• Title/Summary/Keyword: Endoscopy complications

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Videoscopic Surgery for Arteriovenous Hemodialysis Access

  • Jeong, Hyuncheol;Bae, Miju;Chung, Sung Woon;Lee, Chung Won;Huh, Up;Kim, Min Su
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.28-33
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    • 2020
  • Background: When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. Methods: Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. Results: Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). Conclusion: Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.

Endoscopic Intervention for Anastomotic Leakage After Gastrectomy

  • Ji Yoon Kim;Hyunsoo Chung
    • Journal of Gastric Cancer
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    • v.24 no.1
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    • pp.108-121
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    • 2024
  • Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

Isoperistaltic Jejunal Loop Interposition after Total Gastrectomy for Gastric Cancer in Patients with Familial Adenomatous Polyposis

  • Zuin, Matteo;Celotto, Francesco;Pucciarelli, Salvatore;Urso, Emanuele Damiano Luca
    • Journal of Gastric Cancer
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    • v.20 no.2
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    • pp.225-231
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    • 2020
  • Gastric cancer is a rare condition affecting patients with familial adenomatous polyposis (FAP). The mainstay of treatment is total gastrectomy. Since duodenal cancer is the most common cause of death after total colectomy in FAP, endoscopic surveillance for duodenal cancer is mandatory. Here, we describe the use of an isoperistaltic jejunal loop interposition technique to reconstruct the digestive tract after total gastrectomy in 2 patients with FAP. There were no early or late complications. Both patients are still alive and in good clinical condition. They did not experience weight loss or symptoms of dumping syndrome. Duodenal endoscopic surveillance after this technique was easier than after the classical Roux-en-Y reconstruction. Hence, regular follow-up was possible for both patients.

Treatment of dental implant-related maxillary sinusitis with functional endoscopic sinus surgery in combination with an intra-oral approach

  • Nam, Ki-Young;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.87-90
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    • 2014
  • The present report describes the case of a patient who underwent maxillary sinusitis right after dental implant installation with sinus lifting. Computed tomography scan revealed a dental implant (#16) was protruded inside the right maxillary sinus and confirmed the obstruction of ostium. A symptom remission was gained with the dual approaches combined by functional endoscopic sinus surgery and an intra-oral approach. Fully recovered function and healing of sinus were identified after 10 months follow-up. We report the case of sinusitis caused by protrusion of implants with sinus floor lift procedures and propose that practitioners should be aware of the possible its complications and management.

Treatment of multiple craniofacial osteomas by endoscopic approach

  • Yoo, Hyokyung;Doh, Gyeonghyeon;Kim, Baek Kyu
    • Archives of Craniofacial Surgery
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    • v.21 no.4
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    • pp.261-263
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    • 2020
  • Osteomas are benign osteogenic neoplasms that usually occur as solitary craniofacial lesions. Multiple osteomas are rare, particularly those that do not occur as part of an associated syndrome. We report a case of a 72-year-old woman who presented with multiple bony protrusions over the forehead and scalp. She denied any diagnosis of syndromes that are known to be associated with osteomas. Surgical excision was performed by endoscopically resecting more than 30 osteomas of the frontal and bilateral parietal bones. Compared with conventional surgical excision through a direct incision, endoscopic-assisted surgery is a simple and effective method for the treatment of multiple craniofacial osteomas and is associated with excellent cosmetic outcomes and no neurovascular complications.

Endoscopic Treatment of Hypothalamic Hamartomas

  • Shim, Kyu Won;Park, Eun Kyung;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.294-300
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    • 2017
  • Hypothalamic hamartoma (HH) is a benign indolent lesion despite the presentation of refractory epilepsy. Behavioral disturbances and endocrine problems are additional critical symptoms that arise along with HHs. Due to its nature of generating epileptiform discharge and spreading to cortical region, various management strategies have been proposed and combined. Surgical approaches with open craniotomy or endoscopy, stereotactic approaches with radiosurgery and gamma knife surgery or radiofrequency thermos-coagulation, and laser ablation have been introduced. Topographical dimension and the surgeon's preference are key factors for treatment modalities. Endoscopic disconnection has been one of the most favorable options performed in treating HHs. Here we discuss presurgical evaluation, patient selection, surgical procedures, and complications.

