• 제목/요약/키워드: General Surgery

검색결과 3,395건 처리시간 0.035초

Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection

  • Shalaby, Mostafa;Thabet, Waleed;Buonomo, Oreste;Di Lorenzo, Nicola;Morshed, Mosaad;Petrella, Giuseppe;Farid, Mohamed;Sileri, Pierpaolo
    • Annals of Coloproctology
    • /
    • 제34권6호
    • /
    • pp.317-321
    • /
    • 2018
  • Purpose: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). Methods: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL. Results: Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was $66.91{\pm}11.15years$, and the median body mass index was $24kg/m^2$ (range, $20-35kg/m^2$). The median tumor distance from the anal verge was 8 cm (range, 4-12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation. Conclusion: These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.

Do changes in inflammatory markers predict hepatocellular carcinoma recurrence and survival after liver transplantation?

  • Lucas Jose Caram;Francisco Calderon;Esteban Masino;Victoria Ardiles;Ezequiel Mauro;Leila Haddad;Juan Pekolj;Jimena Vicens;Adrian Gadano;Eduardo de Santibanes;Martin de Santibanes
    • 한국간담췌외과학회지
    • /
    • 제26권1호
    • /
    • pp.40-46
    • /
    • 2022
  • Backgrounds/Aims: The role of inflammation in malignant cell proliferation has been well described. High values of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation have shown associations with unfavorable long-term outcomes. The purpose of this study was to determine values of NLR and PLR evaluated prior to and after surgery and their associations with mortality and recurrence rates of liver transplant patients with hepatocellular carcinoma (HCC). Methods: A total of 105 patients with HCC who underwent orthotopic liver transplantation (OLT) were retrospectively reviewed. NLR and PLR values were obtained from complete blood counts prior to and after surgery. Overall survival (OS) and recurrence-free survival (RFS) in relation with delta NLR and PLR were estimated. Results: Serum alpha-fetoprotein levels > 100 ng/mL (p = 0.014) and lymphovascular emboli in the specimen (p = 0.048) were identified to be significant predictors of RFS. Child-Pugh score (p = 0.016) was found to be an independent factor associated with poorer OS. An increasing delta PLR was associated with worse RFS, although it showed no significant association with OS. Conclusions: The analysis of PLR as a continuous variable may predict recurrence outcomes in patients undergoing OLT for HCC. It is more representative than isolated values.

Cancer of the Nasal Fossae

  • 설대위;유병옥;박윤규
    • 대한두경부종양학회:학술대회논문집
    • /
    • 대한두경부종양학회 1985년도 제2차 학술대회 연제순서 및 초록집
    • /
    • pp.6.2-8
    • /
    • 1985
  • PDF

Os Submedialis Malleolare in Sports Players

  • Lee Kyung-Tai;Young Ki-Won;Kim J-Young
    • 대한정형외과스포츠의학회:학술대회논문집
    • /
    • 대한정형외과스포츠의학회 2004년도 The 7th korea-japan joint meeting of orthopaedic sports medicine
    • /
    • pp.60-60
    • /
    • 2004
  • PDF

The Management of Pancreatic Fistula Complicated by Gastric Fistulation Following Emergency Splenectomy

  • Huei, Tan Jih;Lip, Henry Tan Chor;Thou, Chow Sing;Mohamad, Yuzaidi;Alwi, Rizal Imran
    • Journal of Trauma and Injury
    • /
    • 제33권1호
    • /
    • pp.43-47
    • /
    • 2020
  • Pancreatic and gastric fistulas are rare complications of emergency splenectomy, and it is extremely rare for a pancreatic fistula to be further complicated by a fistulation into the stomach. Here, we present a case of pancreatogastric fistula in a 60-year-old man who experienced polytrauma due to a blunt mechanism. He underwent emergency splenectomy for splenic injury and developed a pancreatic fistula as a complication. A percutaneous endoscopic procedure was performed to drain the fistula, after which he developed a pancreatogastric fistula as a further complication. A double-pigtail stent was inserted via gastroscopy into the fistula tract to allow internal drainage of the pancreatic collection into the stomach cavity. When a pancreatic fistula is complicated by gastric fistulation, endoscopic stenting of the pancreatogastric fistula tract for internal drainage is an effective treatment option.

후방으로 전위된 소아 쇄골 원위부 골절의 수술적 치료 - 1예 보고 - (Operative Treatment of Posteriorly Displaced Fracture of the Distal Clavicle in Child - A Case Report -)

  • 박현수;정태원;라종득;장영수;이병훈
    • Clinics in Shoulder and Elbow
    • /
    • 제9권2호
    • /
    • pp.207-210
    • /
    • 2006
  • We presented a case of posteriorly displaced fracture of the distal clavicle in Child. The closed reduction was failed due to posteriorly displaced proximal fragment and interpositon of trapezius muscle and periosteum. We found that periosteal sleeve and coracoclaviclar ligament and acromioclavicular ligament was intact. The open reduction should be considered for the treatment of the irreducible posteriorly displaced fracture of the distal clavicle in child.

만성 재발성 비골건 탈구의 수술적 치료 -1례 보고- (Operative Treatment of Chronic Recurrent Dislocation of Peroneal Tendon -Report of one case-)

  • 최호림;유현종;임영택;이상선;전재균
    • 대한족부족관절학회지
    • /
    • 제3권1호
    • /
    • pp.62-65
    • /
    • 1999
  • Traumatic dislocation of the peroneal tendon is a rare injury. It should be distinguished from other conditions that can cause pain and disability of lateral aspect of the ankle joint. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by deepening of the peroneal groove of the lateral malleolus and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.

  • PDF

Current Progress in the Treatment of Metaplastic Breast Carcinoma

  • Hu, Qing;Chen, Wei-Xian;Zhong, Shan-Liang;Li, Jian;Luo, Zhou;Tang, Jin-Hai;Zhao, Jian-Hua
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제14권11호
    • /
    • pp.6221-6225
    • /
    • 2013
  • Metaplastic breast cancer (MBC) is a rare type of breast carcinoma, characterized by various combinations of mesenchymal, adenocarcinoma and other epithelial components. MBC often manifests as a large mass, with low axillary lymph node involvement and poor prognosis. Knowledge and treatment patterns about MBC demographics, presentation and tumor characteristics are very limited. In clinical practice, MBC is usually treated based on the guidelines developed for infiltrating ductal carcinoma (IDC). The ideal treatment paradigm for MBC is unknown due to its low incidence and pathological variability, so potential predictors of treatment efficacy need to be explored. This review summarizes the current models and strategies for MBC according to the published literature.

Kalix implant를 이용한 편평족의 치료 - 증례보고 - (Treatment of flat foot with Kalix implant - case report -)

  • 이경태;양기원;배상원;탁상보;이승환
    • 대한족부족관절학회지
    • /
    • 제6권2호
    • /
    • pp.238-241
    • /
    • 2002
  • There are two types of flat foot, the one is congenital type and the other is acquired type. The treatments of flat foot are various and conservative treatment is general, except such as congenital talus. But, operative method is needed for treatment of failure of conservative method, severe deformity in X-ray, with tenderness in a juvenile period. We reported using Kalix implant for flat foot with pain and severe deformity.

  • PDF