• Journal of Chest Surgery
• /
• v.52 no.4
• /
• pp.227-231
• /
• 2019

Background: There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches. Methods: We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups. Results: The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5-211 days) in the thoracic approach group and 9.5 days (range, 5-18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3-299 days) when the thoracic approach was used and 5 days (range, 1-11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group. Conclusion: The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

• Journal of Chest Surgery
• /
• v.26 no.6
• /
• pp.492-495
• /
• 1993

We experienced one case of surgical treatment of abdominal aortic aneurysm using retroperitoneal approach. The transperitoneal route has been the standard surgical approach for elective and emergency treatment of aneurysmal or occlusive disease. Among its cited advantages for aortic reconstruction are familarity with the exposure, easy access to the infrarenal aorta and iliac vessels, possibility of simultaneous inspection of the intra-abdominal viscera, and speed of opening and closure.Despite the proved versatility of the transperitoneal approach, it is commonly associated with prolonged ileus, increased third space fluid loss, and significant pulmonary complications. The retroperitoneal approach, on the other hand, has many advantages; excellent exposure for the repair of juxtarenal or suprarenal abdominal aortic aneurysms and visceral vessel occlusive disease, fewer postoperative complications, decreased postoperative third-space fluid losses from intraoperative evaporation and ileus, and improved postoperative pulmonary function. Atherosclerosis was most common cause of abdominal aortic aneurysm. Dacron graft[18mm] was replaced successfully.Postoperative course was uneventful and he was discharged in good condition.

• Journal of Chest Surgery
• /
• v.56 no.3
• /
• pp.171-176
• /
• 2023

Background: This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach. Methods: After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed. Results: Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH. Conclusion: The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.

• Journal of Veterinary Clinics
• /
• v.30 no.1
• /
• pp.66-70
• /
• 2013

This report compared paramedian and flank approaches for the effective removal of abdominal unilateral cryptorchidism in calves. Two Korean native calves of approximately 300 kg in body weight, which had undergone the removal of a testis from the scrotum, were diagnosed as having abdominal unilateral (left) cryptorchidism by rectal palpation. One calf was administered with xylazine (0.2 mg/kg, IV) and was restrained in the dorsal recumbency position on the ground of barn for the paramedian approach, while the other calf was sedated with xylazine (0.03 mg/kg, IV) and restrained in the standing position for a flank approach. For the two calves, 2% lidocaine was administered by local infiltration, along the proposed incision line. Following incisions of the skin, muscle and peritoneum, the testis, which was located between the left kidney and inguinal canal, was grasped, exteriorized out of the abdominal cavity and detached from the gubernaculum testis. Then spermatic cord was ligated and cut. Finally, the testis was removed. An assistant was required to restraint a calf in dorsal recumbency for paramedian approach, and cryptorchidectomy was carried out with operator in a rather uncomfortable squatting posture, while restraint was rather simple and cryptorchidectomy was proceeded with operator in a standing posture where the flank approach was taken. During surgery, the gubernaculum testis was more strained during pulling the testis in the flank approach than in the paramedian approach, as the distance between incision site and the gubernaculum testis was greater in the flank approach than that in the paramedian approach. On the other hand, intra-abdominal pressure was greater in the paramedian approach than in the flank approach during surgery. The elapsed time between restraint and the end of surgery was 10 min shorter where the flank approach (35 min) was taken, than where the paramedian approach (45 min) was taken. In conclusion, this case study demonstrated that the flank approach might be more convenient than the paramedian approach for abdominal unilateral cryptorchidectomy in calves.

• Clinical and Experimental Pediatrics
• /
• v.49 no.2
• /
• pp.129-135
• /
• 2006

Chronic recurrent abdominal pain is a common manifestation in children. Functional abdominal pain is the most common cause of chronic abdominal pain and can be diagnosed properly by the physician without the requirement of specific evaluation when there are no alarm symptoms or signs. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia, according to the Rome II criteria for pediatric functional gastrointestinal disorders. New concepts on the pathogenesis of functional abdominal pain include brain-gut interaction, visceral hypersensitivity, gastrointestinal dysmotility, inflammation, autonomic dysfunction, genetic predisposition, and triggering factors including psycho-social stress.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.17 no.4
• /
• pp.223-231
• /
• 2014

