• Journal of Chest Surgery
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• 제57권2호
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• pp.152-159
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• 2024

Background: Anastomotic leakage (AL) following esophagectomy represents a serious complication that often results in prolonged hospitalization and necessitates repeated interventions, including nothing-by-mouth (NPO) restriction, endoscopic vacuum therapy (EVT), or surgical repair. In this study, we evaluated the patterns and outcomes of AL treatment. Methods: We retrospectively reviewed the medical records of patients who underwent esophagectomy for esophageal cancer at a single center between 2003 and 2020. Of 3,096 examined cases, 181 patients (5.8%) with AL were included in the study: 114 patients (63%) with cervical anastomosis (CA) and 67 (37%) with intrathoracic anastomosis (TA). Results: The incidence of AL was 11.9% in the CA and 3.2% in the TA group (p<0.001). Among patients with CA who developed AL, 87 (76.3%) were managed with NPO, 15 (13.2%) with EVT, and 12 (10.5%) with surgical repair. Over 90% of patients with cervical AL resumed an oral diet by the time of discharge, regardless of treatment method. Among patients with TA and AL, 36 (53.7%) received NPO, 25 (37.7%) underwent EVT, and 6 (9%) required surgery. Of these, 34 patients who were managed with NPO and 19 with EVT could resume an oral diet. However, only 2 patients who underwent surgery resumed an oral diet, and 2 patients required additional EVT. Conclusion: Although patients with CA displayed a higher incidence of AL, their rate of successful oral intake exceeded that of those with TA, regardless of treatment method. Among patients exhibiting AL with TA, EVT was more commonly employed than in CA cases, and it appears effective.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.28.1-28.4
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• 2020

Background: This clinical case presented a novel method of segmental mandible reconstruction using 3D-printed titanium implant with pre-mounted dental implants that was planned to rehabilitate occlusion. Case presentation: A 53-year-old male who suffered osteoradionecrosis due to the radiation after squamous cell carcinoma resection. The 3D-printed titanium implant with pre-mounted dental implant fixtures was simulated and fabricated with selective laser melting method. The implant was successfully inserted, and the discontinuous mandible defect was rehabilitated without postoperative infection or foreign body reaction during follow-ups, until a year. Conclusions: The 3D-printed titanium implant would be the one of the suitable treatment modalities for mandible reconstruction considering all the aspect of mandibular functions.

• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.60-67
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• 2006

Purpose: The purpose of this study was to compare the method of using coraco-clavicular (C-C) sling with modified Phemister operation by postoperative clinical results, radiologic analysis and complications. Materials and Methods: 33 patients of acromioclavicular joint dislocation were included in this study. Thirteen patients were treated with simple C-C sling method and twenty patients were treated with modified Phemister operation. The assesment of clinical and radiological evaluation were performed and the final results were examined by using the Weitzman's classification. Results: In the final result of C-C sling method group, forward elevation $161^{\circ}$, external rotation $70^{\circ}$, internal rotation T8 level, Visual Analogue Scale (VAS) 83.3 points were checked. In modified Phemister operation group, forward elevation $155^{\circ}$, external rotation $67^{\circ}$, internal rotation T6 level, VAS 83.8 points were checked. In coracoclavicular distance of C-C sling method group, pre-operation 12.82 mm and last follow up 8.37 mm were checked. In modified Phemister operation group, pre-operation 12.8 mm and last follow up 7.7 mm were checked. In functional evaluation by the Weitzman criteria, C-C sling group had excellent 8, good 1, fair 1 and modified Phemister group had excellent 13, good 4, fair 3. Conclusion: C-C sling method would be the better than the Modified Phemister operation because of short operation time and smaller skin incision.

• 부모자녀건강학회지
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• 제7권2호
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• pp.160-167
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• 2004

Purpose: The purpose of this study was to examine the effect of a preparation method using hospital play on anxiety and role behaviors of children undergoing tonsillectomy. Method: Twenty-eight children aged 5 to 7 years who were admitted for tonsillectomy were assigned to either an experimental group or a control group purposefully. The preparation method included provision of information using hospital play. The data were analyzed using Mann-Whitney test and Chi-square test. Result: There was no Significant difference in anxiety before surgery between the experimental and control groups. Also, there was no Significant difference in role behaviors on the 1st and the 2nd day of surgery. Conclusion: Even though there was no statistical significance, the result showed that the preparation method had some positive effect on children and parents. It is needed to develop systematic preparation methods for children undergoing surgery to enhance their coping.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.351-356
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• 2020

Background: We have devised a novel surgical method, termed as temporalis muscle tendonperiosteum (T-P) compound surgical method, by modifying pre-existing techniques. Our method is characterized by elevation of temporalis muscle tendon and the periosteum of the mandibular ramus as a single compound. Here, we describe the concept and clinical outcomes of our method. Methods: We conducted both a cadaveric study and a clinical study. First, we used four human cadavers (two males and two females) to confirm the anatomy of the temporalis muscle tendon and availability of sufficient length extension through the elevation of the T-P compound. Moreover, we obtained measurements of the mouth angle and the philtrum angle from a total of six patients (two males and four females) and compared them between preoperatively and postoperatively. Results: The mean length of the periosteal portion was measured as 2.43± 0.15 cm (range, 2.2-2.6 cm). There was an improvement in the mouth angle postoperatively as compared with preoperatively (7.2°± 3.0° vs. 14.5°± 4.7°, respectively). Moreover, there was also an improvement in the philtrum angle postoperatively as compared with preoperatively (7.2°± 3.4° vs. 17.2°± 6.5°, respectively). Conclusion: Our method is a simple, minimally-invasive modality that is effective in achieving good clinical outcomes. Its advantages include an ability to achieve a firm extension of the temporalis muscle tendon as well as a lack of requirement for a donor site that may cause complications.

