• Title/Summary/Keyword: Conservative Surgery

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Management of High-grade Blunt Renal Trauma

  • Lee, Min A;Jang, Myung Jin;Lee, Gil Jae
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.192-196
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    • 2017
  • Purpose: Blunt injury accounts for 80-95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80-85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury. Methods: We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high-grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III-V) renal injury patients were included in the analysis. Results: During the eight-year study period, there were 62 AAST grade III-V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade. Conclusions: Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

Surgical Strategies for Achilles Tendinopathy (아킬레스 건병증의 수술 전략)

  • Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.2
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    • pp.95-99
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    • 2021
  • The surgical treatment of Achilles tendinopathy can be considered after the failure of conservative treatment, and the surgical methods may be divided into two groups; treatments for insertional and non-insertional tendinopathy. In the case of insertional tendinopathy, debridement including tendon and calcification of the diseased lesion, reattachment of the tendon, and calcaneal ostectomy of the Haglund lesion are the primary treatments. If reattachment is not possible, reconstruction should be performed by other methods such as tendon transfer. As a result of surgery for insertional tendinopathy, there is an improvement in the pain and function after surgery, but there are some patients whose pain does not completely disappear. Some residual pain may persist; therefore, the overall success rate of the surgery can be expected to be 80% to 90%. For the patients of non-insertional tendinopathy, conservative treatment through eccentric exercise is the primary treatment, and most of them have reported good results. In case of failure after various conservative treatments, debridement of the diseased lesion and repair of the remaining tendon would be the primary surgical treatments. If the remaining tendon is not sufficient, reconstruction such as tendon transfer should be considered.

The Clinico-Statisitical Analysis of Ameloblastoma of Mandible (하악골에 발생한 법랑아세포종의 임상통계학적 분석)

  • Yu, Kyoung-Hwan;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Lee, Jeong-Hoon;Kim, Jin-Ha
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.551-557
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    • 2010
  • Purpose: In this study, we evaluated the relation between surgical methods and reccurrence rate by investigating clinical, radiological aspects and histopathological patterns of 26 patients who were diagnosed with amelobalstoma. Patients and Methods: In this study, we retrospectively investigated 26 patients who were diagnosed with ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery of Chosun University Dental Hospital from January 2000 to December 2008. Results: The patients comprised 12 males (46.1%) and 14 females (53.9%), and their ages ranged from 10 to 69 years (average, 37.3 years). All cases presented a mandibular location, and in particular, 13 cases (50%) demonstrated an occurrence in the mandibular body. Clinically, 8 cases (30.8%) presented no symptoms, and the most prevalent chief complaint was swelling in 13 cases (50%). Radiographically, a unilocular type appeared in 14 cases (53.8%), and a multilocular type was observed in 10 cases (38.5%). Histopathologically, there were 8 follicular types (30.8%) and 7 plexiform types (26.9%). Conservative treatment was performed in 5 cases (19.2%), and radical treatment was performed in 21 cases (80.8%). The follow-up period ranged from 1 to 10 years. The total recurrence rate was 15.4%, and the mean duration of recurrence was 6.7 years. Three of the 5 cases (60%) that received conservative treatment demonstrated a recurrence, as compared to 1 of the 21 cases (4.8%) that underwent radical treatment. Conclusion: The radical treatment was more effective than the conservative treatment for recurrence prevention. We should consider a continuous follow-up check after operation.

Conservative Treatment Using Marsupialization for Cysts Occurring in the Jaw of Adolescents: A Case Report

  • Yun, Sun-Ung;Jung, Hai-Won;Cho, Byung-Yong;Choi, Byung-Joon;Lee, Baek-Soo;Kwon, Yong-Dae;Ohe, Joo-Young;Lee, Jung-Woo
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.31-37
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    • 2014
  • Dentigerous cyst (DC) is an odontogenic cyst associated with the crown of an impacted, embedded, unerupted, or developing tooth. It is the second most common type of odontogenic cysts, accounting for 14% to 24% of all jaw cysts. Although these cysts occur more frequently during the second and third decades of life, they can also be found in children and adolescents in the mixed dentition stage. Treatment of the odontogenic cyst involves enucleation or marsupialization/decompression methods. The latter approach is preferred for larger cysts, and it is especially helpful in adolescent patients in conserving the unerupted permanent successors. The aim of treatment for DC is the complete elimination of pathology and maintenance of dentition with minimal surgical intervention. Recently defined criteria for the selection of treatment modality include the cyst size and location of the cyst, patient age, dentition involved, stage of root development, position of the tooth involved in the jaw, and relationship with the surrounding vital structure. Marsupialization or decompression technique has been advocated by several authors for treating DCs among young patients. In this conservative technique, the creation of an accessory cavity helps relieve intra-cystic pressure and accelerate the healing of cystic lesion. This technique has been successfully performed and is indicated for growing children and adolescents. Here, we report a large cyst lesion in the mandible treated by marsupialization for conservative management. In conclusion, successful reduction in size was achieved, and intraoperative complication could be prevented.

