• Title/Summary/Keyword: Operative findings

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Implications of abnormal abdominal wall computed tomographic angiography findings on postmastectomy free flap breast reconstruction

  • Ngaage, Ledibabari Mildred;Hamed, Raed R.;Oni, Georgette;Ghorra, Dina T.;Ang, Jolenda Z.;Koo, Brendan C.;Benyon, Sarah L.;Irwin, Michael S.;Malata, Charles M.
    • Archives of Plastic Surgery
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    • v.47 no.2
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    • pp.146-152
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    • 2020
  • Background Preoperative computed tomography angiography (CTA) of the abdominal wall vessels is used when planning free flap breast reconstruction (FFBR) because it provides a surgical road map which facilitates flap harvest. However, there are few reports on the effect of abnormal findings on the operative plan. Methods We conducted a retrospective study of all FFBRs performed at a tertiary referral center over a 6-year period (November 2011 to June 2017). One consultant radiologist reported on the findings. Details on patient demographics, CTA reports, and intraoperative details were collected. Results Two hundred patients received preoperative CTAs. Fourteen percent of patients (n=28) had abnormal findings. Of these findings, 18% were vascular anomalies; 36% tumorrelated and 46% were "miscellaneous." In four patients, findings subsequently prevented surgery; they comprised a mesenteric artery aneurysm, absent deep inferior epigastric (DIE) vessels, bilateral occluded DIE arteries, and significant bone metastases. Another patient had no suitable vessels for a free flap and the surgical plan converted to a pedicled transverse rectus abdominis musculocutaneous flap. The remaining incidental findings had no impact on the surgical plan or appropriateness of FFBR. More than one in 10 of those with abnormal findings went on to have further imaging before their operation. Conclusions CTA in FFBR can have a wider impact than facilitating surgical planning and reducing operative times. Incidental findings can influence the surgical plan, and in some instances, avoid doomed-to-fail and unsafe surgery. It is therefore important that these scans are reported by an experienced radiologist.

Observation between Clinical Outcomes and the Size of the Syrinx with Magnetic Resonance Image

  • Hwang, Ju-Yeon;Kim, Young-Jin;Oh, Seong-Hoon;Kang, Jae-Kyu;Kim, Young-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.169-174
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    • 2006
  • Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.

Tuberculous chest wall abscess (결핵성 흉벽농양)

  • Jo, Gyu-Seok;U, Se-Yeong
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.140-143
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    • 1984
  • We have experienced 30 patients of tuberculous chest wall abscess which was surgically treated at Kyung Hee University hospital during 6 years from Jan, 1978 to Dec, 1983. We analyze 30 cases of clinical findings and surgically treated, and 20 cases of chest X-rays are available. The results of this sturdy are as follows: 1.Sex ratio ; Male: Female = 1:1.72. 2.Chief complaints are fluctuated mass with or without tenderness or pain and pus from wound. 3.Out of 20 cases of chest x-rays revealed 8 cases of osteolytic lesion, 11 cases of soft tissue swelling, 5 cases of pleural changes and 4 cases of negative findings. 4.We resected partially 43 ribs of 30 patients [average: 1.43 resected] in tuberculous chest wall abscess. 5.Operative methods of tuberculous chest wall abscess were partial resection of destructed or denuded periosteum of ribs and curettage of its surrounding tissues in operative field.

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Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy

  • Chang, Chih-Chun;Sun, Jen-Tang;Chen, Jing-Yuan;Chen, Yi-Ting;Li, Pei-Yu;Lee, Tai-Chen;Su, Ming-Jang;Wu, Jiann-Ming;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1427-1431
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    • 2016
  • Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.

Residual Pain after Operative Treatment for Chronic Ankle Instability (만성 발목 불안정증 수술 후의 지속적인 발목 통증)

  • Cho, Byung-Ki;Ahn, Byung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.32-37
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    • 2021
  • Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

Therapeutic Effects of Low-Level Laser Combined with LED on Post-operative Hand

  • Jeong-Sun Lee;Hwa-Kyung Shin
    • The Journal of Korean Physical Therapy
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    • v.36 no.1
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    • pp.14-20
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    • 2024
  • Purpose: This study was performed to identify and investigate the therapeutic effects of low-level laser (LLL) combined with a light-emitting diode (LED) on post-operative wound healing and functional recovery after hand orthopedic surgery. Methods: The study subjects were twenty patients who had passed the acute inflammatory phase after hand orthopedic surgery and were assigned equally to an experimental or a control group. Phototherapy was administered three times weekly for two weeks. Changes in wound length, edema, pain, and hand function were measured. Results: Significant differences in wound length, edema, pain, and hand function were observed between the experimental and control groups (p<0.05). However, no significant intergroup difference was observed (p>0.05). Nonetheless, a comparison of results showed changes in the experiment group over the two-week study period were significantly greater than in the control group (p<0.05). Conclusion: These findings show that combined LLL plus LED phototherapy positively influences post-operative hand rehabilitation.

