• 제목/요약/키워드: Day surgery

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개심술시의 포타시움 변화 (Changes of Potassium in Open Heart Surgery)

  • 이홍섭
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.422-427
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    • 1978
  • Alterations in the serum and urine potassium were studied in twenty patients who underwent open heart surgery in National Medical Center during the period from Jan.1978 to June 1978. There were twelve cases congenital heart disease and eight acquired heart disease. Rigg-Kyvsgaad mark IV roller pump and Polystan bubble oxygenator were used in all patients. Hemodilution was carried out by priming the oxygenator with Hartmann`s solution. Measurements were made of the serum electrolyte, gas analysis and twenty four hour urine electrolytes. During the bypass, the serum potassium decreased Significantly from 4.2?.47 to 3.6?. 72 mEq. per liter. [p<0.05] Fifty seven miliequivalant of potassium chloride were added during operation-urine potassium was higher in the diuretic group than in the non diuretic group. Plasma potassium level in the diuretic group was more significantly reduced than nondiuretic group. In this series large amount of urine potassium loss was noted on the day of operation, the first and second post operative day.

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개심술후 합병되는 횡경신경 손상 -4례 보고- (Phrenic Nerve Paralysis Complicating Topical Cardiac Hypothermia During Open Heart Surgery - A Report of 4 Cases-)

  • 이종욱
    • Journal of Chest Surgery
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    • 제21권4호
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    • pp.772-777
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    • 1988
  • Because of increasing myocardial damage by normothermic arrest, most of cardiac surgeons now uses many kinds of method reducing myocardial injury, such as systemic hypothermia, topical cooling and cold cardioplegic solutions. And phrenic nerve paralysis has been reported with the use of iced slush for topical cooling. So we reviewed the preoperative and postoperative chest X-rays of 54 patients undergoing open heart surgery with the use of iced slush for topical cooling to find phrenic nerve paralysis. Four of 54 patients were known to have phrenic nerve paralysis. The first time known to develop phrenic nerve paralysis was from POD 4 1 day to POD 4 3 day and the phrenic nerve paralysis resolved within a month postoperatively except one. A patient have had phrenic nerve paralysis persistently over 7 months. And the effect of unilateral phrenic nerve paralysis was of no clinical significance.

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악교정 수술후 항생제 투여의 효용성 : 술후 항생제 투여 여부에 따른 창상감염 빈도 (THE EFFECTIVENESS OF POST OPERATIVE ADMINISTRATION OF ANTIBIOTICS IN ORTHOGNATHIC SURGERY: INFECTION FREQUENCY BASED ON POST-SURGICAL APPLICATION OF ANTIBIOTICS)

  • 강상훈;유재하;이충국
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권3호
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    • pp.206-210
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    • 2007
  • This study observed the frequency of post-surgical infection according to post-surgical application of antibiotics in order to evaluate the benefits of the use of antibiotics after the orthognathic surgery. 349 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The mean(SD) age of the 349 patients was 22.7(${\pm}4.25$) with a male-female ratio of 168:181. 226 patients received only 1.0g of a third-generation cephalosporin(Cefpiramide) intravenously 30 minutes prior to the surgery. Likewise, 123 patients received 1.0g of Cefpiramide 30 minutes prior to the surgery and twice daily longer than the third day after surgery. The mean(SD) duration of administration was 4.75(${\pm}0.89$) day. The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. However, 14 patients of 226 patients received antibiotics only prior to the surgery developed postoperative infection, 2 patients of 123 patients received antibiotics longer than postoperative 3 days developed postoperative infection. Postoperative infection frequency showed no significant difference between the two groups(p=0.094). Also, bi-maxillary operation and mandibular operation alone, showed no significant difference in the frequency of post-surgical infection when antibiotics had been continuously used after the surgery. From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

선천성 식도폐쇄 및 기관식도루: 1례 보 (Congenital Esophageal Atresia and Tracheoesophageal Fistula - A Case Report -)

  • 권우석
    • Journal of Chest Surgery
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    • 제20권3호
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    • pp.619-623
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    • 1987
  • We experienced a surgical case of esophageal atresia and tracheoesophageal fistula combined with imperforated anus, tracheal bronchus in a one day baby. A vacuum delivered full term baby, weighing 4.1 Kg showed grunting respiration, repeated regurgitation and distended abdomen after birth. Esophagogram revealed markedly dilated proximal esophagus as blind pouch and also noted displaced type of tracheal bronchus of right upper lobe by incidental bronchogram. Surgical correction with Haight anastomosis was performed successfully on the second day.

