• Journal of Korean Neurosurgical Society
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• 제41권6호
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• pp.382-386
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• 2007

Objective : Various techniques of cervical laminoplasty have been developed to decompress the spinal canal in patients with multilevel cervical spondylotic myelopathy. This study compared the early surgical outcomes between unilateral open-door laminoplasty and midline splitting cervical laminoplasty. Materials and Methods : From March 2004 to August 2005, we performed cervical laminoplasty in 34 patients with cervical myelopathy. Of these patients, 24 were treated by unilateral open-door laminoplasty [open-door group] and 10 by midline splitting cervical laminoplasty [splitting group]. The mean duration of follow up was 9.2 months in the open-door group and 15.8 months in the splitting group. We retrospectively analyzed neurological outcomes using the Japanese Orthopedic Association [JOA] score, and compared the radiological changes between the two groups. Results : Postoperative JOA score and recovery rate were $13.29{\pm}4.01$ and $56.28{\pm}44.91%$ in the open-door group and $15.75{\pm}0.88$ and $72.69{\pm}19.99%$ in the splitting group. There was no statistical difference between the two groups [p>0.05]. Regarding the radiological assessment, the increase of postoperative axial canal area was $63.23{\pm}23.24%$ in the open-door group and $42.30{\pm}14.96%$ in the splitting group [p<0,05]. Conclusion : There was no statistical difference in the neurological outcome when the early surgical outcomes of the open-door group and the splitting group were compared. However, the open-door group showed wider cervical spinal canal areas than the splitting group.

• 대한정형외과스포츠의학회:학술대회논문집
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• 대한정형외과스포츠의학회 2004년도 The 7th korea-japan joint meeting of orthopaedic sports medicine
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• pp.64-64
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• 2004

• Journal of Chest Surgery
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• 제24권11호
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• pp.1068-1073
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• 1991

Bleeding after open heart surgery with cardiopulmonary bypass was a cause of concern. requiring reexploration of the chest in approximately 8 percent of patients who have had operations on the heart. From April., 1983 to October, 1991, 16 patients[2%] out of 777 patients who underwent open cardiac surgery had emergency reexploration with bleeding at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. In 12 cases[75%], reexploration was performed for continuous bleeding and the reminder[4 cases] were performed for suspected tamponade & hypotension. There were 9 cases[56%] of congenital heart disease and 7 cases of acquired heart disease. The mean blood loss were 997$\pm$472ml /sq. M in total cases and 1442$\pm$ 647ml /sq. M in cases repair of cyanotic heart disease. The mean interval till reoperation was 16.6hr [1hr~72hr] and 41 hr[12~72hr] in tamponade cases and 8.4hr[1hr~24hr] in continuous bleeding cases. The bleeding sites were identified in 7 cases: aortotomy site in 2 cases, ventriculotomy site, SVC, thymus, pleura and sternum wiring site in each other case. But no specific sites was found in the remaining 9 cases. The 8 cases had complications but all except 1 cases with hypoxic brain damage were recovered without sequale. We conclude that emergency thoractomy after open heart surgery may be lifesaving and-/or diminishing complications with bleeding if performed promptly with excessive bleeding, tamponade and unexpected hypotension.

• Journal of Chest Surgery
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• 제17권4호
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• pp.804-810
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• 1984

Two hundred twenty one cases of open heart surgery were done in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital from July, 1981 to October, 1984. 1.There were 154 cases [73%] of congenital anomalies and 57 cases [27%] of acquired valvular heart diseases. Among the congenital cases, 128 cases were acyanotic and 26 cases were cyanotic. Among the 57 cases of acquired valvular replacement surgery, 3 cases had open heart commissurotomy, one had Kay annuloplasty. 2.The age distribution of the congenital acyanotic anomalies ranged from 5 to 32 years with mean age of 12.8 years, the congenital cyanotic anomalies from 3 to 29 years with mean age of 14.2 years and the acquired valvular diseases from 9 to 51 years with mean age of 30 years. The difference of sex distribution was no significance. 3.Three methods for debubbling process were used in our institute, in 133 cases, the vent was inserted into the left ventricular apex, in 61 cases inserted into the left atrium through right superior pulmonary vein and in 17 cases used needle aspiration only. 4.For cardioplegia, the GIK solution was infused repeatedly from 30 to 40 minutes interval and brought excellent results for myocardial protection during open heart surgery. 5.Overall mortality was 7.6%. The mortality along with each disease is 1.56% in congenital acyanotic cases, 26.9% in congenital cyanotic cases and 12.3% in acquired valvular disease.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.375-378
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• 2018