Evaluation of Computer-Assisted Quantitative Volumetric Analysis for Pre-Operative Resectability Assessment of Huge Hepatocellular Carcinoma

  • Tang, Jian-Hua;Yan, Fu-Hua;Zhou, Mei-Ling;Xu, Peng-Ju;Zhou, Jian;Fan, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3045-3050
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    • 2013
  • Purpose: Hepatic resection is arguably the preferred treatment for huge hepatocellular carcinoma (H-HCC). Estimating the remnant liver volume is therefore essential. This study aimed to evaluate the feasibility of using computer-assisted volumetric analysis for this purpose. Methods: The study involved 40 patients with H-HCC. Laboratory examinations were conducted, and a contrast CT-scan revealed that 30 cases out of the participating 40 had single-lesion tumors. The remaining 10 had less than three satellite tumors. With the consensus of the team, two physicians conducted computer-assisted 3D segmentation of the liver, tumor, and vessels in each case. Volume was automatically computed from each segmented/labeled anatomical field. To estimate the resection volume, virtual lobectomy was applied to the main tumor. A margin greater than 1 cm was applied to the satellite tumors. Resectability was predicted by computing a ratio of functional liver resection (R) as (Vresected-Vtumor)/(Vtotal-Vtumor) x 100%, applying a threshold of 50% and 60% for cirrhotic and non-cirrhotic cases, respectively. This estimation was then compared with surgical findings. Results: Out of the 22 patients who had undergone hepatectomies, only one had an R that exceeded the threshold. Among the remaining 18 patients with non-resectable H-HCC, 12 had Rs that exceeded the specified ratio and the remaining 6 had Rs that were < 50%. Four of the patients who had Rs less than 50% underwent incomplete surgery due to operative findings of more extensive satellite tumors, vascular invasion, or metastasis. The other two cases did not undergo surgery because of the high risk involved in removing the tumor. Overall, the ratio of functional liver resection for estimating resectability correlated well with the other surgical findings. Conclusion: Efficient pre-operative resectability assessment of H-HCC using computer-assisted volumetric analysis is feasible.

Are Magnetic Resonance Imaging Findings of Ankle Instability Always Correlated with Operative and Physical Examination Findings? (외측 인대 손상의 자기공명영상 소견들이 수술 소견 및 신체검사와 항상 일치할까?)

  • Park, Hyun-woo
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.1-5
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    • 2021
  • Physical examination and surgical findings and symptoms are often inconsistent with magnetic resonance imaging (MRI) findings when diagnosing chronic ankle lateral ligament instability, and confirmed surgical findings are used as the gold standard in most clinical studies. Anterior drawer testing is considered unreliable because normal findings are highly variable, and its accuracy ranges from 50% to 100%. Furthermore, radiographic stress imaging, such as in anterior drawer stress view, is performed under manual stress or using a stress device, and its findings also vary widely and confuse when interpreting stress views. The average accuracy of MRI findings is around 85% (range, 66%~91.7%), and thus, cannot be used as a primary indicator for surgery. For patients with suspected lateral ankle ligament instability, based on symptoms and physical examination findings, MRI may be useful for identifying lesions in ankle joints and for differentiating them from other conditions.

The Effects of Pre-operational Education on Nursing Care Satisfaction and Anxiety;A Comparison between Traditional Face-to-face Education and Mobile Text Messages (정보제공 방법에 따른 암수술환자 가족의 간호요구 만족도와 불안)

  • Lim, Jung-Soon;Chung, Bok-Yae
    • Asian Oncology Nursing
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    • v.7 no.2
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    • pp.162-168
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    • 2007
  • Purpose: This study was aimed to compare two different kinds of pre-operational education methods on nursing care satisfaction and anxiety among family members of cancer patients. Methods: This research used a quasi-experimental design. A total of 80 patients participated in the study. Forty subjects who were in the experimental group were assigned to be received mobile text-information via cellular phone, whereas control group was given the direct messages from nurses during peri-operative time. Peri-operative family needs and anxiety were measured and analyzed by X2-test and t-test. Result: There was no statistically significant difference in the levels of peri-operative family needs satisfaction and the levels of state anxiety between the two groups (p= .05). Conclusion: Based upon these findings, the nursing intervention with cellular phone short message could be as effective as direct peri-operative information in reducing the level of state anxiety and in increasing of the level of nursing care satisfaction among the family members of cancer patients.

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