• Title/Summary/Keyword: Omentopexy

Search Result 11, Processing Time 0.036 seconds

Surgical Treatment of Bronchobiliary Fistula with Pulmonary Resection and Omentopexy

  • Joh, Hyon Keun;Park, Seong Yong
    • Journal of Chest Surgery
    • /
    • v.53 no.1
    • /
    • pp.38-40
    • /
    • 2020
  • Bronchobiliary fistula is a rare disease defined as an abnormal connection between the biliary tract and the bronchial tree. We report the successful surgical repair of bronchobiliary fistula. A 78-year-old man underwent surgery and several rounds of transcatheter arterial chemoembolization and radiofrequency ablation as treatment for hepatocellular carcinoma. He presented with greenish sputum and chronic cough for several months, and his symptoms did not resolve after endoscopic treatment. We performed lobectomy of the right lower lobe and omentopexy for bronchobiliary fistula under laparotomy and thoracotomy. The bronchobiliary fistula was successfully closed, and the bilious sputum disappeared after surgery.

Laparoscopic Primary Repair with Omentopexy for Duodenal Ulcer Perforation: A Single Institution Experience of 21 Cases

  • Ma, Chung Hyeun;Kim, Min Gyu
    • Journal of Gastric Cancer
    • /
    • v.12 no.4
    • /
    • pp.237-242
    • /
    • 2012
  • Purpose: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. Materials and Methods: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. Results: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. Conclusions: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.

Operation of Abomasal Displacement and Foreign Body Removal in the Rumen through the Right Flank Celiotomy (우측 겸부를 통한 제4위전위증 교정 수술과 제1위 절개 수술의 병행)

  • Cho, Jin-Haeng;Kim, Myung-Cheol;Jeong, Seong-Mok;Lee, Jae-Yeon;Shin, Beom-Jun
    • Journal of Veterinary Clinics
    • /
    • v.30 no.1
    • /
    • pp.80-85
    • /
    • 2013
  • Twenty one cows in Goyang and Paju cities were referred due to displacement of the abomasum and foreign body in the rumen. Omentopexy and rumenotomy through a right flank celiotomy were performed for treatment of abomasal displacement and the foreign body removal in the rumen. The right paralumbar fossa is clipped and prepared surgically. Local anesthesia is instituted by performing inverted L block. The abdomen was entered through 25 to 30 cm vertical incision in the right paralumbar fossa starting 4 to 5 cm ventral to the transverse processes of the lumbar vertebrae. A 14-gauge needle with rubber tubing attached is inserted to relieve the gaseous pressure and to facilitate further exploration and manipulation. The rumen was gently pulled out of the abdominal cavity and incision was made at the omentum. Rumenotomy was done and retrieved the foreign body. After the rumen was rinsed with sterile saline, the rumen wall was closed by a Lembert suture technique. The omentum was closed by a simple continuous suture. Right flank omentopexy was performed for the surgical correction of abomasal displacement. Recovery results among 21 cows included 9 excellent, 5 good, 2 fair and 5 bad. It was considered that operation of abomasal displacement and foreign body removal in the rumen through right flank celiotomy was a good surgical technique to reduce expenses, surgical pain, and surgery time.

Surgical Results for Treating Postpneumonectomy Empyema with BPF by Using an Omental Pedicled Flap and Thoracoplasty (전폐절제술 후 기관지 흉막루를 동반한 농흉에서 유경성 대망 이식편과 흉곽성형술을 이용한 수술적 치료에 대한 임상 고찰)

  • Jeong, Seong-Cheol;Kim, Mi-Jung;Song, Chang-Min;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
    • /
    • v.40 no.6 s.275
    • /
    • pp.420-427
    • /
    • 2007
  • Background: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy. Material and Mehod: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: $45.9{\pm}9$ years). The patients were followed up for a mean of 58 months (median: 28 months, range: $6{\sim}169$). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema, Result: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8). Conclusion: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to 75-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.

Management of Post-Pneumonectomy Empyema (전폐절제술후 생긴 농흉의 치료)

  • Song, Jong-Phil;Chung, Sung-Hyock;Hur, Yong;Kim, Byung-Yul;Lee, Jeong-Ho;Ahn, Wook-Su
    • Journal of Chest Surgery
    • /
    • v.32 no.3
    • /
    • pp.276-280
    • /
    • 1999
  • Background: Post-pneumonectomy empyema(PPE) is an uncommon but a serious complication. The management remains as challenge for general thoracic surgeons. Material and Method: During the period of January 1990 to December 1996, we evaluated the results of 20 patients with post-pneumonectomy empyema. Result: Sex ratio were 15 male and 5 female patients with mean age of 41.5${\pm}$21.5 yrs. The occurrence ratio of left to right side was 8:12. The most common disease for prior pneumonectomy was pulmonary tuberculosis. The duration between pneumonectomy and PPE was variable in 1 month to 6yrs. Fever was the most frequent symptom and S. aureus was the most frequent pathogen. In 13 cases, there were combined with BPF. Four patients underwent trans-sternal closure, and Clagett procedure was performed. There was one recurrence that later underwent muscle plombage and omentopexy later. Nine patients underwent omentopexy, muscle plombage and thoracoplasty. There were 7 cases that were not combined with BPF. All 7 patients underwent thoracoplasty, and two of them were combined with muscle plombage. Mean follow-up duration is 40${\pm}$32.3 months. There were no late deaths nor recurrences of PPE. Conclusion: We conclude that early diagnosis and proper drainage in PPE patients are important in its initial stage of management, and also management is completely achieved in thoracoplasty with muscle plombage or omentopexy.

