• Title/Summary/Keyword: Postoperative treatment

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Two cases of postoperative chylothorax treated with parenteral octreotide and conservative therapy (보존요법과 함께 octreotide 주입을 이용한 수술후 유미흉 치험 2례)

  • Choi, Eun Jin;Lee, Sub
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.298-301
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    • 2007
  • Chylothorax is a rare complication following cardiac surgery for congenital heart diseases. Although conservative management is successful in the majority of cases, surgical intervention is required in a refractory one. Recently, subcutaneous or intravenous infusion of octreotide has been used as a safe treatment that helps avoiding surgical intervention. Herein, we report two cases of postoperative chylothorax treated with parenteral octreotide and conservative therapy.

Postoperative Problems of Hirshsprung's Disease and It's Management (Hirschsprung's Diease: 수술 후 치료와 문제점)

  • Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.8 no.1
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    • pp.64-67
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    • 2002
  • Since Swenson and Bill established the treatment principles of Hirshsprung's disease in 1948, there have been significant advances in the management of this disease. During the last decade, one-stage correction of Hirshsprung's disease without colostomy and primary laparoscopic pull-through procedure became popular with recent advances in the technology and refinement of the equipments. But the outcomes for Hirshsprung's disease are not always successful, and long-term follow-up isessential. Most children after corrective surgery show significant improvement in respect to fecal continence and constipation, that may not be apparent until late adolescence. The purpose of this study was to review the postoperative problems of Hirschsprung's disease and it's management.

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The Modified $Brostr{\ddot{o}}m$ Procedure for Chronic Lateral Ankle Instability (만성 족관절 외측 불안정성에 대한 $Brostr{\ddot{o}}m$ 변형 술식)

  • Song, Ha-Heon;Shim, Dae-Moo;Lee, Byoung-Chang;Kim, Dong-Churl;Cho, Yong-Woo;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.81-85
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    • 2004
  • Purpose: The purpose of this study is to evaluate the surgical results of modified $Brostr{\ddot{o}}m$ procedure for chronic lateral ankle instability and to assess whether or not associated injuries may affect postoperative satisfaction. Materials and Methods: Twenty- four patients with chronic lateral ankle instability were evaluated retrospectively from August 1998 to March 2002. Average age was 29.3 years. All patients were performed pre & postoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device, MRI and intraoperative arthroscopic evaluations before ligament reconstruction. Results: Of the 24 cases, 23 cases was improved more than average 12 points on AOFAS scales. On modified scales of Hamilton, 3 excellent, 20 good, 1 fair results. On stress view, average 2.2 mm difference was improved on anterior drawer test and average 1.7 degree on varus test. Associated injuries were 8 osteochondral defects, 4 anterior impingements, 2 loose bodies, 2 os subfibulare, 2 os submalleolare and 2 partial ruptures of peroneus brevis. 8 cases with no associated injuries rated excellent or good. Conclusion: The modified $Brostr{\ddot{o}}m$ procedure is believed to be an effective and successful method for chronic lateral ankle instability that didn't respond to conservative treatment. Because associated injuries in chronic lateral ankle instability may affect postoperative satisfaction, appropriate detection and treatment may need for postoperative satisfaction.

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Postoperative Radiotherapy for Sebaceous Carcinoma of the Upper Eyelid (상안검 피지선암의 수술후 방사선 치료 1례)

  • Chung Su-Mi;Choi Byung-Ock;Choi Ihl-Bohing;Shin Kyung-Sub;Byoun Jun-Hee
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.36-40
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    • 1995
  • Sebaceous carcinomas of the eyelids are uncommon but lethal tumors. Lesions are usually seen in the elderly, predominantly women. The meibomian glands of the tarsus are the most frequent site of origin. Less commonly, the tumor arises in other sebaceous glands, e.g., the gland of Zeis, eyebrow or caruncle. Regardless of the location, sebaceous malignancies must be considered aggressive neoplasms with a potential for regional and distant metastasis. Diagnosis may be difficult, given the low incidence and inconsistencies in histopathologic classification. Treatment requires wide surgical excision with removal of involved regional lymph nodes and exenteration is reserved for those patients with orbital involvement or diffuse intraepithelial neoplasia. Opinions are divided regarding the use of postoperative irradiation or chemotherapy. Recently we experienced 46-year-old male patient with a 12-month history of painless, firm nodule and conjunctivitis due to sebaceous carcinoma of the left upper eyelid. After surgery, serial sections of the entire conjunctiva and eyelids showed a positive cut margin in medial and lateral border. We report herein this patient that supports irradiation as the postoperative treatment of these tumors in selected patients with a review of literatures.