In this report, we present a case of successful treatment of a bowel fistula in the open abdomen by perforator flaps and an aponeurosis plug. A 70-year-old man underwent total gastrectomy and developed anastomotic leakage and dehiscence of the abdominal wound a week later. He was dependent upon extracorporeal membrane oxygenation, continuous hemodiafiltration, and a respirator. Bowel fluids contaminated the open abdomen. Two months after the gastric operation, a plastic surgery team, in consultation with general surgeons, performed perforator flaps on both sides and constructed, as it were, a bridge of skin sealing the orifice of the fistula. The aponeurosis of the external oblique muscle was elevated with the flap to be used as a plug. The perforators of the flaps were identified on preoperative and intraoperative ultrasonography. This modality allowed us to locate the perforators precisely and to evaluate the perforators by assessing their diameters and performing a waveform analysis. The contamination decreased dramatically afterwards. The bare areas were gradually covered by skin grafts. The fistula was closed completely 18 days after the perforator flap. An ultrasound-guided perforator flap with an aponeurosis plug can be an option for patients suffering from an open abdomen with a bowel fistula.

• Clinics in Shoulder and Elbow
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• 제9권1호
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• pp.20-26
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• 2006

Purpose: To evaluate the usefulness and functional results of open repair of massive rotator cuff tears combined with or without the tenoplasty of biceps long head. Materials and Methods: From March 2003 to August 2004, we evaluated 18 cases of the patient treated with open repair of massive rotator cuff tears. The mean age was 56 years and mean follow-up period was 15 months. We performed open repair of massive rotator cuff tears by tendon to bone repair, but in irrepairable 4 cases for tendon to bone repair performed open repair combined with tenoplasty of biceps long head. The functional results were assessed using the Constant score, the parameters of which were pain, dialy activity, mobility, strength and satisfaction. Results: The functional results were excellent in 4 cases, good in 8 cases, fair in 3 cases and poor in 3 cases. And the results of open repair combined with tenoplasty of biceps long head were good in 2 cases and fair in 2 cases. Re-repair was done in 1 case for re-rupture. And the functional result of this case was fair. The 3 poor cases were suspected re-rupture, the factor of which old age and weakened rotator cuff. It was impossible to do re-repair. Conclusion: The open repair combined with or without tenoplasty of biceps long head is a useful and effective method for massive rotator cuff tear.

• 대한족부족관절학회지
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• 제25권3호
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• pp.133-140
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• 2021

Purpose: This paper reports the surgical treatment results of open calcaneal fractures performed at the author's clinics focusing on open calcaneal fractures to help understand the appropriate treatment and realistic outcomes. Materials and Methods: This study was conducted on 22 cases out of 30 patients who visited the hospital from February 2009 to December 2019 and were followed up for more than one year. In open fractures, the fracture was classified using the Gustilo-Anderson classification and was evaluated using the soft tissue status at the time of visit. Intra-articular calcaneal fractures were classified using Sanders classification. The radiological parameters were measured for the Böhler angle, Gissane angle, calcaneal length, height, and width before and after surgery, and at the last follow-up. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and investigated complications. In addition, statistical analysis of the incidence and associated factors of posttraumatic arthritis was conducted. Results: In all cases, the surgical treatment was performed by minimally invasive surgery. The AOFAS ankle-hindfoot scale conducted for a clinical evaluation of the final follow-up was averaged 72.5 points. In the classification of open fractures, the Gustilo-Anderson classification type IIIA was the most common, and the Sanders type III was the most common. Of the 22 cases after surgery, 15 cases had complications, 11 cases had posttraumatic arthritis, eight cases had an infection, and 4 cases had both complications. Only the Sanders classification showed a statistically significant correlation with the incidence of posttraumatic osteoarthritis (p-value 0.032). Conclusion: In treating open calcaneal fractures, internal fixation by a minimally invasive approach showed relatively satisfactory results. However, follow-up research will be needed, including the results of a long-term follow-up through a large number of cases and comparative studies with other surgical methods.