  • PDF

Effects of the b-FGF to Early Revascularization and Epithelial Regeneration in the Rabbit's Tracheal Autograft (염기 섬유아세포 성장인자가 토끼기관의 자가이식편의 초기 혈관재형성 및 상피세포 재생에 미치는 영향)

  • 성숙환;원태희
    • Journal of Chest Surgery
    • /
    • v.30 no.6
    • /
    • pp.559-565
    • /
    • 1997
  • Donor airway ischemia is a significant problem after tracheal replacement with homograft or lung transplantation, Several factors such as omentopexy, heparin, PGl2 and fibroblast growth factor, have been shown to induce angiogenesis in vitro and in vivo. This study was designed to investigate whether omentopexy and basic flbroblast growth factor can enhance rabbit tracheal revascularization and epithelial regeneration, Three different experiments were performed with New Zealand white rabbit. In group I(n= 15 control group), only coNical tracheal autotransplantation was done. In group II(n= 15), cervical tracheal autotransplantation with omentopexy was done through subcutaneous route. In group III(n= 15), cervical tracheal autotransplantation was done and lug basic flbroblast growth factor was applied. After 3, 7 and 14 days, the animals were sacrificed. The extent of revascularization was investigated by means of uptake of the human serum albumin labelled with 99m technetium, and epithelial regeneration were assessed by means of light microscope. In the group investigated at day 3, there was statistically significant high tracheal revascularization in group III(p<0.05), but no difference at 7 and 14 days. And epithelial regenerations at day 3 were better in group III(p<0.05), and at day 7 in group II and III. But there was no difference at day 14. We concluded that b-FGF can enhance the revascularization and epithelial regeneration of the tracheal autograft especially in early phase.

  • PDF

Bronchoaortic Fistula (기관지 대동맥루)

  • 정일영
    • Journal of Chest Surgery
    • /
    • v.25 no.10
    • /
    • pp.1137-1140
    • /
    • 1992
  • Bronchoartic Fistula Secondary to Pulmoanry Tuberculosis Bronch-aortic fistula is a exceptionally rare complication of pulmonary tuberculosis. We report herein, a case of 39 years woman who underwent successful repair of aor-tobronchofistula. She was admitted because of massive hemoptysis via emergency room, she had several bouts of massive hemoptysis prior to hospitalization. Thoracic-aortic pseudoaneurysm had detected by chest CT by chance. The eroded, perforated descending aorta was repaired with patch aortoplasty during temporarily clamping, followed by Left lower lobectomy and omentopexy. Pathological examination revealed pulmonary tuberculosis of superiror seg. of lerg lower lobe and aortitis. The patient had uneventful recovery was well at OPD follow-up check.

  • PDF

Observational Study on the Recurrences of Left Abomasal Displaement after, Surgical Correction (유우의 제4위 좌측전위증의 수술적인 교정방법에 따른 재발)

  • Kim Doo
    • Journal of Veterinary Clinics
    • /
    • v.5 no.2
    • /
    • pp.95-99
    • /
    • 1988
  • An observational study on the recurrences of left abomasal displacement after surgical correction was conducted in 178 Holstein cows. The correction methods were right flank omentopexy (A), right ventral paramedian abomasopexy (B) and left flank abomasopexy (C). Four(5.4) out of 74 cows by method A, 2(2.0) out of 101 cows by method B and 1(33.3%) out of 3 cows by method C had the recurrence of the disease after the first operation. As for the method A, 3 cows and a cow recurred 13-18 months and 27 months after the first operation, respectively. As for the method B, recurrence of the disease in two cows occurred 14 and 19 days after surgery, respectively. In a cow which had been indicated by method C, the recurrence was recurred 14 months after the operation.

  • PDF

Surgical Treatment of T4 Lung Cancer with the Use of Extracorporeal Circulation -A case report of long-term survival - (체외순환을 이용한 T4 폐암의 수술적 치험 -장기 생존 1예 보고-)

  • 조규도;조민섭;윤정섭;김치경;곽문섭
    • Journal of Chest Surgery
    • /
    • v.37 no.2
    • /
    • pp.180-183
    • /
    • 2004
  • We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1MO). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.