• 제목/요약/키워드: Conservative surgery

검색결과 1,166건 처리시간 0.022초

2세 유아에서 발생한 고도 전위성 치상돌기 골절의 보존적 치료 (Conservative Management for a Highly Displaced Dens Fracture in a Two-Year-Old Child)

  • 임성준;김건중;김용민
    • 대한정형외과학회지
    • /
    • 제56권6호
    • /
    • pp.530-534
    • /
    • 2021
  • 소아, 특히 유아의 치상돌기 골절은 매우 드물고, 따라서 그 진단 및 치료에 대하여 정립된 기술을 쉽게 볼 수 없다. 특히 전위가 심한 경우 보존적 혹은 수술적 치료 중 무엇을 적용해야 할지 결정하기가 어렵다. 이론적으로 수술적 고정을 통해 골절의 조기 정복과 견고한 유지가 가능할 것으로 보이나, 작고 연약한 소아에서 안전하게 수행되기가 쉽지 않고, 환축추 관절의 영구적 고정이라는 문제가 남는다. 저자들은 교통사고로 발생한 2세 여아의 고도 굴곡 전위된 치상돌기 골절 1예를 보존적으로 치료하여 양호한 결과를 얻었기에 이 체험을 문헌 고찰과 함께 보고하는 바이다.

하지 외측 구획에 국한된 구획 증후군에서 수술적 치료와 보존적 치료 간에 비교: 증례 보고 (Comparison between Surgical and Conservative Treatments in Isolated Lateral Compartment Syndrome of the Lower Leg: A Case Report)

  • 곽희철;서영채;정수환;김대유
    • 대한족부족관절학회지
    • /
    • 제26권3호
    • /
    • pp.136-142
    • /
    • 2022
  • Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.

Surface structure characteristics of dental implants and their potential changes following installation: a literature review

  • Pitchaya Aneksomboonpol;Basel Mahardawi;Pheeradej Na Nan;Palawat Laoharungpisit;Thongnard Kumchai;Natthamet Wongsirichat;Napapa Aimjirakul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제49권3호
    • /
    • pp.114-124
    • /
    • 2023
  • Dental implants have been utilized for many years to treat individuals with missing teeth. To optimize the long-term success rate of such implants, new designs, surfaces, and materials have been analyzed. It is important for the clinician to have a background in the field of implant surface design, to be familiar with the strengths and limitations of the available options, and to be aware of the alterations in surface structure that may occur following installation. This article provides a detailed review of the structure and the surface characteristics of dental implants, the modifications of implant surface, as well as the methods of evaluating implant surface structure. Moreover, it provides information concerning the structural changes that may take place at the time of dental implant placement. It is important for clinicians to be aware of such changes to plan and execute implant procedures with the highest possible success and implant survival rates.

Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management

  • Giacomo Emanuele Maria Rizzo;Giuseppina Ferro;Giovanna Rizzo;Giovanni Di Carlo;Alessandro Cantone;Gaetano Giuseppe Di Vita;Carmelo Sciume
    • Clinical Endoscopy
    • /
    • 제55권2호
    • /
    • pp.292-296
    • /
    • 2022
  • Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computed tomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverse event is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, to consider a conservative approach and avoid surgical treatment.

좌측 광범위 경부 림프절 청소술 후 발생한 양측 유미흉 2예 (Bilateral Chylothorax after Left Modified Radical Neck Dissection : Two Cases)

  • 신종현;이잔디;윤지섭;임치영;남기현;정웅윤;박정수
    • 대한두경부종양학회지
    • /
    • 제22권2호
    • /
    • pp.179-182
    • /
    • 2006
  • Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Early diagnosis of chylothorax is important due to the consequences on metabolic & cardiopulmonary conditions. This present report describes our recent experiences with two cases of bilateral chylothorax following left modified radical neck dissection that was treated successfully by conservative management.

Gastropleural Fistula: A Rare Complication of Ewing Sarcoma

  • Bozkurt, Mehmet Abdussamet;Kones, Osman;Basoglu, Irfan;Alis, Halil
    • Journal of Chest Surgery
    • /
    • 제46권4호
    • /
    • pp.293-294
    • /
    • 2013
  • Gastropleural fistula (GPF) is a rare condition that can occur as a consequence of prior pulmonary surgery, trauma, or malignancy. Conservative management usually fails, and gastrectomy and even thoracotomy is often required, especially in debilitated patients. We present a patient with GPF who had a history of Ewing's sarcoma. Diagnosis of GPF was confirmed by upper gastrointestinal system endoscopy and radiographic contrast examination, and the patient underwent a laparoscopic wedge resection of the fistula. To our knowledge, this is the first report of a GPF, in the formation of which recurrence of Ewing's sarcoma had played a role and in the treatment of which wedge resection of the fistula was performed. Laparoscopic treatment of GPF may be associated with less morbidity and should be considered as the initial procedure of choice.