• Journal of Chest Surgery
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• 제36권9호
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• pp.678-682
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• 2003

이차성 자연 기흉은 흉강경 수술의 좋은 적응증이다. 이 방법은 흔히 전신마취와 일측폐환기를 필요로 한다. 그러나 전신마취와 일측폐환기가 위험성이 큰 환자도 있다. 대상 및 방법: 1999년 9월부터 2001년 8월까지 15명의 고위험군 환자를 대상으로 경막외 마취하에 흉강경수술을 시행하였다. 결과: 15명이 성공적으로 흉강경 수술을 마쳤다. 술 후 누출 기간은 평균 4.3일이었고, 의미 있는 합병증은 없었으며 재발도 없었다. 결론: 흉강경 수술은 고위험인자를 가진 이차성 자연 기흉환자의 치료로 경막외 마취하에 안전하게 시행할 수 있다.

• 한국정밀공학회지
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• 제26권8호
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• pp.126-131
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• 2009

Acetabular dysplasia is a condition defined by inadequate development of an individual's acetabulum. Individual diversity of the symptoms in this disease needs safe and accurate preoperative planning. Technologies that utilize multidimensional image information are thus important. The assessment method by Janzen et al. was suggested a coefficient method in evaluation of acetabular dysplasia. In this study, we applied it, using a three-dimensional computed tomography (3D CT) on the koreans. 19 cases of the normal hips and 4 cases of the acetabular dysplasia were investigated to evaluate the proved method; 3D CT was used to define the geometric center of the femoral head and to measure center edge angles at $10^{\circ}$ rotational increments around the acetabular rim. Mean and standard deviation in CEAs (Center Edge Angle) of normal 19 hips at $10^{\circ}$ rotational increments from anterior to posterior rim were determined, and termed as a 'normal curve'. Then this normal values were compared with the CEA data measured from 4 cases of acetabular dysplasia patiens. Quantative comparison of the CEA values between the normal cases and dysplasia cases was successfully demonstrated, and thus, we claim that this simple CT method of assessing acetabular dysplasia can be well applicable to diagnosis, quantification and surgical planning for adult acetabular dysplasia patients.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.32-39
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• 2020

Background: Rhinoplasty is one of the most commonly performed cosmetic surgery procedures. Most Asians desire elevation of their relatively flat nasal dorsum and tip to make them appear more prominent. This study introduces a simple method of nasal tip plasty using three-dimensional (3D)-printed polycaprolactone (PCL) (Smart Ball^®), which provides the required length and volume for this purpose and enables the creation of a nasal tip of the desired shape in a safe and simple manner. Methods: Between September 2014 and May 2017, 22 patients participated in a survey to assess postoperative satisfaction levels. Additionally, three plastic surgeons compared patients' pre- and 1-year postoperative photographs to evaluate the results. All patients underwent 2- to 4-year postoperative follow-up. Results: Levels of subjective satisfaction among patients were 3.59, 3.50, 3.82, 3.73, 3.55, and 3.82 for each of the 6 categories evaluated, with a mean of 3.67/4 points, indicating high satisfaction levels. The mean plastic surgeon-reported score for the 22 patients was 4.47/5 points, which also indicates highly successful outcomes. Postoperative nasal tip rotation and tip projection were ideal in most patients. Conclusion: Our novel method using 3D-printed PCL (Smart Ball^®) provides the optimal length and volume required for nasal tip plasty and enables the creation of a nasal tip of the desired shape, in a safe and simple manner. An advantage of our method is that it retains the original nasal structure in contrast to structural changes observed with the use of conventional methods.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.281-286
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• 2005

The goal in facial paralysis treatment is to achieve the normal appearance of the face as well as to reconstruct the natural symmetrical smile. In cases of facial paralysis, a widely accepted procedure is the two stage method, which combines neurovascular free muscle transfer with cross face nerve grafting. Although the results are promising, the two operations of this method, which are about 1 year apart, impose an economic burden on the patients and require a lengthy period before results are obtained. In order to overcome these drawbacks, one stage method, using latissimus dorsi neurovascuular free muscle flap was introduced. Between January 2000 and January 2004, fifteen patients with long standing facial paralysis were treated in the Korea University Anam Hospital. The segmental latissimus dorsi with long nerve and pedicle was transferred to the paralyzed side of the face. The first postoperative movement of the transferred muscle was reported at 8.9 months, faster than that of the two stage method. During the next 24 months, a constant increase in the power of muscle contraction was observed. The fifteen cases were evaluated within an average of 31.7 months following the surgery and satisfactory results including muscle contraction were obtained in eleven of the cases but muscle contraction was not found in three cases.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.454-460
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• 2005

Dematofibrosarcoma protuberans(DFSP) is a moderate-degree malignant tumor with high recurrence rate and low metastasis rate, from soft tissue. Principle of treatment is wide excision or Mohs micrographic surgery(MMS). Although wide excision has been performed with surgical margins of 2-5 cm until nowadays, there are problems of preservation of surrounding normal tissue. Therefore the authors tried to identify desirable surgical margins and operative method. From January 1999 to April 2003, 12 patients with DFSP were operated. We applied different surgical margins and operative methods according to the location of lesions. On the face, we performed MMS with surgical margin of 3-4 mm in 2 cases although there are problems of operation time and expense. But on the extremities and trunk, we performed authors' method to begin excising with surgical margins of 1 cm and excise extensively with MMS by 1 cm in 4 cases after April, 2001 although we had performed wide excision with surgical margin of 3 cm in 6 cases before. There was no recurrence or metastasis in the follow-up period. So we think that author's method is effective in surgical excision of DFSP