The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case (조기 치근관 배농술을 이용한 하악 골절선상 감염치아들의 보존적 관리: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Seol, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.309-313
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    • 2010
  • The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

Conservative Management of Postoperative Chylothorax Using Octreotide - A case report- (옥트레오타이드를 이용한 수술 후 유미흉의 보존적 치료 -1예 보고-)

  • Kim Kun Il;Park Jong Un;Park Sang Hyun;Lee Jae Woong;Hong Ki Woo;Choi Young Jin;Lee Weon Yong
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.172-174
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    • 2005
  • Chylothorax is a rare but serious and well-recognized complication of thoracic and cardiac procedures. A postoperative chylothorax developed in a 3-month-old male patient after ligation of patent ductus arteriosus and repair of coarctation of aorta. He was treated successfully with conservative management using a combination of parenteral octreotide and medium-chain triglyceride (MCT) -enriched fomula with pleural drainage. We report a case of successful conservative treatment using octreotide for postoperative chylothorax.

Temporomandibular Joint Disorder and Occlusal Changes: Case Reports

  • Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.11 no.1
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    • pp.21-31
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    • 2018
  • Occlusion may change spontaneously but dental treatment or trauma in the patients with temporomandibular disorders (TMDs) may also alter occlusion. This report presents three cases displaying occlusal changes. Review of literature emphasizes the significance of TMD treatment. Conservative treatment modalities such as counseling, medication, physical therapy and splint therapy may be selected as initial treatment options. Irreversible or invasive treatment, such as orthodontic, prosthodontic, and occlusal adjustment should not be attempted early. In case there is no response to conservative treatment, joint injection, muscle injection, arthrocentesis or arthroscopic surgery might be performed.

Treatment of Esophaocutaneous Fistula -2Cases Report- (식도피부루의 치험;2례 보고)

  • 최승호
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.583-585
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    • 1993
  • An esophagocutaneous fistula following anterior cervical fusion is rare.We had experienced two cases of postoperative cervical esophagocutaneous fistula, which one case was treated with nonoperative management and the other with operative management.The operation was tried when the conservative treatment seemed to be unsuccessful.They were eventually recovered with conservative treatment, whitch consisted of wound drainage and intravenous administration of antibiotics and operative management with the transposition of sternocleidomastoid muscle flap respectively.

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Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

  • Kim, Kyoung-Tae;Kim, Young-Baeg
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.473-479
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    • 2010
  • A cervical radiculopathy is the most common symptom of cervical degenerative disease and its natural course is generally favorable. With a precise diagnosis using appropriate tools, the majority of patients will respond well to conservative treatment. Cervical radiculopathy with persistent radicular pain after conservative treatment and progressive or profound motor weakness may require surgery. Options for surgical management are extensive. Each technique has strengths and weaknesses, so the choice will depend on the patient's clinical profile and the surgeon's judgment.

Cemento-Osseous Dysplasia Largely Occurring in the Mandible: Case Report (하악골에 광범위하게 발생한 백악-골 이형성증의 치험례)

  • Kim, Sin-Guen;Park, Jong-Wook;Nam, Jong-Hoon;Bok, Sung-Cheol;Lee, Young-Man;Park, Ki-Nam;Choi, Dong-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.454-458
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    • 2011
  • Cemento-Osseous dysplasia is a benign condition of the jaw known to orginate from the periodontal ligament or medullary bone. Its treatment can be categorized according to clinical symptom. If there is no pain or other discomfort, a regular recall examination and having patients maintain proper oral hygeine are the best management. However, if clinical symptoms do exist, proper treatments such as resectioning of the mandible or mandibulectomy are needed. This clinical report describes a rare symptomatic case of cemento-osseous dysplasia which was treated with a conservative surgical method. Using this method, we obtained satisfactory results without additional grafts.