• Title/Summary/Keyword: 축소 수술

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Factors Affecting Prognosis in Early Gastric Cancer (조기위암 환자의 예후에 영향을 주는 인자)

  • Han, Ki-Bin;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Ju;Mok, Young-Jae;Kim, Chong-Suk
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.238-245
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    • 2009
  • Purpose: Treatment strategies for early gastric carcinoma (EGC) should be based on achieving a complete cure, but clear indications for limited surgery have not been established. We investigated surgical outcomes for early gastric cancer to determine the optimal? treatment strategy for EGC. Materials and Methods: Subjects included 881 patients who underwent curative surgery for EGC between 1986 and 2003. Retrospective uni & multi-variate analysis for prognostic factors, factors affecting lymph node metastasis, and risk factors for cancer recurrence were analyzed. Results: In multivariate survival analyses, age, operation method, macroscopic appearance and lymph node stage proved to be independent prognostic factors. Lymph node metastasis, depth of tumor invasion, tumor size, lymphatic and venous invasion were also significant risk factors in multivariate analyses. In multivariate analyses for cancer recurrence, depth of tumor invasion and lymph node metastasis proved to be significant risk factors. Conclusion: Appropriate surgical treatment with lymph node dissection is necessary for EGC patients with risk factors for lymph node metastasis.

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Surgical Treatment for Common Iliac Arteriovenous Fistula after Lumbar Laminectomy (요추궁절제술 후에 발생한 총장골동맥의 동정맥루에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.455-458
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    • 2007
  • A 40 year-old male patient admitted for dyspnea and edema of the lower extremities. A pulsatile abdominal mass with a bruit was palpable in the right lower quadrant. Four months previously, he had underwent left partial lam-inectomy ($L4{\sim}5$) and discectomy at the L4 level due to disc protrusion, Computed tomography showed an ilio-iliac AV fistula with pseudoaneurysm at the L5 level. Because massive bleeding occurred when the aneurysm was entered, we closed the aneurysm and performed resection and suture of the aorta and both iliac arteries very near the aneurysm. After exclusion of the arterial side, we performed reduction angioplasty at the aneurysm and aorto-biiliac reconstruction with an artifcial graft. Twenty-four months after operation, he is doing well and hasn't had any complications on the follow-up.

A Posterior Annuloplasty, Papillary Muscle Plication and Left Ventricle Reduction Through Left Ventriculotomy in Severe Ischemic Cardiomyopathy with Mitral Regurgitation (승모판 폐쇄 부전을 동반한 허혈성 심근병증에서 좌심실 절개를 통한 승모판 성형술 및 유두근 단축술과 좌심실 용적 축소술)

  • Jung Jong-Pil;Cho Won-Chul;Kim Joon-Bum;Lee Jae-Won
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.549-552
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    • 2006
  • In the mitral regurgitation (MR) accompanied with a serious ischemic cardiomyopathy (ICMP), coronary revascularization to viable myocardium, LV reduction and mitral reconstruction become the main surgery under the bad conditions that the cardiac transplantation is not so easy. The MR in ischemic cardiomyopathy appears as various pathologic factors, among them, the papillary muscle displacement in addition to the annular dilatation is pointed out as the important cause. Our hospital would like to report the experience of the surgery about coronary revascularization to the left main with 3-vessel coronary disease, severe ICMP patients accompanied with the MR, posterior mitral annuloplasty and papillary muscle plication through the LVtomy.

The Effect of Radiation Therapy on the Healing Ability of Subsequent Surgical Wounds (방사선조사가 피부의 창상치유에 미치는 실험적 연구)

  • Suh, Hyun-Suk;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.17-25
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    • 1991
  • This study was undertaken to find the effect of radiation therapy on the healing ability of surgical wounds and on this basis, to find the proper time interval between the radiation therapy and surgery. Two hundred and fifty-two mice were used and a single dose of 2000 cGy was given in each instances to the hind limb of mice. Incisional wounds were produced after varying intervals in the previously irradiated areas and then they were followed up at regular intervals by the measurement of tensile strength. The wounds which received surgery immediately, 1 or 2 weeks after irradiation revealed marked delay and the wounds which received surgery 12, 16 or 20 weeks after irradiation demonstrated slight delay in wound healing in terms of tensile strength measurement. But the wounds which received irradiation 4 or 8 weeks before surgery did not differ much in the wound healing process from that of the control group. Histopathologic studies of the wounds demonstrated epithelization in most instances as quickly as in the control wounds. The appearance of fibroblasts and collagen fibers has delayed momently and appeared to have close correlation with the tensile strength healing curves.