A Clinical Case Report of Non-erosive Reflux Disease Treated with Traditional Oriental Medicine (한방치료(韓方治療)로 호전된 비미란성 위식도 역류질환 1례)

  • Yoon, Seong-Woo;Park, Jae-Woo
    • The Journal of Internal Korean Medicine
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    • v.27 no.4
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    • pp.991-998
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    • 2006
  • Gastroesophageal reflux disorder (GERD) refers to reflux of gastric contents into the esophagus leading to esophagitis, reflux symptoms (e.g. heartburn, regurgitation and non-cardiac chest pain) sufficient to impair quality of life, or long term complications. Non-erosive reflux disease (NERD), a subdivision of GERD, is diagnosed when there were some reflux symptoms without esophagitis and mucosal breaks at endoscopy. We report that severe NERD symptoms and lower quality of life which have not responded to more than 6 months' western medical therapy (acid suppression) were successfully improved with traditional oriental medicine.

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Complications of Donor Site in Latissimus Dorsi Muscle Flap (광배근 피판의 공여부에 대한 문제점의 분석)

  • Chung, Duke-Whan;Han, Chung-Soo;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.149-153
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    • 1999
  • Purpose : To investigate the complication of donor site in latissimus dorsi muscle flap. Materials and Methods : From April 1983 to March 1999, forty patients with latissimus dorsi muscle flap for reconstruction of extremity and with a follow-up period of more than 12 months were included. We analysed the complication, shoulder function, degree of shoulder muscle weakness, skin scar width after operation. Results After 1 year, skin scar widening in 12 cases(30%), limitation of shoulder motion in 9 cases(12.5%), muscle weakness in 14 cases(17.5%) were found. Conclusion. The rate of complication at donor site after latissimus dorsi flap operation is around 10%. To minimize the complication, avoiding axillary skin incision, minimal invasive harvesting by endoscopy, meticulous suturing of subcutaneous layer are needed.

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Supraorbital Endoscopic Evacuation for Traumatic Intracerebral Hematomas in the Frontal Lobe

  • Oh, Hyuk-Jin;Hwang, Sun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.846-852
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    • 2022
  • Objective : Traumatic intracranial hematomas have been rarely evacuated by endoscopic surgery. The frontal lobe is the usual location for the traumatic intracerebral hematoma (TICH). Endoscopic evacuation for the frontal TICHs via an eyebrow incision is to be presented as minimally invasive surgery. Methods : Thirteen patients with frontal TICHs were managed with endoscopic hematoma evacuation via eyebrow incision. After making the incision in the lateral eyebrow, a small frontal craniotomy was made, and the hematoma was evacuated under direct visualization of a rigid endoscope. No catheter was placed. Orbital rim resection, hematoma evacuation rate, surgical complications, and outcome at discharge were analyzed. Results : Men were 11 and the mean age was 54 years old (range, 27-86). Orbitotomy was performed in four patients, and no effect on the hematoma evacuation rate was observed. More than 80% of the hematoma volume was successfully removed in 10 cases. Hematoma configuration was not related to the hematoma evacuation rate. None of the patients underwent revision operation or decompressive craniectomy. Conclusion : Endoscopic evacuation of the TICHs with the supraorbital approach may be a good method to evacuate the hematoma located in the frontal base.

Simultaneous laparoscopic removal of a Todani type II choledochal cyst and a microlithiasic cholecystitis

  • Alfonso Grottesi;Simonetta Iacovitti;Paolo Ciano;Francesco Borrini;Maddalena Zippi
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.281-284
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    • 2022
  • Diverticula of the choledochus, better known as Todani type II cysts, are very rare and represent a predominantly pediatric pathology. Their identification by radiological methods, even if occasional, requires clinical doctors to request a surgical consultation, even for asymptomatic subjects, to proceed with their removal, given the risk of associated neoplasms. The laparoscopic approach for surgical treatment of these cysts has been recently introduced with excellent results. Due to the poor clinical records, currently there are neither shared protocols about their management nor long-term follow-up of operated patients. We report a case of an adult female suffering for years from biliary colic due to the presence of a duodenal diverticulum associated with microlithiasis' cholecystitis, who was laparoscopically treated, with excellent results in terms of symptomatic regression, reduced hospitalization, and no surgery-related complications.