Chyle Leakage after Esophageal Cancer Surgery

  • Yang, Young Ho;Park, Seong Yong;Kim, Dae Joon
    • Journal of Chest Surgery
    • /
    • 제53권4호
    • /
    • pp.191-199
    • /
    • 2020
  • Surgeons recommend dissecting lymph nodes in the thorax, abdomen, and neck during surgery for esophageal cancer because of the possibility of metastasis to the lymph nodes in those areas through the lymphatic plexus of the esophageal submucosal layer. Extensive lymph node dissection is essential for accurate staging and is thought to improve survival. However, it can result in several complications, including chyle leakage, which refers to continuous lymphatic fluid leakage and can occur in the thorax, abdomen, and neck. Malnutrition, fluid imbalance, and immune compromise may result from chyle leakage, which can be potentially life-threatening if it persists. Therefore, various treatment methods, including conservative treatment, pharmacological treatment such as octreotide infusion, and interventions such as thoracic duct embolization and surgical thoracic duct ligation, have been applied. In this article, the risk factors, diagnosis, and treatment methods of chyle leakage after esophagectomy are reviewed.

Treatment of post-traumatic chin deformities using bilateral botulinum toxin injections

  • Park, Eon Ju;In, Seok Kyung;Yi, Hyung Suk;Kim, Hong Il;Kim, Ho Sung;Kim, Hyo Young
    • 대한두개안면성형외과학회지
    • /
    • 제20권5호
    • /
    • pp.310-313
    • /
    • 2019
  • Post-traumatic hematoma formation is a common complication of contusion. If the hematoma is large enough to aspirate or drain, it can be treated quickly and appropriately. However, if the hematoma is small or concealed by local swelling, it may be overlooked and left untreated. In most cases, a hematoma will resolve following conservative treatment; however, associated infection or muscle fibrosis can occur. Herein, we present the case of a patient with a chin deformity caused by a post-traumatic hematoma. The deformity was treated using botulinum toxin and triamcinolone acetonide injections as minimally invasive treatments. The course of treatment was good.

지간 신경종에서 보존적 치료의 임상적 결과 (Clinical Results of Conservative Treatment for Interdigital Neuroma)

  • 이진우;최윤락;한수봉
    • 대한족부족관절학회지
    • /
    • 제8권1호
    • /
    • pp.58-63
    • /
    • 2004
  • Purpose: The purpose of this study is to evaluate the effectiveness of low-dose gabapentin for interdigital neuroma. Metrials and Methods: Between April 2000 and June 2003, 32 patients (39 feet) with interdigital neuroma were treated with using low-dose gabapentin. Two of the 32 patients were male, and thirty were female, and the average age was 47.4 years. The follow-up was 6 to 44months (mean 15.1 months). All cases were diagnosed by physical examination and ultrasonography or MRI. Low-dose gabapentin (300-600 mg) was prescribed and shoe modification was recommended. The patients were evaluated through questionnaire. Results: Neuroma was found in twenty one cases at the third intermetatarsal space, and thirteen at the second intermetatarsal space. The sensitivity of ultrasonography was 96% and that of MRI was 79%. Overall satisfaction was rated as excellent or good by 18 cases (57%). Average pain relief ratio was 50.3%, and in 14 cases, more than 80% of pain relief was noted. Nine (28%) of 32 patients showed they had no activity restrictions, such as daily activities or work, whereas 8 (25%) had mild restrictions and 15 (47%) had major restrictions. Twelve of 15 patient with major restrictions had been treated operatively (neurectomy; 10 cases, decompression; 2 cases). One case had gastrointestinal problem. Conclusion: Low-dose gabapentin for interdigital neuroma was one of the effective conservative treatments. The operation may be preserved for patient with the persist symptoms, nevertheless the conservative treatments and use of low-dose gabapentin.

  • PDF

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

  • Lee, Ji-Eun;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Jung-Ae;Rim, Chai-Hong;Kim, Chul-Yong
    • Radiation Oncology Journal
    • /
    • 제30권2호
    • /
    • pp.62-69
    • /
    • 2012
  • Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.