• 제목/요약/키워드: Partial resection

검색결과 280건 처리시간 0.029초

전측두엽 절제술시 해마체 절제 범위와 경련 예후 (The Seizure Outcome and Extent of Hippocampal Resection in Anterior Temporal Lobectomy)

  • 이완수;이정교;이상암;강중구;고태성
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1650-1656
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    • 2000
  • Objective : Little consensus exists concerning which temporal lobe structures need to be resected or how much resection should be done during hippocampal resection. The purpose of this study is to identify whether the extent of hippocampal resection influences seizure after anterior temporal lobectomy. Materials and Methods : The extent of hippocampal resection was assessed in 96 patients who underwent temporal lobectomy for medically intractable complex partial seizures originating from a unilateral seizure focus in the anteromesial temporal lobe. Patients who had structural lesion were excluded from the study. Postoperative magnetic resonance imaging in the coronal and saggital planes were used to quantify the extent of the hippocampal and lateral cortical resection. The patients were divided into two groups. Patients who underwent hippocampal resection to the level of the cerebral peduncle were included in the partial resection group, and those who had resection to the level of the colliculus were assigned to total resection group. Seizure outcomes were defined according to the Engel classification and compared between the two groups. Neuropsychologic outcomes in the selected cases were reviewed. Results : The over-all seizure-free outcome(Engel classification 1) was accomplished in 75%(72/96) of the patients (mean duration of follow-up, 36.8 months). The total hippocampectomy group had a statistically superior seizure outcome than the partial hippocampectomy group(87.3% versus 58.5% seizure-free, p-value=0.001). Also, younger patients had a more favorable outcome. Other variables such as laterality, the extent of lateral cortical resection, age at onset and gender were not significant. The pre- and postoperative memory functions were evaluated in 24 patients. A worse postoperative memory outcome was associated with partial hippocampectomy. However this was not acceptable due to a former bias. Conclusion : The result of this study conforms that aggressive hippocampectomy resulted in a better seizure outcome.

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암 침윤 기관협착에 대한 외과적 치료 (Surgical managements of tracheal cancer invasion)

  • 박재길;전해명;전진영
    • 대한기관식도과학회지
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    • 제8권1호
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    • pp.50-56
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    • 2002
  • Advanced or recurrent thyroid cancer, and metastatic paratracheal lymph nodes may directly invade the trachea and lead to tracheal stenosis. In these cases the stenosis is not circumferential and it would be possible to reconstruct the trachea after partial resection of the stenotic trachea. We experienced five cases of tracheal reconstruction after partial resection of the tracheal wall in four Patients of advanced thyroid cancer, and in one Patient of malignant paratracheal lymphadenopathy.

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Surgical Management of Complex Spinal Cord Lipomas : A New Perspective

  • Pang, Dachling
    • Journal of Korean Neurosurgical Society
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    • 제63권3호
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    • pp.279-313
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    • 2020
  • This review summarises the classification, anatomy and embryogenesis of complex spinal cord lipomas, and describes in some detail the new technique of total lipoma resection and radical reconstruction of the affected neural placode. Its specific mission is to tackle two main issues surrounding the management of complex dysraphic lipomas : whether total resection confers better long term benefits than partial resection, and whether total resection does better than conservative treatment, i.e., no surgery, for asymptomatic lipomas. Accordingly, the 24 years progression-free survival data of the author and colleagues' series of over 350 cases of total resection are compared with historical data from multiple series (including our own) of partial resection, and total resection data specifically for asymptomatic lesions are compared with the two known series of non-surgical treatment of equivalent patients. These comparisons amply support the author's recommendation of total resection for most complex lipomas, with or without symptoms. The notable exception is the asymptomatic chaotic lipoma, whose peculiar anatomical relationship with the neural tissue defies even our aggressive surgical approach, and consequently projects worse results (admittedly of small number of cases) than for the other two lipoma subtypes of dorsal and transitional lesions. Prophylactic resection of asymptomatic chaotic lipomas is therefore not currently endorsed.