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Midterm Result of Starnes Operation - A case report - (Starnes 수술의 증기결과 - 1예 보고 -)

  • Sung, Si-Chan;Son, Bong-Su;Kim, Young-Kyu;Park, Chin-Su;Chang, Yoon-Hee;Lee, Hyoung-Doo
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.696-700
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    • 2007
  • We report here on the midterm results after a Starnes operation for a severely symptomatic neonate with Ebstein's anomaly. A one-day-old baby presented with cyanosis and severe cardiomegaly. We peformed patch closure of the tricuspid valve with a central shunt after failure of tricuspid valve repair with vertical plication of the atrialized ventricle at her age of 19 days. The coronary sinus was drained into the right ventricle. She underwent bidirectional cavopulmonary shunt and extracardiac conduit Fontan operation at her age of 16 and 30 months, respectively. She is now 56 months old and is doing very well. The recent follow-up study revealed that she was in normal sinus rhythm and had a normal sized left ventricle with good function and the small right ventricle without thrombus formation.

One Case of Nasal Surgery in Obstructive Sleep Apnea Syndrome (비강수술로 호전된 폐쇄성 수면무호흡증후군 1 례)

  • Choi, Ji-Ho;Lee, Heung-Man;Kwon, Soon-Young;Lee, Sang-Hag;Shin, Chol;Lee, Seung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.64-67
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    • 2005
  • Obstructive sleep apnea syndrome(OSAS) is a common disease in the field of otorhinolaryngology and is characterized by repeated upper airway occlusions occurring during sleep. OSAS can occur due to various etiologies of the nasal, oral, pharyngeal and laryngeal airway in adults. Nasal obstruction can be caused by septal deviation, nasal polyps, concha bullosa, choanal atresia, neoplasms, foreign body, postoperative/post-traumatic synechiae, various rhinitis and so on. There are various kinds of surgical treatment of OSAS including nasal surgery, LAUP, UPPP, surgery of tongue base, tracheostomy and so on, but the effect of nasal surgery on snoring and OSAS is controversial. The authors report the case of a patient who had experienced nasal obstruction, moderate snoring and OSAS and who improved after septoplasty and turbinoplasty.

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Reduction Aortoplasty with Suture Plication Technique for Dilatation of the Ascending Aorta associated with Aortic Valve Disease (대동맥판막 질환과 동반된 상행대동맥 확장에 대한 봉합봉축법에 의한 대동맥 축소성형술)

  • Na Chan-Young;Oh Sam-Sae;Lee Chang-Ha;Whang Seong Wook;Lee Cheol;Lim Hong Gook;Kim Jae Hyun;Seo Hong Ju;Kim Gun Gyk;Baek Man-Jong
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.221-228
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    • 2005
  • Reduction aortoplasty has been advocated for dilatation of the ascending aorta associated with aortic valve disease in older, high-risk patients. We report our results with modification of reduction aortoplasty and aortic valve replacement. Material and Method: Between July 2001 and December 2002, 14 consecutive patients who underwent modification of reduction aortoplasty, suture plication technique without excision of the dilated aortic wall, were reviewed. The mean age was 63.7$\pm$6.7 (50 to 75) years. Ten patients had congenital bicuspid aortic valve, Twelve patients had severe aortic valve stenosis and 6 had regurgitation of grade III$\~$IV. The diameter of the ascending aorta was measured before and immediately after surgery and 6 and 12 months postoperatively using echocardiography or computed tomography. Follow-up was complete in an average of 14.7$\~$5.4 (7 to 24) months. Result: There were no early postoperative deaths and no bleeding complications. Reduction aortoplasty with suture plication technique decreased the diameter of ascending aorta from 49.4$\pm$3.5 mm preoperatively to 33.2$\pm$3.4 mm postoperatively (p <0.001). During follow-up, there were no late deaths and no aneurysm recurrence on the ascending aorta. Conclusion: Suture plication technique of reduction aortoplasty without excision of the dilated aortic wall offers good early and short-term results in older, high-risk patients with dilatation of the ascending aorta associated with aortic valve disease. Surgical long-term results of our technique should be evaluated in further studies.

