• Title/Summary/Keyword: Extent of surgery

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Ganglionic Cyst of the Peroneal Nerve - A Case Report - (총 비골 신경에 발생한 결절종 - 증례보고 -)

  • Song, Kwang-Son;Jeon, Si-Hyun;Kim, In-Kyu
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.212-216
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    • 2003
  • A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.

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Reconstruction of Distal Radius Using Ultrahigh Molecular Weight Polyethylene Liner after Excision of Giant Cell Tumor - A Case Report - (원위 요골에 발생한 거대 세포종의 일괄 절제 후 초고분자량 폴리에틸렌 삽입물을 이용한 재건술 - 증례보고 -)

  • Jeon, Dae-Geun;Song, Won-Seok;Oh, Jung-Moon
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.1
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    • pp.29-33
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    • 2004
  • A giant cell tumor (GCT) of the distal radius is not common. Curettage with bone cementation is considered as a treatment of choice but, in the case of recurrence, marked cortical disruption, or articular invasion, en bloc excision and reconstruction with proximal fibular bone graft is usual procedure. In reconstruction of en bloc resected distal radius which had recurred GCT after conservative operation, we used the ultrahigh molecular weight polyethylene (UHMWPE) liner with intramedullary rod and bone cement, because the contamination was extent in previous operation and recurrence after fibular bone graft was fearful. This article introduce our new surgical procedure.

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A Case Report of Congenital Eyelid Defect without Any Other Deformities (다른 기형을 동반하지 않은 선천성 상안검 결손증 1례 보고)

  • Moon, Jae Won;Yang, Jeong Yeol
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.90-92
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    • 2008
  • Purpose: Congenital upper eyelid defect is rare anomaly whether it is compared with syndromic anomaly or not. It has many clinical manifestation in the extent, location. Many operation procedures such as simple closure, semicircular rotation flap, Cutler Beard procedure, lower lid rotation flap, etc can be used to reconstruct eyelid defects. We intend to introduce a simple, congenital eyelid defect which was not compared with syndromical anomaly, ophthalmic complication. Methods: Our experience is a case of 19 years old female who had a upper eyelid coloboma without any other anomalies. we could not find any skeletal deformity in orbital CT scan. she had no ophthalmic problem. we reconstructed the defect with bilateral marginal flap after deepithelization of supramarginal area and tarsal reposition. Results: There were no visible deformity of lid lining. postoperative scar was favorable. satisfactory results were obtained in cosmetic and functional aspects. Conclusion: Upper lid coloboma without other anomalies is rare. we obtained satisfactory outcome as treated this rare case with marginal flap advancement.

Beginner Surgeon's Initial Experience with Distal Subtotal Gastrectomy for Gastric Cancer Using a Minimally Invasive Approach

  • You, Yung Hun;Kim, Yoo Min;Ahn, Dae Ho
    • Journal of Gastric Cancer
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    • v.15 no.4
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    • pp.270-277
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    • 2015
  • Purpose: Minimally invasive gastrectomy (MIG), including laparoscopic distal subtotal gastrectomy (LDG) and robotic distal subtotal gastrectomy (RDG), is performed for gastric cancer, and requires a learning period. However, there are few reports regarding MIG by a beginner surgeon trained in MIG for gastric cancer during surgical residency and fellowship. The aim of this study was to report our initial experience with MIG, LDG, and RDG by a trained beginner surgeon. Materials and Methods: Between January 2014 and February 2015, a total of 36 patients (20 LDGs and 16 RDGs) underwent MIG by a beginner surgeon during the learning period, and 13 underwent open distal subtotal gastrectomy (ODG) by an experienced surgeon in Bundang CHA Medical Center. Demographic characteristics, operative findings, and short-term outcomes were evaluated for the groups. Results: MIG was safely performed without open conversion in all patients and there was no mortality in either group. There was no significant difference between the groups in demographic factors except for body mass index. There were significant differences in extent of lymph node dissection (LND) (D2 LND: ODG 8.3% vs. MIG 55.6%, P=0.004) and mean operative time (ODG 178.8 minutes vs. MIG 254.7 minutes, P<0.001). The serial changes in postoperative hemoglobin level (P=0.464) and white blood cell count (P=0.644) did not show significant differences between the groups. There were no significant differences in morbidity. Conclusions: This study showed that the operative and short-term outcomes of MIG for gastric cancer by a trained beginner surgeon were comparable with those of ODG performed by an experienced surgeon.

