• Title/Summary/Keyword: Extent of surgery

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Outcomes of Surgical Management of Xanthelasma Palpebrarum

  • Lee, Hoon Young;Jin, Ung Sik;Minn, Kyung Won;Park, Young-Oh
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.380-386
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    • 2013
  • Background Xanthelasma palpebrarum (XP) is a benign disorder manifesting as yellowish cholesterol-laden plaques on the eyelids. This paper presents the outcomes in patients with XP who have undergone surgical excision as the main modality of treatment. Methods A retrospective review of patients who received surgery for xanthelasma palpebrarum from March 2007 to March 2011 was conducted. Patients were classified into four grades according to the location and extent of the lesion, with grade I being the mildest and grade IV being the most diffuse. Simple excision was performed in grade I and II lesions, while local flaps and skin grafts were performed in the more advanced grades. Results Ninety-five cases from March 2007 to March 2011 were included in this study. 66 cases (70%), were treated by simple excision. Twenty-four cases (25%) and 5 cases (5%) were treated by simple excision in combination with or without local flaps and skin grafts. In approximately 1/4 of the patients, orbicularis oris muscle involvement was observed. 4 patients (4.2%) developed scar contracture postoperatively, which required a secondary procedure. Recurrence was reported in 3 patients (3.1%). Otherwise. There were no other reports of major complications or disfigurement. Conclusions We found that for lesions involving the deep dermis and/or muscle, surgical excision was the most appropriate therapeutic option.

A Case of Parotid Metastasis after Eyelid Cancer Operation (안검암 수술후 이하선에 발생한 전이성 병변 1예)

  • Kim, Tae Min;Song, In Sik;Joo, Jae Woo;Kim, Min-Su;Oh, Kyoung Ho;Kwon, Soon Young
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.61-64
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    • 2016
  • There are various types of malignancy in eyelid, such as squamous cell carcinoma, melanoma, and sarcoma. These malignant tumors have potential of metastasis by regional lymph node drainage. The lymph node around parotid gland has been known as a common site of regional lymph node metastasis. The rarity of malignant tumors in the periorbital area makes it difficult to determine the optimal extent of treatment. We report a case of parotid metastasis after eyelid cancer operation in a 60-year-old man.

Delayed-type retrobulbar hematoma caused by low temperature after reconstruction of inferior blow-out fracture

  • Lee, Da Woon;Kim, Tae Hyung;Choi, Hwan Jun;Wee, Syeo Young
    • Archives of Craniofacial Surgery
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    • v.22 no.2
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    • pp.110-114
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    • 2021
  • Retrobulbar hemorrhage is a disastrous condition that can lead to permanent blindness. As such, rapid diagnosis and treatment are critical. Here, we report a patient who presented with retrobulbar hemorrhage following an orbital floor fracture. Restoration of inferior orbital wall with porous polyethylene implant was underwent. Four days after the orbital floor reconstruction, the patient smoked a cigarette outdoors in -3℃ weather. Cold temperature and smoking caused an increase in his systemic blood pressure. The elevated blood pressure increased intraorbital pressure to the extent of causing central retinal artery occlusion and exacerbated oozing. During exploratory surgery, 3 mL of hematoma and diffuse oozing without arterial bleeding were observed. Prompt diagnosis and treatment prevented vision impairment. Few studies have reported on the risk factors for retrobulbar hemorrhage. This case showed that daily activities, such as exposure to cold weather or tobacco smoking, could be risk factors for retrobulbar hemorrhage.

Clinical characteristics and treatment propensity in elderly patients aged over 80 years with colorectal cancer