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Long-Term Nutritional Outcomes of Near-Total Gastrectomy in Gastric Cancer Treatment: a Comparison with Total Gastrectomy Using Propensity Score Matching Analysis

  • Seo, Ho Seok;Jung, Yoon Ju;Kim, Ji Hyun;Park, Cho Hyun;Kim, In Ho;Lee, Han Hong
    • Journal of Gastric Cancer
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    • v.18 no.2
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    • pp.189-199
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    • 2018
  • Purpose: This study sought to examine whether near total gastrectomy (nTG) confers a longterm nutritional benefit when compared with total gastrectomy (TG) for the treatment of gastric cancer. Materials and Methods: Patients who underwent nTG or TG for gastric cancer were included (n=570). Using the 1:2 matched propensity score, 25 patients from the nTG group and 50 patients from the TG group were compared retrospectively for oncologic outcomes, including long-term survival and nutritional status. Results: The length of the proximal resection margin, number of retrieved lymph nodes and tumor nodes, metastasis stage, short-term postoperative outcomes, and long-term survival were not significantly different between the groups. The body mass index values, and serum total protein and hemoglobin levels of the patients decreased significantly until postoperative 6 months, and then recovered slightly over time (P<0.05); however, there was no difference in the levels between the groups. The prognostic nutritional index values and serum albumin levels decreased significantly until postoperative 6 months and then recovered (P<0.05); the levels decreased more in the nTG group than in the TG group (P<0.05). The mean corpuscular volumes and serum transferrin levels increased significantly until postoperative 1 year and then recovered slightly over time (P<0.05); however, there was no difference between the groups. Serum vitamin $B_{12}$, iron, and ferritin levels of the patients did not change significantly over time, and no difference existed between the groups. Conclusions: A small remnant stomach after nTG conferred no significant nutritional benefits over TG.

Radiation Treatment and Survival of Maxillary Sinus Carcinoma (상악동암의 방사선치료와 생존율)

  • Oh W.Y.;Kim G.E.;Suh C.O.;Loh J.K.;Hong W.P.;Kim K.M.;Lee W.S.
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.25-35
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    • 1987
  • Irradiated 88 patients of Maxillary Sinus Carcinoma at Yonsei Cancer Center for 10years between 1971 and 1980 were retrospectively analysed. The majority of patients had very advanced disease(87.5% of $T_3\;and\;T_4$) and 17% of cervical lymph node involvement. 80.6% of all patients were epidermoid type. In 44 cases(50%), irradiation alone was performed. 28 cases(32%) of postoperative radiation after incomplete surgery and the remaining 16 cases(18%) of postoperative radiation after radical surgery were done. The majority of patients except 6 cases had irradiation a dose between 60Gy and 80Gy in 30-40 fractions over 6-8 weeks. The actuarial overall 3 and 5 year survival rate were 362% and 26%, respectively. The actuarial 5 year survival rate for 44 cases of radiation alone group was 14.1%, The actuarial 5 year survival rate for 28 cases of incomplete surgery and postoperative radiation group and 16 cases of radical surgery and postoperative radiation group were 312% and 67.4% respectively. In the actuarial 5 year survival rate according to the stage, stage II, III and IV were 79.5%, 20.9% and 0%. In recent, for the improvement of survival rate of advanced Maxillary Sinus Carcinoma at Yonsei Cancer Center, combined multidisplinary or trimodal treatment modality have been applied and in near time the more excellent results expect to be analyse.

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Comparative Study Between Inaba's Procedure and Modified Inaba's Procedure with Delayed Suture in the Treatment of Osmidrosis Axillae (액취증의 치료에서 Inaba씨 방법과 절개창을 지연 봉합한 Inaba씨 변법의 비교 조사)

  • Lee, Seong Pyo;Suhk, Jeong Hoon;Yang, Wan Suk
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.727-734
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    • 2009
  • Purpose: The Inaba's procedure, the treatment of osmidrosis axillae, has the advantages of low recurrent rate and easy to learn, yet it produces early postoperative discomfort and scar formation by tie - over dressing. The authors modified the Inaba's procedure by using delayed suture of the incision wound and omitting tie - over dressing. The comparative study of Inaba's procedure and its modification was performed to confirm the advantages of modified procedure. Methods: The study contains the retrospective analysis of the medical records of 296 patients with osmidrosis who were treated using the Inaba's procedure from December, 1996 to February, 2007. The study also contains the prospective analysis of 20 patients, from March, 2007 to July, 2008, who were treated by the modified Inaba's procedure with delayed suture of the incision wound and gentle pressure dressing instead of tie - over dressing. The operative results of two groups were compared and verified by Mann - Whitney U test(SPSS 12.0). Results: The incidence of complications was 14.5% in the Inaba's procedure, whereas 6.2% in the modified Inaba's procedure. Both procedures have the same basic surgical procedure in terms of the location of incision site and subdermal shaving of the sweat glands, and therefore similar good results were obtained in the aspect of postoperative axillary odor, recurrent rate and postoperative condition of axillary hair. Certainly, the modified Inaba's procedure had better outcome in each element of PSS(Patient Scar Self-Rating Scale), compared to the Inaba's procedure. In addition, the modified Inaba's procedure showed a statistical significance in dressing - related pain reduction and overall satisfaction. Conclusion: The modified Inaba's procedure had advantages of decreased early postoperative complications such as hematoma, discomfort and pain caused by tie - over dressing, and decreased scar formation. However, the drawback was delayed suture of the incision wound after 48 hours.

