• Journal of Chest Surgery
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• 제28권3호
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• pp.274-279
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• 1995

To evaluate clinical pattern and operative outcome of atherosclerotic obstructive disease in the lower extremity, surgical experience in 25 patients between September 1987 and June 1994 was analyzed. There were 24 male patients and 1 female patient. The age of the patients ranged between 36 and 77 years[mean:60.9 years . Disabing intermittent claudication, rest pain, or ischemic gangrene[or ulceration was the operative indication. The patients were classified into three groups according to the level of obstruction: Aortoiliac level[11 cases/44% , femoropopliteal level[6 cases/24% , and whole level[8 cases/32% . Anatomic bypass with prosthetic graft was performed in all cases: aortobifemoral or aortofemoral bypass in 15 procedures, iliofemoral bypass in 5 procedures, femoropopliteal bypass in 13 procedures. The perioperative mortality rate was 12%. Two patients received postoperative major amputation. Twenty two patients were followed-up for 1 to 70 months[mean: 21 months . Late graft obstruction occurred in two patients. The cumulative patency rate at 3 years was 69.5%. The cumulative limb salvage rate at 3 years was 92.0%.

• Journal of Chest Surgery
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• 제28권3호
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• pp.253-257
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• 1995

Forty-eight patients with significant left main coronary artery obstruction underwent coronary artery bypass graft between September,1989 and September,1993. They consisted of 29 males and 19 females with the mean age of 58 [range 33 - 78 . Seventeen patients[35% had stenosis in left main coronary artery only and twenty-nine[61% had associated lesions in other coronary artery systems as well.Two[4% had isolated left coronary ostial lesion. The operative mortality was 4.17% [2/48 which is comparable to the mortality of overall coronary artery bypass surgery cases during the same period[p >0.05 . Perioperative myocardial infarction was occurred in two patients[4.17% . And the infarction rates between the two groups also showed no difference[p >0.05 . The forty-six survivors showed significant improvement in exercise tolerance as well as symptomatology. We conclude that surgery for left main coronary artery disease can be done with no increased risk through careful anesthesia,surgery, and aggressive postoperative care in the critical period.

• Journal of Chest Surgery
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• 제18권2호
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• pp.193-204
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• 1985

During the period from February to March, 1984, we employed a partial left heart bypass [left atrium to ascending aorta] in 2 patients who could not weaned from cardiopulmonary bypass with inotropic agents and cardiac pacing after coronary bypass surgery. These two patients showed significant improvement in ventricular function 18 to 47 hours after inserting the left heart bypass and were able to wean from the left heart bypass under using inotropic agents. Two patients died of multiple organ failures 11 days and 15 days postoperatively. These results indicate that early institution of left heart bypass in ventricular failure patients after open heart surgery can provide satisfactory long-term result.

• Journal of Chest Surgery
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• 제18권3호
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• pp.398-406
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• 1985

103 cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital in 1984. There were 90 congenital cardiac anomaly and 13 acquired heart diseases. Out of 90 congenital cardiac anomaly, 63 cases of acyanotic group and 27 cases of cyanotic group were noted. In 63 cases of acyanotic group, 11 ASD, 45 VSD and 7 other acyanotic anomaly were included. In 27 cases of cyanotic group, 4 Trilogy of Fallot, 15 TOF, 3 Pentalogy of Gasul and 5 other cyanotic anomaly were found. Among 13 cases of acquired heart diseases, 12 valvular lesions and 1 atrial myxoma were noted. Two open mitral commissurotomy and ten valve replacements were performed for 12 valve lesions. The frequent complications were acute respiratory insufficiency and low cardiac output syndrome occurred in 5 cases. The perioperative mortality was 4.8% in acyanotic congenital cardiac anomaly, 7.4% in cyanotic congenital cardiac anomaly, and 0% in acquired heart diseases. Overall mortality for 103 cases of open heart surgery was 4.9%.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1107-1112
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• 2000

Recently various operative procedures including microsurgery or endovascular surgery have been increasing for the management of ischemic cerebrovascular diseases. Carotid endarterectomy(CEA), extracranial-intracranial(EC-IC) arterial bypass, embolectomy, decompressive craniectomy, arterial transposition, intravascular thrombolysis, and percutaneous transarterial angioplasty and stenting (PTAS) are available surgical modalities for ischemic stroke. This article focuses the complications and perioperative management of patients treated with CEA and carotid PTAS among various surgical managements for ischemic stroke.