• Advances in pediatric surgery
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• 제17권2호
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• pp.139-144
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• 2011

Hypertrophic pyloric stenosis (HPS) is the most common infantile surgical condition and the standard treatment is open pyloromyotomy. Recently, laparoscopic techniques have rapidly advanced, and the laparoscopic approach has become widely adopted by pediatric surgeons. The aim of this study was to compare the clinical outcomes between open and laparoscopic pyloromyotomy. We retrospectively evaluated outcomes of pyloromyotomy for HPS by the open (OP) and the laparoscopic (LP) method. The procedures were performed at the Samsung Medical Center between September 2001 and March 2009. We analyzed patient age, sex, birth weight, length of hospital stay, postoperative length of stay (LOS), operating time, time to feeding commencement, postoperative vomiting frequency, the time to full feeding without vomiting, and surgical complications. A total of 54 patients were included in the study. There were 26 OP and 28 LP patients. There was no statistically significant difference in age, sex, birth weight, operating time, postoperative emesis. In contrast, postoperative LOS in the LP group was statistically significantly shorter than that in the OP group (2.0 vs. 3.3 days, p=0.0003) and time to full feeding was significantly shorter following LP. (p=0.018) There were no wound complications. Laparoscopic pyloromyotomy significantly reduced postoperative LOS and time to full feeding compared to open pyloromyotomy.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.51-57
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• 2013

Purpose: Additional gastrectomy is needed after endoscopic resection for early gastric cancer when pathology confirms any possibility of lymph node metastasis or margin involvement. No studies depicted the optimal type of surgery to apply in these patients. We compared the short-term and long-term outcomes of laparoscopic gastrectomy with those of open gastrectomy after endoscopic resection to identify the optimal type of surgery. Materials and Methods: From 2003 to 2010, 110 consecutive patients who underwent gastrectomy with lymphadenectomy either by laparoscopic (n=74) or by open (n=36) for gastric cancer after endoscopic resection were retrospectively analyzed. Postoperative and oncological outcomes were compared according to types of surgical approach. Results: Clinicopathological characteristics were comparable between the two groups. Laparoscopic group showed significantly shorter time to gas passing and soft diet and hospital day than open group while operation time and rate of postoperative complications were comparable between the two groups. All specimens had negative margins regardless of types of approach. Mean number of retrieved lymph nodes did not differ significantly between the two groups. During the median follow-up of 47 months, there were no statistical differences in recurrence rate (1.4% for laparoscopic and 5.6% for open, P=0.25) and in overall (P=0.22) and disease-free survival (P=0.19) between the two groups. Type of approach was not an independent risk factor for recurrence and survival. Conclusions: Laparoscopic gastrectomy after endoscopic resection showed comparable oncologic outcomes to open approach while maintaining benefits of minimally invasive surgery. Thus, laparoscopic gastrectomy can be a treatment of choice for patients previously treated by endoscopic resection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권5호
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• pp.422-426
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• 2005

Purpose : The purpose of this study was to investigate the vertical stability after BSSRO surgery in skeletal class III malocclusion patients with mild anterior open bite and to present a method to increase the stability. Materials and methods : 36 patients, 11 male and 25 female, who received BSSRO surgery with the diagnosis of skeletal class III with anterior open bite at the Department of Oral and Maxillofacial Surgery in Samsung Medical Center, from January 2002 to August 2003, were selected for this study. The patients were between 18 to 45 years of age. Preoperative and postoperative (immediate, 6 months, and 1 year after operation) lateral cephalograms were compared to evaluate the vertical stability by measuring the distance of nasion-menton, mandibular plane angle, and overbite. Results : The nasion-menton distance decreased by 1.65mm immediately after the operation in comparison to the preoperative value. This distance further decreased by 0.60 mm at 6 months and 1.06mm at 1 year after the operation. The mandibular plane angle increased after the operation and further increased at 6 months and 1 year. The amount of overbite increased by the operation was 2.34mm and an additional increase of 0.70mm at 6 months and 0.94mm at 1 year were shown. Conclusion : Clinically, none of the patients showed relapse of anterior open bite and the vertical stability is highly influenced by orthodontic treatment after the operation. In this study, BSSRO surgery is considered to be a rather reliable procedure that restores stability to skeletal class III malocclusion patients with slight anterior open bite.