  • Jung, Yun Hwa;Kim, Jae Young;Jang, Yu Na;Yoo, Sang Hoon;Kim, Gyo Hui;Lee, Kang Min;Lee, In Kyu;Chung, Su Mi;Woo, In Sook
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1182-1193
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    • 2018
  • Background/Aims: Elderly patients (${\geq}80years$) with colorectal cancer (CRC) tend to avoid active treatment at the time of diagnosis despite of recent advances in treatment. The aim of this study was to determine treatment propensity of elderly patients aged ${\geq}80years$ with CRC in clinical practice and the impact of anticancer treatment on overall survival (OS). Methods: Medical charts of 152 elderly patients (aged ${\geq}80years$) diagnosed with CRC between 1998 and 2012 were retrospectively reviewed. Patients' clinical characteristics, treatment modalities received, and clinical outcome were analyzed. Results: Their median age was 82 years (range, 80 to 98). Of 152 patients, 148 were assessable for the extent of the disease. Eighty-two of 98 patients with localized disease and 28 of 50 patients with metastatic disease had received surgery or chemotherapy or both. Surgery was performed in 79 of 98 patients with localized disease and 15 of 50 patients with metastatic disease. Chemotherapy was administered in only 24 of 50 patients with metastatic disease. Patients who received anticancer treatment according to disease extent showed significantly longer OS compared to untreated patients (localized disease, 76.2 months vs. 15.4 months, p = 0.000; metastatic disease, 9.9 months vs. 2.6 months, p = 0.001). Along with anticancer treatment, favorable performance status (PS) was associated with longer OS in multivariate analysis of clinical outcome. Conclusions: Elderly patients aged ${\geq}80years$ with CRC tended to receive less treatment for metastatic disease. Nevertheless, anticancer treatment in patients with favorable PS was effective in prolonging OS regardless of disease extent.

Simultaneous Neck Dissection in Transoral $CO_2$ Laser Surgery for Supraglottic Cancer (성문상부암에서의 경구강 $CO_2$ 레이저 수술과 동시경부청소술)

  • Kim, Sung-Won;Lee, Kang-Dae
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.18-23
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    • 2009
  • Objectives : In $CO_2$ laser surgery for supraglottic cancer, neck dissection is generally done in second stage. We investigated simultaneous neck dissection with primary resection could be available in laser supraglottic surgery. Material and Methods : We analyzed 13 patients with supraglottic cancer who were treated with transoral supraglottic laryngectomy and simultaneous neck dissection from 2001 to 2007. Tumor stage, extent of laser surgery, histological results, survival rate, local control rate, complications, and functional results were reviewed. Results : 5-year local control rate, survival rate and disease specific survival rate from the neck was 100%, 69.9%, 100% respectively. Tracheotomy was done in all 13 cases. One patient had a long tracheotomy indwelling (191 days). In the rest of 12 patients average decanulation time was 7.4 days(1-22 days). Nasogastric tube was inserted in 5 cases, and average oral intake was possible in 3.5 days(1-16 days). Average hospital days was 29.7 days. There was no serious complication associated with neck dissection. Conclusion : Simultaneous neck dissection with primary laser resection for supraglottic cancer is oncologic sound and can be performed without significant surgical morbidity.

Prognostic Factors and Survival Rates of Stage III Gastric Cancer Patients after a Gastrectomy (3기 위암 환자의 술 후 생존율 및 예후 인자 분석)

  • Jang Seok-Won;Kim Chi-Ho;Kim Sang-Woon;Song Sun-Kyo
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.137-142
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    • 2004
  • Purpose: There have been some controversies over the therapeutic principles of advanced gastric cancer, and the results of treatment have been variable, especially for stage III disease. This study was conducted to define the prognostic factors of stage III gastric cancer. Materials and Methods: This retrospective study was based on the medical records of 179 patients with stage III disease who received a gastrectomy from January 1990 to December 1994. The 5-year survival rate was analyzed according to the age, sex, tumor location, tumor size, Borrmann's type, depth of invasion, lymph-node metastasis, ratio of metastatic lymph nodes, type of surgical resection, extent of lymphnode dissection, curability of resection, postoperative chemotherapy, and pathological stage. The statistical analysis was done by using the Kaplan-Meier method, the log-rank test, and the Cox proportional hazards model. Results: The overall 5-year survival rate was $61.6\%$ the 5-year survival rates according to subgroup were $69.7\%$ for stage IIIa ($100\%$ for $T_{2}N_{2}$, $70.0\%$ for $T_{3}N_{1}$, $68.6\%$ for $T_{4}N_{0}$), and $54.1\%$ for stage IIIb ($T_{3}N_{2}$) (P<0.05). Among various clinicopathologic factors of stage III gastric cancer, the age of the patient, the tumor location, the gross type of tumor, the type of gastric resection, the extent of lymph-node dissection, the curability of resection, and the subgroups of stage III were statistically significant in the univariate survival analysis. The multivariate analysis defined the curability of resection, the extent of lymph-node dissection, the type of operation, the stage of disease, and the age of the patient as independent prognostic factors. Conclusion: A curative surgical resection and an extended lymph-node dissection are thought to be most important for improving the survival rate in stage III gastric cancer patients.