취조직 재생능에 관한 실험 (Experimental Study of the Pancreatic Regeneration after Partial Pancreatectomy in Rat)

  • 이명선;이선영
    • 대한약리학회지
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    • 제14권1_2호
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    • pp.47-54
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    • 1978
  • Recently, a major resection of the pancreas has been carried out not only to treat carcinoma of pancreas but also chronic pancreatitis. But limited and often contradictory reports have been made on the exocrine effects after partial surgical pancreatectomy in mammals. It was suggested that the growth of the residual tissue in pancreatectomized rat is very active, because pancreas has the great power of regeneration after partial pancreatectomy, while others observed that rat pancreas after partial surgical resection revealed a perplexing mixture of atrophy and regeneration of acinar tissue. On the other hand, another results showed that the amount of insulin required to control diabetes after partial resection of pancreas is much greater than that needed after total pancreatectomy. Because the anti-insulin system, such as glucagon secretion and hypophyseoadrenal function, is probably depressed after total pancreatectomy. Furthermore, minimal resection line which will not influence the normal function of pancreas is not agreeable, such 75%, 80% or 95% resection of the total pancreas in rat. So far, studies on the exocrine function other than endocrine function after partial pancreatectomy have been limited. Therefore, the main purpose of this study is to examine the changes of exocrine as well as endocrine function of pancreas at the different time interval after 60% or 80% pancreatectomy in rats. The results summerized as follow: 1) In both 60% and 80% resected groups, a slight decrease of the total body weight was observed at a day after partial pancreatectomy in rats, but the body weight was continued to increase for following 100 days. 2) The weight of residual pancreas was continuously increased during experiment in both 60% and 80% resected groups. But the content of tissue protein in residual pancreas was significantly decreased comparing with those of resected pancreas. 3) The flow rate of pancreatico-biliary juice was significantly decreased immediately after pancreatectomy in both resected groups. But it was recovered to control level after a day in 60% resected group, after 30 days in 80% resected group. 4) The output of amylase and lipase in resected groups were significantly decreased right after pancreatectomy comparing with control group. In the 60% resected group, the output of amylase was recovered during the following 100 days after pancreatectomy, while lipase output in 3 days. However, in the 80% resected group, the output of amylase and lipase were not recovered during 100 days after pancreatectomy. 5) In order to examine the endocrine function, blood sugar level were examined at all experimental periods after partial pancreatectomy. There was no difference between control and 60% resected group in the sugar level. But in the 80% resected group the level was significantly incresed immediately after pancreatectomy, and reached the highest level at 3 days. Then it was decreased to control level during the next 10 days after pancreatectomy. The above results showed that in 60% resected group little changes were observed on pancreatic function, but severe functional impairments were observed in 80% resected group. This results suggested that the endocrine function was recovered within a short period, although the exocrine function was not recovered for a long time after 80% pancreatectomy in rats.

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Partial Breast Reconstruction Using Various Oncoplastic Techniques for Centrally Located Breast Cancer

  • Park, Hyo Chun;Kim, Hong Yeul;Kim, Min Chul;Lee, Jeong Woo;Chung, Ho Yun;Cho, Byung Chae;Park, Ho Yong;Yang, Jung Dug
    • Archives of Plastic Surgery
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    • 제41권5호
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    • pp.520-528
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    • 2014
  • Background As the breast cancer incidence has increased, breast-conserving surgery has replaced total mastectomy as the predominant procedure. However, centrally located breast cancers pose significant challenges to successful breast-conserving surgeries. Therefore, we performed partial mastectomy and oncoplastic procedures on centrally located breast cancer as a means of partial breast reconstruction. The authors examined and evaluated the functional and aesthetic usefulness of this reconstruction method. Methods From January 2007 to June 2011, 35 patients with centrally located breast cancers who underwent various oncoplastic procedures based on the breast size and resection volume. The oncoplastic procedures performed included volume displacement surgical techniques such as purse-string suture, linear suture, and reduction mammaplasty. Other oncoplastic procedures included volume replacement procedures with an adipofascial, thoracoepigastric, intercostal artery perforator, thoracodorsal artery perforator, or latissimus dorsi flap. Results Mean patient age was 49 years, and mean follow-up period was 11 months. In cases of small to moderate-sized breasts and resection volumes <50 g, volume displacement procedures were performed. In cases of resection volumes >50 g, volume replacement procedures were performed. In cases of larger breasts and smaller resection volumes, glandular reshaping was performed. Finally, in cases of larger breasts and larger resection volumes, reduction mammaplasty was performed. This reconstruction method also elicits a high patient satisfaction rate with no significant complications. Conclusions In centrally located breast cancer, oncoplastic surgery considering breast size and resection volume is safe and provides appropriate aesthetic outcomes. Therefore, our method is advisable for breast cancer patients who elect to conserve their breasts and retain a natural breast shape.

