 발거가 불가능했던 경우는 술전에 이미 양측성대마비가 있던 경우 l례, 문합부위 아래에 새로운 협착 부위가 생겼던 1례, 기관 연골의 과도한 결손이 있었던 경우가 1례 있었다. 합병증으로 창상감염 1례, 육아조직 3례의 경우는 치료되었으며 양측성대마비가 있던 경우는 편측성대절제를 하여 관찰 중이다. 이상의 결과를 볼 때 기관절제 및 단단문합술이 실패한 경우는 2례로 술전 동반질환의 정확한 검사 및 절제부위의 국소화, 수술시 문합부위의 장력을 최소화하여 시행한다면 합병증은 비교적 받아들일만 하며 비교적 성공율도 기대할 만한 술식으로 여겨졌다.

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An Irreducible Posterolateral Dislocation of Knee by the Detached Femoral Cartilage - A Case Report - (대퇴 연골편에 의해 정복이 불가능한 슬관절 후외방 탈구 - 1예 보고 -)

  • Kim, Seong-Tae;Lee, Bong-Jin;Park, Woo-Sung;Lee, Sang-Hoon;Kim, Tae-Ho;Lee, Sung-Rak
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.126-129
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    • 2007
  • An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.

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Treatment of Locally Unresectable Carcinoma of the Pancreas (국소적으로 절제불가능한 췌장암의 치료)

  • Park Woo Yoon;Cho Moon June;Ha Sung Whan;Park Charn Il;Choe Kuk Jin;Lee Kuhn Uk;Kim Noe Kyung
    • Radiation Oncology Journal
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    • v.4 no.2
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    • pp.141-145
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    • 1986
  • From January,1981 to December,1985,22 patients with locally unresectable carcinoma of the pancreas were treated in the Department of Therapeutic Radiology, Seoul National University Hospital. Radiation was given in two spl it courses; each consisting of 2000 cGy over two weeks sepatated by two-week rest period. 5-FU was administered on the first three days of each radiation therapy course. FAM (5-fluorouracil, adriamycin, mitomycin) was administered for maintenance chemotherapy. For pain control, complete relief was obtained in $22\% (4/18)$ of patients and partial relief in 39% (7/18). Median survival was 31 weeks. Pretreatment performance status was the only statistically significant prognostic factor.

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Surgery of Esophageal Cancer with Metastasis to Distant Abdominal Lymph Nodes(M1LYN) (원격 복부 림프절의 전이(M1LYN)를 동반한 식도암의 수술)

  • 이종목;임수빈;이현석;박종호;조재일;심영목;백희종
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1248-1256
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    • 1996
  • From June 1987 to December 1994, 372 patients underwent operation for resection of esophageal cancer, and 48 patients with metastasis to distant abdominal lymph nodes were analyzed.. The primary tumors were located predominantly in lower thoracic esophagus(n=29). The location of involved lymph nodes were celiac L/N(n=45), common hepatic L/N(n=4), paraaortic L/N(n=l), and retropancreatic L/N(n=l). Most tumors penetrated the esophageal wall(T3,T4, n=43), metastased to regional L/N(N1, n=41), but a few tumors were limited to the esophageal wall(T1,T2, n=5), metastased to distant abdominal L/N without metastasis to regional L/N(NO, n=7). Resectability rate was 87.5%(42/48), and complete resection was possible in 31 patients(64.6%). The most frequent cause of incomplete resection and unresectability was unresectable T4 lesions(n=8), extranodal invasion(n=7). Overall operative mortality and morbidity was 4.2%, 22.9%, and resection mortality was 4.8%. Adjuvant therapy was given to 27 patients, and postoperative follow-up was possible in all patients(median follow-up, 32 months). The 1 year and 3 year survival for resection group was 54.0%, 18.1%(median, 386 days) including operative deaths. Our results suggest that resection of the esophageal cancer with metastasis to distant abdominal lymph nodes(M1LYN) can be done with acceptable mortality and morbidity, and may playa role in long-term survival in carefully selected patients because prognosis is dismal in unresectable esophageal cancer. We recommend that lymph nodes around celiac axis be dissected thoroughly for exact staging and possible prolongation of survival, and multimodality therapy as necessary because most patients with M1(LYN) esophageal cancer do poorly with only primay surgical treatment.

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Corticotomy and the Intrusive Tooth Movement (피질골 절제술을 응용한 치아의 함입 이동)

  • Kim, Sang-Cheol;Tae, Ki-Chul
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.399-405
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    • 2003
  • Tooth movement facilitated by corticotomy and distraction osteogenesis, new paradigm in orthodontics, was discussed. Intrusive tooth movement of anterior or posterior teeth was thought to be difficult or impossible. In this study, a part of cortical bone, which was a sort of resistance to tooth movement in alveolar bone, was removed. On the other hand, active bone deposition was made possible in the tension side. That was the main concept of tooth movement facilitated by corticotomy and distraction osteogenesis. Teeth moved at such a speedy tate as we could not imagine in conventional tooth movement, which lead to the reduction of total treatment Period. And intrusive movement was Possible without a side effect, lot example, root resorption or the periodontal breakdown. Those were the superior aspects to the conventional orthodontics.

Left Upper Mediastinal Lymph Nodes Dissection during Minimally Invasive Esophagectomy (식도암 최소 침습 수술 시 좌측 종격동 림프절 절제술)

  • Lee, Kyo-Seon;Jeong, In-Seok;Ryu, Sang-Woo;Song, Sang-Yun;Na, Kook-Joo
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.244-246
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    • 2007
  • Mediastinal lymph node dissection is a method that increases the long term survival of patients with an esophageal carcinoma. However, dissection of the left mediastinal lymph node is almost impossible, as it is not easy to see. Herein, a left mediastinal lymph node dissection, with thoracoscopy through a cervical incision wound during minimal invasive esophageal surgery, is reported.

Preoperative Chemotherapy in Gastric Cancer (위암의 선행화학 요법)

  • Hong, Young-Seon;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.3 s.19
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    • pp.139-145
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    • 2005
  • Gastric cancer is the most prevalent cancer in Korea and comprises the second cause of cancer death. Surgery only can provide chance of cure, but most locally advanced cancers recur after a curative resection, even though important advances in the surgical and nonsurgical treatments of gastric cancer have taken place. Preoperative chemotherapy theoretically can provide the advantages of reducing the bulk of tumor, which might improve the R0 resection rate, and of treating micrometastases early. Also, preoperative chemotherapy is expected to render unresectable tumors resectable without increasing postoperative morbidity and mortality. There are many new chemo-therapeutic agents available for the treatment of advanced gastric cancer, but still the most effective agent, the optimal time and number of cycle for administration are still not known. The addition of postoperative chemotherapy through an intraperitoneal route and/or radiotherapy might affect the outcome of surgery favorably, but that hasn't been proved yet. A multicenter prospective randomized phase III trial should be peformed to answer for those questions and to improve the curability of gastric cancer treatment.

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Extended Sleeve Lobectomy for Tuberculous Bronchial Stenosis - A case report- (결핵성 기관지 협착에 대한 확대 소매 폐엽절제술 - 1예 보고 -)

  • Kim, Dae-Hyun;Kwak, Young-Tae;Choi, Cheon-Woong;Yoo, Ji-Hong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.793-796
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    • 2010
  • Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.