Surgical Treatment of Tracheal Stenosis (기관 협착증의 외과적 치료)

  • 최준영;장인석;김종우;김병균;이정은;김성호;이상호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.565-569
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    • 2000
  • Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.

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Articulation Changes after Partial Glossectomy in Patients with Early Tongue Cancer (초기 구강설암 환자에서 부분 설절제술 후 조음변화)

  • Lee, Gil-Joon;Youm, Hye-Youn;Lee, Gang-Gyu;Lee, Eun-Kyoung;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.42-47
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    • 2010
  • Backgrounds and Objects: Carcinoma of the tongue is the most common cancer of the oral cavity. A primary treatment strategy includes surgery and/or radiotherapy. Resection of the tongue often results in speech dysfunction, which depends on the site and extent of resection, type of reconstruction, and the mobility of remaining tongue. This study aimed to evaluate the characteristics of articulation errors that were resulted from the partial glossectomy without free flap reconstruction. Materials & Method : Articulation evaluations including speech intelligibility and percent of correct consonants (PCC) were performed for 24 patients who underwent partial glossectomy for their T1 or T2 tongue cancer. Mobility of the tongue, size of the resected tongue, and the history of adjuvant radiotherapy were analyzed for their relationship with the results of articulation evaluation. Results: Speech intelligibility score was $6.4{\pm}0.9$ (on 7-point scale) and overall PCC was 96.9%. There were close relationships between the size of resection and limitations in the tongue mobility, especially in "protrusion and elevation (r=-0.687)" and "retroflexion (r=-0.775)". Errors in "alveolar fricatives" and "palatal affricates" were also closely related with the size of resection (r=-0.537 and -0.538, respectively). PCC for "liquid sound" /r/ was 83.2%, which was closely related with the history of radiation therapy. Conclusion : Overall articulatory function was satisfactory in cases of early tongue cancer after partial glossectomy of a limited volume without flap reconstruction. However, the size of resection and the history of radiation therapy were closely related to the limitations in some types of tongue mobility and the resultant articulation errors.

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Effect of leukocyte alteration on treatment outcomes following preoperative chemoradiotherapy in patients with rectal cancer

  • Kim, Tae Gyu;Park, Won;Choi, Doo Ho;Park, Hee Chul;Kim, Seok-Hyung;Cho, Yong Beom;Yun, Seong Hyen;Kim, Hee Cheol;Lee, Woo Yong;Lee, Jeeyun;Park, Joon Oh;Park, Young Suk
    • Radiation Oncology Journal
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    • v.35 no.3
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    • pp.217-226
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    • 2017
  • Purpose: Hematotoxicity following anti-cancer treatment is known to be related to treatment efficacy in several malignancies. The purpose of this study was to examine the hematologic parameters related to the tumor response and survival in patients treated with curative surgery following preoperative chemoradiotherapy (CRT) for rectal cancer. Materials and Methods: Four hundred eighteen patients with rectal cancer who underwent preoperative CRT and curative surgery were analyzed, retrospectively. The main clinical factors and blood cell counts before and after CRT were investigated with respect to their relationships with tumor downstaging and patient survival. Results: The post-CRT leukocyte count was significantly different between the tumor downstaging group and the non-downstaging group (median, 4740/uL vs. 5130/uL; p = 0.013). Multivariate analysis showed that histological grade, circumferential extent, and post-CRT leukocyte count were related to tumor downstaging. In addition, histological grade, post-CRT leukocyte count, and tumor downstaging were related to disease-free survival. The 5-year disease-free survival and overall survival in patients with post-CRT leukocyte count ${\leq}3730/uL$, which is the cut-off value derived from the receiver operation characteristic (ROC) curve analysis, were significantly higher than those with higher counts (88.0% vs. 71.6%, p = 0.001; 94.4% vs. 84.1%, p = 0.024). Conclusion: Post-CRT leukocyte count of ${\leq}3730/uL$ could be regarded as a good prognostic factor for tumor response and survival in rectal cancer patients treated with preoperative CRT.