Purpose: With previous methods based on only age and location, there are many difficulties in identifying the etiology of acute abdominal pain in children. We sought to develop a new systematic classification of acute abdominal pain and to give some helps to physicians encountering difficulties in diagnoses. Methods: From March 2005 to May 2010, clinical data were collected retrospectively from 442 children hospitalized due to acute abdominal pain with no apparent underlying disease. According to the final diagnoses, diseases that caused acute abdominal pain were classified into nine groups. Results: The nine groups were group I "catastrophic surgical abdomen" (7 patients, 1.6%), group II "acute appendicitis and mesenteric lymphadenitis" (56 patients, 12.7%), group III "intestinal obstruction" (57 patients, 12.9%), group IV "viral and bacterial acute gastroenteritis" (90 patients, 20.4%), group V "peptic ulcer and gastroduodenitis" (66 patients, 14.9%), group VI "hepatobiliary and pancreatic disease" (14 patients, 3.2%), group VII "febrile viral illness and extraintestinal infection" (69 patients, 15.6%), group VIII "functional gastrointestinal disorder (acute manifestation)" (20 patients, 4.5%), and group IX "unclassified acute abdominal pain" (63 patients, 14.3%). Four patients were enrolled in two disease groups each. Conclusion: Patients were distributed unevenly across the nine groups of acute abdominal pain. In particular, the "unclassified abdominal pain" only group was not uncommon. Considering a systemic classification for acute abdominal pain may be helpful in the diagnostic approach in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.14 no.1
• /
• pp.26-32
• /
• 2011

Chronic abdominal pain (CAP) is a common complaint encountered in pediatric clinics and a great concern for patients and their caretakers as well as health care professionals. A constant challenge is detecting individuals with organic diseases or psychosomatic disorders from the majority of patients who have a functional disorder including functional dyspepsia, irritable bowel syndrome, functional abdominal pain, and abdominal migraine. Beginning with a detailed history and physical examination, physicians must determine a differential diagnosis of CAP by applying the symptom-based Rome III criteria to positively identify a functional disorder. These findings should then be further analyzed based on diagnostic clues and red flags that indicate the presence of specific organic diseases and/or the need for further testing. Once a functional diagnosis has been made or an organic disease is suspected, physicians can initiate an empiric therapeutic trial. Since psychological distress accompanies both organic and non-organic abdominal pain in children, a cooperative diagnostic approach involving pediatricians and psychiatrists is recommended.

• Clinical and Experimental Pediatrics
• /
• v.49 no.2
• /
• pp.117-128
• /
• 2006

Non-traumatic acute abdominal pain in children presents a diagnostic dilemma. Numerous disorders can cause abdominal pain. Although many etiologies are benign, some require a rapid diagnosis and treatment in order to minimize morbidity. This review concentrates on the clinical office evaluation of acute abdominal pain in infants and children and details the clinical guideline for the diagnostic approach to imaging and the salient clinical features of some of the conditions. The clinical outcomes of children presenting with acute abdominal pain and the risk factors of the high risk underlying diseases would be provided for the diagnostic algorithm.

• Industrial Engineering and Management Systems
• /
• v.7 no.1
• /
• pp.90-98
• /
• 2008

This research selects the lifting task to be the main subject. Four experiments were designed to measure which among lifting postures, lifting heights, waist-belt, and breathing control significantly influences intra-abdominal pressure (Gallagher, 1991; Lavender, Andersson and Natarajan, 1999). The experimental results were taken to be the recommendations of the manual materials handling work design. The research findings reveal that the symmetrical stoop posture is the most significant to the intra-abdominal pressure within all lifting postures. When the lifting height is increased, the intra-abdominal pressure produced relatively goes up. Also, the combination of symmetrical stoop posture, waist-belt use, and inspiration and holding at the same time is the most efficient in carrying out lifting tasks. Simultaneously, the research discovers that for any posture, the volume of the intra-abdominal pressure is much bigger when using the waist-belt compared to when it is not used. Therefore, the waist-belt design for the lifting works might be the future research approach.

• CELLMED
• /
• v.5 no.3
• /
• pp.19.1-19.2
• /
• 2015

This is a case report involving a novel setting of sonographic scan for thickness of superficial abdominal fat and a non-invasive approach for reduction of the fat thickness. A 38-year-old woman complained of her abdominal contour asymmetry after the laser-assisted liposuction performed two years ago. Compression-free sonographic scanning confirmed that her superficial abdominal fat was thicker in left side than that of right side. After 9 sessions of 40KHz therapeutic ultrasound, the contour asymmetry was reduced.