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Left lobe living donor liver transplantation using the resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (RAPID) procedure in cirrhotic patients: First case report in Korea

  • Jongman Kim;Jinsoo Rhu;Eunjin Lee;Youngju Ryu;Sunghyo An;Sung Jun Jo;Namkee Oh;Seungwook Han;Sunghae Park;Gyu-Seong Choi
    • 한국간담췌외과학회지
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    • 제28권3호
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    • pp.388-392
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    • 2024
  • In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor-resection and partial liver segment 2-3 transplantation with delayed total hepatectomy (LD-RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT). We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD-RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD-RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.

A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • 제47권4호
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    • pp.406-408
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    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

식도폐쇄증과 동반된 기관연화증 - 1예 보고 - (Tracheomalacia Associated with Esophageal Atresia - A case report -)

  • 송승환;장윤희;이창훈;신동훈;성시찬
    • Journal of Chest Surgery
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    • 제39권8호
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    • pp.643-647
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    • 2006
  • 선천적으로 발생한 식도 폐쇄증과 연관된 기관연화증은 매우 드문 기형이다. 본 증례는 생후 1일째 식도 폐쇄증 수술을 받은 환아가 기관연화증으로 진단되어 생후 40일에 교정수술을 하였다. 식도수술 후에 진행하는 호흡곤란과 천명음을 보였으며, 삼차원 컴퓨터촬영상 기관 중부에 심한 협착소견을 보였다. 심폐바이패스 하에서 협착부를 절제하고 단단 문합하였다. 조직학적 검사상 연골이 없을 뿐 아니라 식도조직을 보여 선천성 기관연화증으로 진단할 수 있었다.

Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma

  • Park, Yun Chul;Jo, Young Goun;Kang, Wu Seong;Park, Eun Kyu;Kim, Hee Jun;Kim, Jung Chul
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.231-234
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    • 2017
  • Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

선천성 혈액 응고 인자 Ⅹ(10번) 결핍증 환아에서 구개성형술의 증례보고 (A Case Report of Palatoplasty in a Patient with Clotting Factor Ⅹ Deficiency)

  • 김석화;정의철;윤병민;최태현;강형진
    • Archives of Plastic Surgery
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    • 제36권6호
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    • pp.792-794
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    • 2009
  • Purpose: Clotting factor X deficiency is one of the most uncommon coagulation disorders. The authors describe a case of cleft palate in a patient with a congenital clotting factor X deficiency. Methods: In pediatric patients with a cleft palate, the coagulation problem is more worrisome, because they are more sensitive to blood than adults, and because postoperative bleeding can cause blood ingestion with subsequent vomiting, aspiration, and airway obstruction. To prevent hemorrhagic complications in the described case, fresh frozen plasma (FFP) was administered every 24 hrs from the day before surgery to the second postoperative day. Results: Good hemostasis, normal healing, and no complications was shown postoperatively. Conclusion: The replacement of fresh frozen plasma was useful in the case of congenital clotting factor deficiency for bleeding prophylaxis in cleft palate operation.

난소암 환자의 복부 수술 및 온열항암화학요법 후유증에 대한 한방 치험 1례 (Korean Medical Treatment of Sequela Following Abdominal Surgery with Hyperthermic Intraperitoneal Chemotherapy for Ovarian Cancer: a Case Report)

  • 조수연;김동철
    • 대한한방부인과학회지
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    • 제29권4호
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    • pp.57-68
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    • 2016
  • Objectives: This paper aims to report the effects of Korean medical treatment on a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer. Methods: An ovarian cancer patient underwent abdominal surgery and got Korean medical treatment during 7-day hospitalization. About 2 years later, with metastasis to the lymph nodes detected, she had abdominal surgery with hyperthermic intraperitoneal chemotherapy and got Korean medical treatment during 10-day hospitalization. The treatment included herbal medicine and acupuncture. Numerical Rating Scale (NRS) of symptoms was measured every morning. Results: After the treatment, sequela following surgery decreased, and general conditions improved. During 1st and 2nd hospitalization, NRS of general weakness, heartburn and dorsal chill significantly decreased (10 to 5, 10 to 5 and 10 to 2, respectively) while edema in both legs remained the same. Conclusions: This case shows that Korean medical treatment is effective for a patient who underwent abdominal surgery with hyperthermic intraperitoneal chemotherapy for ovarian cancer.