Effects of Intraperitoneal Bupivacaine Instillation on Postoperative Pain Behavior after Laparoscopic Ovariohysterectomy in Dogs (개에서 복강경을 이용한 난소자궁절제술시 복강 내 Bupivacaine의 점적투여가 술 후 통증행동에 미치는 영향)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Lee, Scott-S.;Suh, Euy-Hoon;Chang, Hong-Hee;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.33-39
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    • 2011
  • The present study was aimed to investigate the effect of intraperitoneal bupivacaine instillation on postoperative pain after laparoscopic ovariohysterectomy (LOHE) in dogs. Twelve female German shepherd dogs (17-30 kg) were divided into two groups. The treatment group received 4.4 mg/kg of instilled intraperitoneal bupivacaine diluted to 0.25% with an equivalent volume of saline after pneumoperitoneum, but the control group received 1.76 ml/kg of 0.9% saline. Two blind observers measured the extent of dog's pain and sedation by using dynamic interactive visual analogue scale (DIVAS) preoperatively and 0.5, 1, 2, 4, 6, and 12 h postoperatively. At each designated time, blood cortisol, glucose, and creatine kinase (CK) concentrations were also measured. Based on the repeated-measures ANOVA, there were significant differences in time-dependent postoperative changes in patterns of DIVAS-pain score between two groups. In addition, the treatment group had significantly lower DIVAS-pain scores at 1, 2, 4, and 6 h postoperatively compared to the control group. DIVAS-sedation score and biochemical measures including cortisol, glucose, and CK did not show any significant differences between two groups. No complications associated with bupivacaine administration were observed. Thus, instilled bupivacaine intraperitoneally may be an effective method on relieving behavioral expressions associated with postoperative pain after laparoscopic ovariohysterectomy in dogs.

Comparative analysis of the amount of postoperative drainage after intraoral vertical ramus osteotomy and sagittal split ramus osteotomy

  • Kim, Hyunyoung;Chung, Seung-Won;Jung, Hwi-Dong;Park, Hyung-Sik;Jung, Young-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.169-172
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    • 2014
  • Objectives: The purpose of this retrospective study was to compare the amount of postoperative drainage via closed suction drainage system after intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO). Materials and Methods: We planned a retrospective cohort study of 40 patients selected from a larger group who underwent orthognathic surgery from 2007 to 2013. Mean age (range) was 23.95 (16 to 35) years. Patients who underwent bilateral IVRO or SSRO were categorized into group I or group II, respectively, and each group consisted of 20 patients. Closed suction drainage system was inserted in mandibular osteotomy sites to decrease swelling and dead space, and records of drainage amount were collected. The data were compared and analyzed with independent t-test. Results: The closed suction drainage system was removed at 32 hours postoperatively, and the amount of drainage was recorded every 8 hours. In group I, the mean amount of drainage was 79.42 mL in total, with 31.20 mL, 19.90 mL, 13.90 mL, 9.47 mL, and 4.95 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. In group II, the mean total amount of drainage was 90.11 mL, with 30.25 mL, 25.75 mL, 19.70 mL, 8.50 mL, and 5.91 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. Total amount of drainage from group I was less than group II, but there was no statistically significant difference between the two groups (P=0.338). There was a significant difference in drainage between group I and group II only at 16 hours postoperatively (P=0.029). Conclusion: IVRO and SSRO have different osteotomy design and different extent of medullary exposure; however, our results reveal that there is no remarkable difference in postoperative drainage of blood and exudate.

Immunohistochemical Characteristics of Primary and Recurrent Pleomorphic Adenoma (원발성 다형선종과 재발성 다형선종의 면역조직화학적 특성)

  • Suh Myung-Whan;Hah J.Hun;Lee Kyung-Bun;Jung Young-Ho;Kwon Seong-Keun;Kim Kwang-Hyun;Sung Myung-Whun
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.146-150
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    • 2005
  • Background and Objectives: When the pleomorphic adenoma(PA) recures, the tumor tends to become a multinodular mass that infiltrates into the normal tissue which is not a common condition for a benign tumor. This manifestation is probably due to the difference in cell biology of the recurrent tumor compared to that of the primary PA. The aim of this study is to assay the immunhistochemical characteristics of the recurrent PA compared to the primary PA and to evaluate whether this property can be used for developing a method that can select the patients who have higher risk to recur. Materials and Methods: Thirteen patients were enrolled in the primary PA group and 15 patients who had a recurrent PA were enrolled in the recurrent PA group. To evaluate the cell biology of the tumor, immunohistochemical stainings of Ki-67, bcl-2 and p53 were performed. Results: There was no difference in the expression of Ki-67 (p=0.117, p=.208) and p53 (p=.430, p=.328). The extent stained by bcl-2 was significantly larger in the recurrent PA group (p=.033, p=.014). The expression of bcl-2 did not increase while time passed. Conclusion: The high expression of bcl-2 seems to be a property of the recurrent PA group which can be found even during first operation before recurrence. By this immunhistochemical characteristic, we would be able to sort out the patients who have higher risk to recur.