• Journal of Chest Surgery
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• 제17권3호
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• pp.389-397
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• 1984

Sixty cases of open heart surgery were performed in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital from July, 1983 to June, 1984. The patients were consisted of 40 [66%] congenital anomalies containing 26 [43%] patients of acyanotic group and 4 [23%] of cyanotic group, and 20 [34%] acquired heart diseases which involved one or more cardiac valves. The male patients were 42 and the female 18. In 20 valvular heart diseases, open mitral commissurotomy was done in 5 patients, mitral valvular replacement with tissue valve in 6, mitral valvular replacement with mechanical valve in 5, mitral valvular replacement with tricuspid annuloplasty in 2, mitral annuloplasty in 1, and mitral and aortic valvular replacements with mechanical valves in 1. The most frequency complication was low cardiac output syndrome occurred in 9, and the next was urethral stenosis, ARDS, and postoperative bleeding, etc. The perioperative mortality was 21% in congenital cyanotic heart disease, 12% in congenital acyanotic heart disease, and 5% in acquired heart disease.

• 대한관절경학회지
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• 제14권1호
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• pp.29-32
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• 2010

비만환자에서 유용한 수술적 술기와 증가된 술전 및 술후 위험성에 대한 보고들은 있으나, 비만이 관절경적 시술에 미치는 영향에 대한 보고는 거의 없는 실정이다. 저자들은 체중 120kg의 17세 남자환자에서 반월상연골 부분절제술을 시행한 후, 현재까지 출간된 문헌들을 고찰하고 비만환자들에서 슬관절 관절경술 시행시 발생할 수 있는 합병증과 수술적 술기에 대한 정보를 제공하고자 한다.

• 대한기관식도과학회지
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• 제17권2호
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• pp.89-91
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• 2011

Robotic surgery have been increasingly applied in the past several years to assist in a variety of operations. Some applications, such as in prostatectomy, have been widely adopted and have largely supplanted the alternative minimally invasive or open techniques. However, the use of surgical robots in esophagectomy has not been as common. Although a limited number of case reports demonstrated the feasibility of robotic esophagectomy, no large series of patients has been reported to date. The data on robotic-assisted esophagectomy suggest that the procedure is safe, feasible, and associated with perioperative outcomes similar to open and minimally invasive esophagectomy. Benefits of robotic system could be maximized when we do a extensive total mediastinal lymphadenectomy. For this procedure to gain widespread acceptance, identifiable benefit relative should be demonstrated in near future.

• 대한위암학회:학술대회논문집
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• 대한위암학회 2002년도 제13회 춘계학술대회
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• pp.37-46
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• 2002

전통적으로 수술 전 평가는 수술 전날 밤에 시행되는 것이 일반적이었다. 그러나 외래수술을 받는 환자의 증가로 인하여 많은 환자들이 수술 당일 아침에 마취과 의사를 처음 만나게 되는 경우가 많고 심지어는 심각한 내과적 문제를 가진 환자들도 충분한 수술 전 평가가 이루어지지 않은 상태에서 수술실로 들어오게 되는 경우가 있다. 그러나 이러한 상황에서도 마취과의사는 주술기(perioperative period)의 환자 상태를 관리하는 주된 역할자로서 수술 전 환자에 대한 평가를 충실히 해야 한다. 수술 전 평가는 환자의 현재 상태를 평가하는 것이고, 수술 중 발생할 수도 있는 상황에 대비하며, 수술실을 넘어서 중환자실, 통증치료실에서의 마취의사의 역할로 이어지도록 하는 것이다. 최근 발전하고 있는 수술 전 평가 클리닉은 환자의 수술준비의 기초적인 정보를 제공한다. 이는 마취의사에게는 상당한 장점과 편리성을 제공하는 것이고, 환자 관리의 질적 향상과 급변하는 병원관리정책의 요구에 부합하는 것이다.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.73-78
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• 2013

Surgery is still considered to be the mainstay for the treatment of localized gastric cancer with negative margins (R0-resection) and an adequate lymph-node-dissection (D2-lymphadenectomy). Unfortunately, most cases of gastric cancer are only diagnosed at an advanced stage due to frequent recurrences after primary resection in curative intent. In order to improve prognosis after curative resection, in the recent past, patients with locally advanced tumors were subjected to a pre-, peri-, or postoperative treatment. Interestingly, postoperative chemotherapy has significantly improved survival after gastric resection in Asia, adjuvant radiochemotherapy is favored in North America and perioperative chemotherapy is considered as a treatment of choice in Europe indicating region specific approach towards the treatment. Recently there has also been growing evidence of positive outcomes of neoadjuvant radiochemotherapy on patient survival. In the present article, we discuss the concepts of neoadjuvant treatment approach and provide recommendations to surgeons based on current evidence.