• Title/Summary/Keyword: Postoperative treatment

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Conservative Management and Postoperative Rehabilitation of Chronic Lateral Ankle Instability (만성 외측 족관절 불안정성의 보존적 치료와 수술적 치료 후의 재활운동)

  • Park, Young Hwan;Kim, Hak Jun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.6-11
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    • 2019
  • As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

Subaxillary Minithoracotomy for Treatment of Primary Spontaneous Pneumothorax (액와부 소절개를 통한 원발성 자연기흉의 치료)

  • 정성규
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1020-1024
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    • 1992
  • Thirty-four patients underwent 39 subaxillary minithoracotomies for the treatment of primary spontaneous pneumothorax from June 1987 to April 1992. The age of patients ranged from 17 to 32 years. The ratio of male to female was 8.8: 1 with male predominance. The associated pulmonary lesions and pleural adhesion were not seen on the chest X-rays in all cases. Average operative time was 83 minutes[30~130 min]. Postoperative average duration of air leakage was 2.4 days, the chest tube indwelling was 5.1 days, and postoperative hospital stay was 8 days, Analgegics were not given for pain control postoperatively In conclusion, the subaxillary minithoracotomy has the following advantages: reducing the operative time, postoperative pain, morbidity, hospital stay, shoulder problems, and excellent cosmetic result.

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Recent Advances in Sentinel Node Navigation Surgery for Early Gastric Cancer

  • Eisuke Booka;Hiroya Takeuchi
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.159-170
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    • 2023
  • Maintaining the postoperative quality of life (QOL) while ensuring curability without overtreatment is important in the treatment of early gastric cancer. Postoperative QOL is anticipated to be maintained through minimally invasive function-preserving gastrectomy in early gastric cancer. The concept of the sentinel lymph node (SN) basin is essential to maintain the curability of early gastric cancer using minimally invasive function-preserving gastrectomy. However, additional resection after surgery is difficult to perform in gastric cancer. Thus, the SN basin theory is important. Recently, a multicenter randomized phase III trial in South Korea (SENORITA trial) proved that laparoscopic sentinel node navigation surgery (LSNNS) for stomach preservation results in better postoperative QOL compared with standard gastrectomy in patients with early gastric cancer. LSNNS contributes to patients' QOL based on the concept that curability is not impaired. A multicenter nonrandomized phase III trial is ongoing in Japan, and oncologic safety is expected to be demonstrated. LSNNS has been established as a treatment option for selected patients with early gastric cancer, and its application will become widespread in the future.

Surgical Treatment of Tracheal Stenosis - Report of 2 Cases - (기관협착증의 외과적 치료;2례 보고)

  • 우석정
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1061-1065
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    • 1992
  • There are more patients with tracheal stenosis lately due to the increased use of tracheostomy and assisted ventilation. Recently we have experienced two cases of post tracheostomy tracheal stenosis and successfully performed circumferential resection and end-to-end anastomosis of the trachea. Postoperative tracheostomy was not performed. The postoperative courses were uneventful and they are now conducting an usual life.

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Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

  • Tae-Yeong Kim;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.339-346
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    • 2022
  • Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

Postoperative Traditional Korean Medicine Treatment - A Study on the Perception of Gynecological Surgery Patients on Traditional Korean Medicine Treatment in One University Hospital (한 대학병원 산부인과 수술 환자의 수술 후 한방 치료에 대한 인식 조사)

  • Lee, Ji-Yung;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.2
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    • pp.151-162
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    • 2009
  • Purpose: The purpose of this study is to analyze the perception that gynecological surgery patients have on Traditional Korean Medicine(TKM) treatment. Methods: We studied the perception of TKM treatment by questionnaire from August, 2008 to Febrary, 2009 in Kyung-Hee University East-West Neo medical center. A questionnaire was given to 180 women and 150 women answered. Results: Out of 150 women, 93 women(62%) had been given TKM treatment during the last 3 years, while 57 women(32%) hadn't. 53 women(35.5%) had taken herbal medicine within the last 2 weeks, while 97 women(64.7%) hadn't. 71 women(47.3%) reported that they had been given TKM treatment related to the causative disease for the operation, while 22 women(14.7%) hadn't. And 97 women(64.7%) indicated that they were willing to use TKM as a part of their postoperative medical care, 53 women(35.3%) indicated that they weren't. Conclusion: Many patients are willing to take TKM treatment as postoperative care. We need more accumulation of data for demonstrating the efficacy and safety of TKM treatment.