Quality of Life of Long-term Survivors after a Subtotal or a Total Gastrectomy for Gastric Cancer (위암 수술 후 장기생존자에서 위 절제 범위에 따른 삶의 질)

  • Lee, Seung-Soo;Han, Sung-Won;Jeong, Hye-Yeon;Song, Jye-Won;Chung, Ho-Young;Yu, Wan-Sik
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.34-39
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    • 2010
  • Purpose: The aim of this study was to compare quality of life of long-term survivors after a subtotal or a total gastrectomy for gastric cancer. Materials and Methods: The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and QLQ-STO22 questionnaire were used to assess quality of life of 166 patients on their 5th annual follow-ups after gastrectomy for gastric cancer. One hundred twenty-six patients underwent a subtotal gastrectomy and 40 patients a total gastrectomy. Results: The subtotal gastrectomy group revealed a trend to have better quality of life in functional scales (physical, role, emotional, cognitive and social), fatigue, pain, dyspnea, diarrhea and financial difficulties. The total gastrectomy group showed a trend to have better quality of life in the global health status and quality of life, nausea and vomiting, insomnia, appetite loss and constipation. In all scales of the EORTC QLQ-STO22, the subtotal gastrectomy group had a trend to have better quality of life. However these did not reach the statistical significance. Conclusion: Surgeons may not limit the extent of resection concerning long-lasting poor quality of life. Oncologically sound resection is recommended.

The Surgical Diagnosis for Detecting Early Gastric Cancer and Lymph Node Metastasis: Its Role for Making the Decision of the Limited Surgery (조기위암 및 림프절 전이에 대한 수술 중 외과적 병기판정의 정확도 및 유용성)

  • Park, Eun-Kyu;Jeong, Oh;Ryu, Seong-Yeop;Ju, Jae-Kyun;Kim, Dong-Yi;Jeong, Mi-Ran;Kim, Ho-Goon;Kim, Hoe-Won;Park, Young-Kyu
    • Journal of Gastric Cancer
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    • v.9 no.3
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    • pp.104-109
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    • 2009
  • Purpose: The aim of this study is to evaluate the accuracy of surgically diagnosing early gastric cancer (EGC) and lymph node metastasis, and to determine its role for performing limited surgery for EGC. Materials and Methods: We reviewed 369 patients who underwent gastrectomy for primary gastric carcinoma. The surgical diagnosis was evaluated by determining its sensitivity, specificity and accuracy, and this was compared with the preoperative examinations. Results: The sensitivity, specificity, and accuracy of the intraoperative diagnosis for EGC were 74.5%, 95.7% and 83.7%, respectively. The predictive value for EGC according to the intraoperative diagnosis was 95.7%. The surgical diagnosis of EGC showed higher specificity and a higher predictive value than preoperative examinations, which significantly reduced the risk of underestimating advanced gastric cancer (AGC) to EGC. The sensitivity, specificity, and accuracy for lymph node metastasis according to the surgical diagnosis were 73.2%, 78.1% and 76.4%, respectively. For 70 patients with a discrepancy in the diagnosis of EGC between the pre- and intra-operative diagnosis, the surgical diagnosis was correct in 63 (90%) patients, but the preoperative examinations were correct in only 7 (10%) patients. Conclusion: The surgical diagnosis showed better accuracy than the preoperative examinations for detecting EGC and lymph node metastasis. Our results suggest that the decision for conducting limited surgery based on the surgical diagnosis might reduce the risk of under-treatment of AGC to EGC better than the preoperative examinations.

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Design and Implementation of Network-based Image Processing System for Deformity Analysis (네트워크 기반 기형분석 영상처리시스템 설계 및 구현)

  • 홍헬렌;김민아;김명희
    • Proceedings of the Korean Information Science Society Conference
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    • 1999.10b
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    • pp.527-529
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    • 1999
  • 기형부위의 구조적 복잡성으로 인하여 부상이나 질병을 진단하거나 수술계획을 수립하는데 있어 많은 어려움이 있다. 본 논문에서는 네트워크 기반 기형분석 영상처리시스템을 설계하고 구현하였다. 본 시스템은 기형부위를 구성하는 뼈간의 관계를 정의하고 기형 정도를 파악하기 위하여 일련의 2차원 진단 영상들을 공간적으로 구성하고 입체적 영상을 생성한 후, 객체별 모델링 및 렌더링을 가능하게 하며, 이동, 회전, 확대/축소, 컬러링과 같은 다양한 조작 기능을 제공한다. 본 개발 시스템은 클라이언트-서버 구조로 이루어졌으며, 시스템 간 사용되는 메시지 처리를 위한 진단 제어 관리기, 기형부위 영상별 가시화 및 조작을 위한 단면 및 입체 영상처리기, 원격 사용을 위한 통신망 제어기, 그리고 각종 환자 정보를 위한 데이터베이스 관리기로 구성된다. 또한 범용의 데스크탑 컴퓨터 상에서 사용자 인퍼테이스를 통하여 서버에 접속하여 영상처리시스템을 사용함으로서 보다 많은 사용자들이 동시에 사용할 수 있는 이점이 있다.

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