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Aideo-Assisted Thoracic Surgery in Pleural Adhesion (늑막유착을 동반한 질환에서의 비디오 흉부수술)

  • Seong, Suk-Hwan;Kim, Hyeon-Jo;Lee, Chang-Ha;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.916-922
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    • 1996
  • In patients with pleural adhesion, video-assisted thoracic surgery (VATS) has been regarded as a contra- indication. When such adhesions were found during a thoracoscopic trial, the thoracotomy proceeded with for fear of parenchymal Injury and bleeding. We had a question whether or not thoracoscopic surgery should be done in such pleural adhesions. Of the 226 consecutive thoracoscopic surgeries from Jul. 1992 through Sep. 1995, pleural adhesions were detected intraoperatively in 50 cases (22.1%): a detailed breakdown is as follows: pneumothorax (16 cases), pleural disease (15), benign pulmonary nodule(7), mediastinal mass(5), hyperhidrosis (2), diffuse parenchymal or interstitial lung disease (2), bronchiectasis(2), and primary lung cancer(1). We classified pleural adhesions according to their extent and severity. Extent is categorized as the involved area of the lung: degree 1, II, or III; severity is given one of four grades: mild, moderate, severe, or ve y severe. In cases of very severe severity requiring decortication, the possibility of VATS was excluded. Of the 50 cases, mild adhesions were detected in 15 cases(30.0%), moderate in 29 (58.0%), and severe in 6 (12.0%). As for the extent of the adhesions, 8 cases (16.0%) were categorized as degree 1, 32 cases (64. 0%) as degree II, and 10 cases (20.0%) as degree III. For patients with pleural adhesions, the operation time, the chest tube indwelling time, and the postoperative hospital stay were all longer than for patients in the non-adhesion group. Postoperative complications, namely prolonged air-leakage and pleural drain- age, were more common (18.0% and 6.0%, respectively) than in the non-adhesion group (5.1% and 1.7%, respectively). Only two bronchiectatic patients (4%) were converted to an open thoracotomy because of in- ability to control bleeding. Although complications were encountered more frequently in the group with adhesions, patients were still able to enjoy the benefi s of thoracoscopic surgery. It is advisable to proceed with thoracoscopic surgery even in cases of unpredicted pleural adhesions.

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An accurate diagnosis of odontogenic cutaneous sinus tract by different computed tomography unit setting

  • Sodnom-Ish, Buyanbileg;Eo, Mi Young;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.1
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    • pp.51-56
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    • 2021
  • Due to their rarity and the lack of associated dental symptoms, odontogenic cutaneous sinus tracts (OCSTs) are often misdiagnosed and confused with cutaneous lesions or non-odontogenic infections. It has been estimated that 50% of individuals affected by OCSTs are subjected to inappropriate treatments before the correct diagnosis is established. We describe the diagnosis and treatment of two cases of OCSTs. By using a computed tomography (CT) with soft tissue window setting, the extent of cortical bone destruction and the path of the sinus tract in the soft tissue was easily identified. Thus, we recommend the use of imaging techniques such as CT, which can confirm the odontogenic origin and the exact location of the OCST.

Surgical Treatment of Chronic Pericarditis: Case Analysis of 19 Cases (만성 심낭염의 외과적 요법)

  • Lee, Dong-Jun;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.273-280
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    • 1978
  • 19 chronic pericarditis patients reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 10 years from January of 1968 to January of 1978. 2. There were 14males and 5 females in this series. Range of age varied from 110 days to 61 years. 2. There were two hospital death, one expired 2 days and another 3 days after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factor. 2. Clinical and histological study showed tuberculous origin in 8 cases, nonspecific chronic inflammatory changes in 6 cases and pyogenic infection cases in 5 patients. 2. The postoperative complications were observed in 6 cases, and the most common was cardiac arrhythmia and wound infection. 2. The extent of pericardiectomy should be confined to the left and right ventricles to correct the hemodynamic anomaly in general. The results of this procedure has been satisfactory in 89 percent of the cases. 2. Optimal myocardial function in cases of constritive pericarditis was the key to the successful outcome of this procedure.

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Chopart Joint Fracture and Dislocation: A Report of Three Cases (Chopart 관절 골절 및 탈구: 3예 보고)

  • Kim, Sung-Hyun;Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.120-126
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    • 2018
  • Chopart joint fracture and dislocation are rare injuries compared with other joint injuries with various clinical manifestations. Moreover, there is a lack of knowledge of the radiological findings of the joints, and thus, the extent of joint ligament damage may be underestimated, leading to improper treatment. This paper reports three cases of Chopart joint injury and seeks to reconsider the importance of Chopart joint evaluation and treatment.