The postoperative trismus, nerve injury and secondary angle formation after partial masseter muscle resection combined with mandibular angle reduction: a case report

  • Kim, Jeong-Hwan;Lim, Seong-Un;Jin, Ki-Su;Lee, Ho;Han, Yoon-Sic
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권1호
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    • pp.46-48
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    • 2017
  • A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.

흉선종의 외과적 치료에 대한 연구 -18례 분석- (A Study on Surgical Treatment of Thymoma -Analysis of 18 Cases-)

  • 이형렬
    • Journal of Chest Surgery
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    • 제27권4호
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    • pp.303-309
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    • 1994
  • Eighteen patients with thymoma have undergone surgical treatment at Pusan National university Hospital from 1983 to 1993. The mean age of the patients was 47.3$\pm$13.3 years old and male to female ratio was 1.6 : 1. Eleven of the patients[61.1%] with thymoma had myasthenia gravis; 12 cases[66.7%] were encapsulated and 6[33.3%] invasive. Operation was complete resection in 14[77.8%] of the patients, partial resection with residual tumor in 3[16.7%], and simple biopsy in one[5.5%]. Adjuvant radiotherapy was administered in 5 of 6 invasive thymoma. Postoperatively one patient died for excessive bleeding and sepsis. A tumor relapse was observed in one patient who had invasive thymoma and underwent partial resection followed by postoperative radiotherapy. The overall 5-year survival rate was 88.2$\pm$ 7. 9%.The presence of myasthenia gravis is not considered as an adverse factor for survival but it contributes to early discovery of associated thymoma.

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기관지내 발생한 과오종 -1례 보고- (Endobronchial Hamartoma -One Case Report-)

  • 이원진
    • Journal of Chest Surgery
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    • 제28권12호
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    • pp.1178-1182
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    • 1995
  • We experienced one case of endobronchial hamartoma on left lower lobar bronchus in sixty year old male patient. Less than 1 % of lung tumors are benign, and the prevalence of endobronchial hamartoma is reported to be from 3 % to 40 %. The mean age was 52.9 years, and equal gender prevalence.Symptoms were related to intraluminal growth, including fever, chill, productive cough, hemoptysis, exertional dyspnea, recurrent pneumonia and so on. Bronchoscopic finding was tumor present as polypoid mass in the lumen of a left main stem bronchus,distal to 3 cm from carina. Biopsy was done. The histopathologic pattern showed several nodules of loose myxoid tissue and islands of cartilage. We performed partial resection of the affected bronchus,1cm anterior to the superior segmental bronchial opening to just distal from superior segmental orifice. Including superior segmentectomy, partial resection of the left lower lobar bronchial resection and end-to-end anastomosis with 4-0 Poly dioxanone sutere materials interruptedly. We report this case with the brief review of literatures.

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연속적 재발성 미성숙 기형종의 외과적 치료 (Surgical Experience of Recurrent Immature Teratoma - Report of a case -)

  • 홍민수
    • Journal of Chest Surgery
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    • 제24권8호
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    • pp.792-796
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    • 1991
  • Immature teratoma can be viewed as intermediate between mature teratoma and embryonal carcinoma. Unlike the mature teratoma, elements of the three perm cell layers are incompletely differentiated and not arranged in organoid fashion In some area, more mature forms of these tissues may also be seen, Although this tumor is clearly malignant, they may not display clear-cut cytologic features of malignancy. The clinical prognosis is poor. We have experienced one case of recurrent immature teratoma. In first operation[1987, April], tumor of anterior mediastinum was removed with wedge resection of ant. segment of RUL % med. segment of RML. In 2nd operation[1990, June], recurrent teratoma of right inner thoracic wall was resected with partial 5th rib resection and wedge resection of lat. segment of middle lobe. Two months later, the 3rd operation[1990, September] was done, which was a removal of mass on thoracic wall near sup, segment of RLL and partial rib resection of 3rd, 4th & 5th. In November 1990, last operation[4th operation] was made. It was enucleation of walnut sized tumor located between medial segment of RML, and 4th. intercostal space, well encapsulated with endothoracic fascia and invaded into lung parenchyme, Adjuvant chemotherapy was done after each operation, but radiotherapy[5000 Rad] was done only after 1st operation. There was no evidence of recurrence after last operation. The patient is well-being still now.

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