EFFECT OF THIRD MOLAR ON POSTOPERATIVE INFECTION AFTER REDUCTION OF THE MANDIBULAR ANGLE FRACTURE (하악 제3대구치가 하악 우각부골절 정복술후 감염에 미치는 영향에 관한 연구)

  • Choi, Moon-Gi;Min, Seung-Ki;Lee, Dong-Keun;Oh, Seung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.217-225
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    • 2001
  • Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

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Retrospective analysis of intensity-modulated radiotherapy and three-dimensional conformal radiotherapy of postoperative treatment for biliary tract cancer

  • Lee, Hyo Chun;Lee, Jong Hoon;Lee, Sea-Won;Lee, Joo Hwan;Yu, Mina;Jang, Hong Seok;Kim, Sung Hwan
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.279-285
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    • 2019
  • Purpose: This study was conducted to compare the outcome of three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for the postoperative treatment of biliary tract cancer. Materials and Methods: From February 2008 to June 2016, 57 patients of biliary tract cancer treated with curative surgery followed by postoperative 3D-CRT (n = 27) or IMRT (n = 30) were retrospectively enrolled. Results: Median follow-up time was 23.6 months (range, 5.2 to 97.6 months) for all patients and 38.4 months (range, 27.0 to 89.2 months) for survivors. Two-year recurrence-free survival is higher in IMRT arm than 3D-CRT arm with a marginal significance (25.9% vs. 47.4%; p = 0.088). Locoregional recurrence-free survival (64.3% vs. 81.7%; p = 0.122) and distant metastasis-free survival (40.3% vs. 55.8%; p = 0.234) at two years did not show any statistical difference between two radiation modalities. In the multivariate analysis, extrahepatic cholangiocarcinoma, poorly-differentiated histologic grade, and higher stage were significant poor prognostic factors for survival. Severe treatment-related toxicity was not significantly different between two arms. Conclusions: IMRT showed comparable results with 3D-CRT in terms of recurrence, and survival, and radiotherapy toxicity for the postoperative treatment of biliary tract cancer.

Arthroscopic Treatment of Post-traumatic Stiff Shoulder by Rotator Interval Bridging Scar Adhesion - Case Report - (회전근 개 간격의 가교 반흔 유착에 의한 외상성 견관절 강직증의 관절경적 치료 - 증례 보고 -)

  • Kim Young-Mo;Rhee Kwang-Jin;Kim Kyung-Cheon;Byun Byung-Nam
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.41-45
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    • 2004
  • In adhesive capsulitis of the shoulder of no response to nonoperative treatment, an arthroscopic capsular release and manipulation improves range of motion and pain relief. We performed an arthroscopic examination in the stiff shoulder, of which she had no response to nonoperative treatment, after the conservative treatment of a clavicular shaft fracture by motorcycle-driver traffic accident. We found the intra-articular 'rotator interval bridging scar adhesion' between subscapularis tendon and antero-superior glenoid fossa under the rotator interval which was no adhesion and contracture itself. We performed the scar adhesion removal and synovectomy, maintaining the rotator interval. We recommended nonsteroidal anti-inflammatory drug for postoperative pain relief and continuous active and passive range of motion (ROM) exercise to gain motions. Preoperatively, active and passive range of motion were 70° for forward elevation, 60° for abduction and especially 0° for external rotation. After postoperative 2 months, active ROM were 150° for forward elevation, 130° for abduction and 80° for external rotation. After postoperative 6 months, passive and active ROM were full. UCLA score improved from preoperative 9 points to postoperative 29 points.

Efficacy of corticosteroids for postoperative endodontic pain: A systematic review and meta-analysis

  • Nath, Ranjivendra;Daneshmand, Ali;Sizemore, Dan;Guo, Jing;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.205-221
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    • 2018
  • This systematic review aimed to analyze the efficacy of corticosteroid premedication compared to placebo or no treatment to reduce postoperative pain in endodontic patients. Randomized controlled trials (RCTs) assessing corticosteroids via oral, intramuscular, subperiosteal, intraligamentary or intracanal route compared to passive or active placebo, or no treatment were included. Four databases were searched: PubMed, Web of Science, Cochrane Library and Embase up to 2/21/2018. Risk of bias was assessed with Cochrane Risk of bias tool. Fourteen RCTs with 1,462 generally healthy adults in need of endodontic treatment were included. 50% of the studies were at unclear risk and 50% at high risk of bias. Meta-analysis showed Visual Analog Scale (VAS) pain at 4-6 hours after Inferior Alveolar Nerve Block (IANB) was significantly lower by 21 points (0-100 scale) in the corticosteroid group compared to the control group (95% CI -35 to -7; P = 0.003), however this difference was not statistically significant after 24 hours (P = 0.116). The route of administration was oral and intraligament injection. Patients who received corticosteroids prior to IANB were 70.7% more likely to have none or mild pain 4-8 hours after treatment (P = 0.001) and 13.5% more likely 24 hours after IANB (P = 0.013) than patients in the control group. In conclusion, corticosteroid administration (oral or intraligamental) may clinically reduce the level of postoperative pain at 4-8 hours after IANB, however the quality of the evidence was low/moderate due to risk of bias and heterogeneity. Further studies are recommended.