Long Term Clinical and Radiological Follow-up Study in Spondylolisthesis, Grade I : Decompression with or without Instrument (GradeⅠ요추부 척추 전방 전위증의 치료 : 감압성 후궁절제술과 고정기구 삽입술의 비교)

  • Chung, Seung Young;Kim, Gook Ki;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.235-241
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    • 2001
  • Objective : Controversy exists which surgical treatment better in lumbar grade I spondylolisthesis, decompressive laminectomy with or without lumbar instrumentation. Methods : Out of Sixty-four patients with lumbar spondylolisthesis underwent surgery, 18 patients operated with decompressive laminectomy alone and 44 patients with decompession and lumbar instrument, during recent 5-years between January, 1994 and December, 1998. The author studied a long term follow-up in the above two groups to analyzing the overall clinical outcomes in each group and to determining the incidence of pos-toperative radiologic instability. Results : 1) Overall postoperative symptoms improvement were not so different in both groups. 2) Postoperative progressive subluxation is more common after decompressive laminectomy without instrumentation than with instrumentation group. 3) Overall clinical outcomes were slightly better in decompressive laminectomy without instrumentation than with instrumentation group but there was no significant difference. 4) Postoperative radiologic changes did not seem to influence the patient-reported clinical outcomes. 5) Postoperative complications is more common in decompressive laminectomy with instrumentation group than without instrumentation group. Conclusion : In the surgical management of grade I spondylolisthesis, the efficiency and superiority of surgical treatments requires the cost effectiveness and risk/benefit analysis of decompressive laminectomy with or without instrumentation. Therefore, Further detailed studies of long term follow up in a large number of patients in each group are needed for choice of best treatment.

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Surgical approach for venous malformation in the head and neck

  • Ryu, Jeong Yeop;Eo, Pil Seon;Lee, Joon Seok;Lee, Jeong Woo;Lee, Seok Jong;Lee, Jong Min;Lee, Sang Yub;Huh, Seung;Kim, Ji Yoon;Chung, Ho Yun
    • Archives of Craniofacial Surgery
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    • v.20 no.5
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    • pp.304-309
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    • 2019
  • Background: Treatment for venous malformations of the head and neck includes sclerotherapy, surgical resection, or a combination of both. Surgical resection can remove or reduce the volume of vascular lesions; however, surgery can cause postoperative scarring and potential surgical complications. This study sought to determine the effectiveness of surgery for the treatment of venous malformations of the head and neck. Methods: A retrospective review of the medical records of patients who received surgeries for venous malformations of the head and neck from January 2011 to July 2019 was performed. Using clinical photographs, preoperative and postoperative Doppler ultrasonography, outpatient clinic records, and operation records, the postoperative result and complications were evaluated for each case. Results: Among patients who visited our vascular anomalies clinic, 43 patients (ratio of male to female= 24:19) received surgeries for venous malformations of the head and neck. Twenty-nine patients had undergone surgery only, five patients received sclerotherapy after surgery, and nine patients received surgery after preoperative sclerotherapy. In postoperative evaluations, the result was excellent in 24 patients, good in 18 patients, and poor in one patient. Four patients experienced a recurrence of lesions with lagophthalmos, drooping of the corner of the mouth, partial wound necrosis, and scar widening found in one patient each. Conclusion: Because the head and neck region is the most exposed area in the body, more active implementation of surgical treatments with or without sclerotherapy is essential to reduce the functional and cosmetic impairments associated with venous malformations.

The Usefulness of Postoperative Direct Voice Therapy in Vocal Polyps (성대폴립 환자에서 수술 후 음성치료의 유효성)

  • Oh, Dong Ju;Kim, So Yeon;Choi, In Hak;Han, Hye Min;Byeon, Hyung Kwon;Jung, Kwang Yoon;Baek, Seung Kuk
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.686-691
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    • 2018
  • Background and Objectives Previous studies have suggested the usefulness and importance of postoperative voice therapy, for which there are indirect and direct methods. The aim of this study was to evaluate the efficacy of treatment according to different voice therapy methods. Subjects and Method Patients with vocal polyp were divided into three groups. Group 1 received direct voice therapy after phonomicrosurgery and Group 2 indirect voice therapy after phonomicrosurgery. Group 3 did not receive any voice therapy. Results Perceptual, acoustic, aerodynamic voice outcome parameters differed significantly between pre and post-operative treatments. In almost all of the voice analysis, Group 1, who underwent direct voice therapy, improved more significantly compared with Group 2 and 3. Conclusion Postoperative voice therapy following phonomicrosurgery may be an effective adjuvant treatment in patients with vocal polyps. In particular, direct voice therapy can be effective for improving postoperative voice outcome.