• 제목/요약/키워드: Postoperative treatment

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만성교약성 심낭염의 외과적 요법 -35예 보고- (The Surgical Treatment of Chronic Constrictive Pericarditis -A Report of 35 Cases-)

  • 김주현
    • Journal of Chest Surgery
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    • 제7권2호
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    • pp.179-188
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    • 1974
  • An analysis of &5 cases of constrictive pericarditis treated surgically in this department of Seoul National University Hospital between the years 1958 and 1974 has been presented. 1.Of the patients with constrictive pericarditis,29 were males and 6 were females. Their ages averaged 23.8 years. 2. All patients who had pericardiectomy showed excellent postoperative results, and no operative mortality was noted in this group of patients but 3 hospital death [9.1%] occurred. 3. Besides shortening of circulation time elevated venous pressure was restored to normal range after pericardiectomy from a preoperative average 25.8cm $H_2O$ to a postoperative average 14.8cm $H_2O$. 4. Electrocardiographic changes consisted chiefly of low voltage complexes, P-wave and T-wave changes and characterized by vertical or semivertical heart position. The ECG was returned to normal or near normal after Pericardiectomy. 5. There were seven postoperative complications in this series. 6. In ten cases [32.3%], the pathology revealed evidence of tuberculosis in the pericardium or the myocardium, and others were described as chronic, proliferative, fibrous pericarditis or hyalinization of the pericardium.

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이강우심실의 외과적 치험6례 보고 (Surgical experience of Double Chambered Right Ventricle. - 6 Cases -)

  • 강경훈
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.765-772
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    • 1987
  • Double-chambered right ventricle [DCRV] as a clinical and anatomic entity was separated from other forms of right ventricle obstruction, and frequently associated with VSD. We experienced surgical treatment of 6 cases of DCRV with VSD. Among them, PDA in a case, PFO in two cases and one case of mild infundibular PS were associated. Preoperative cardiac catheterizations and RV cineangiograms showed about 69 mmHg. of pressure gradient in average between RV inflow and outflow portion, and filling defect by anomalous muscle bundles in the sinus portion of RV. On operation, VSD and other associated anomaly were corrected after resection of anomalous muscle bundle for relief of the obstruction through the vertical RV-tomy site. Postoperative EKG showed complete RBBB, but hemodynamic problems were not developed. Postoperative cardiac catheterizations showed markedly decreased pressure gradient between two chambers, that was about 15 mmHg. in average. Postoperative course was smooth and discharged without any problems.

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심실중격결손증을 동반한 폐동맥 폐쇄증 [Pulmonary Atresia] 의 외과적 치료-2예 보고- (Surgical Treatment of Pulmonary Atresia with VSD - A Report of 2 Cases -)

  • 강면식
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.780-785
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    • 1987
  • Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

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Common risk factors for postoperative pain following the extraction of wisdom teeth

  • Rakhshan, Vahid
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권2호
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    • pp.59-65
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    • 2015
  • The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies.

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

  • 최은진;이섭
    • Clinical and Experimental Pediatrics
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    • 제50권3호
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    • pp.298-301
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    • 2007
  • 선천성 심장병의 수술후 발생되는 유미흉은 드문 합병증이다. 이는 수분, 전해질 및 영양의 불균형을 초래할 뿐만 아니라 감염에 취약함을 보이기도 한다. 지금까지의 보존요법에 대해 비교적 치료성적이 좋으나 치료에 반응하지 않는 경우에는 수술적 중재가 불가피하다. 저자들은 보존요법과 octreotide 주입을 병행하여 수술적 중재를 피하고 효과적으로 치료한 수술후 발생된 유미흉 2례를 보고하는 바이다.

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

  • 최승훈
    • Advances in pediatric surgery
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    • 제8권1호
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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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만성 족관절 외측 불안정성에 대한 $Brostr{\ddot{o}}m$ 변형 술식 (The Modified $Brostr{\ddot{o}}m$ Procedure for Chronic Lateral Ankle Instability)

  • 송하헌;심대무;이병창;김동철;조용우;양정환
    • 대한족부족관절학회지
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    • 제8권1호
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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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상안검 피지선암의 수술후 방사선 치료 1례 (Postoperative Radiotherapy for Sebaceous Carcinoma of the Upper Eyelid)

  • 정수미;최병옥;최일봉;신경섭;변준희
    • 대한두경부종양학회지
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    • 제11권1호
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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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    • 제18권2호
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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.

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

  • 오원용;김귀언;서창옥;노준규;홍원표;김광문;이원상
    • 대한두경부종양학회지
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    • 제3권1호
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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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