• Title/Summary/Keyword: Postoperative treatment

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No-fat diet for treatment of donor site chyle leakage in vascularized supraclavicular lymph node transfer

  • Seong, Ik Hyun;Park, Jin-Woo;Woo, Kyong-Je
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.376-379
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    • 2020
  • Supraclavicular lymph node (SCLN) flap is a common donor site for vascularized lymph node transfer for the treatment of lymphedema. Chyle leakage is a rare but serious complication after harvesting SCLN flap in the neck. We report a case of chyle leakage at the SCLN donor site and its successful management. A 52-year-old woman underwent SCLN transfer for treatment of lower extremity lymphedema. After starting a regular diet and wheelchair ambulation on the 3rd postoperative day, the amount of drainage at the donor site increased (8-62 mL/day) with the color becoming milky, which suggested a chyle leak. Despite starting a low-fat diet on the 4th postoperative day, the chyle leakage persisted (70 mL/day). The patient was started on fat-free diet on the 5th postoperative day. The amount of drainage started to decrease and the drain color became more clear within 24 hours. The drainage amount remained less than 10 mL/day from the 8th postoperative day, and we removed the drain on the 12th postoperative day. There was no seroma or other wound complications at follow-up 4 weeks after the operation. The current case demonstrates that a fat-free diet can be a first-line treatment for low output chyle leakage after a SCLN flap.

Satisfaction with the Effect of Local Dynamical Micro-massage Therapy on the Pain and Discomfort after Breast Reconstruction Surgery

  • Ahn, Kwang Hyeon;Lee, Sun Jae;Park, Eun Soo;Park, Yu Gil
    • Medical Lasers
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    • v.9 no.1
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    • pp.39-43
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    • 2020
  • Background and Objectives Breast reconstruction has the advantage of reducing the loss of the body image of patients after mastectomy surgery, and also improving the quality of the social and sexual life of breast cancer patients. However, in surprising and unfortunate number of patients, acute postoperative pain persists beyond the normal course of postsurgical recovery. We set out to investigate the effect of local dynamical micro-massage (LDM) treatment for achieving pain relief and reducing other postoperative complications. Materials and Methods We performed a retrospective analysis on 58 patients who underwent LDM treatment for postoperative pain management at Soonchunhyang University Bucheon Hospital between February 2017 and June 2019. Those patients who complained of persistent postoperative pain, which was uncontrollable with medication, were treated with LDM. The degree of pain and discomfort with contracture were recorded using numerical rating scale (NRS) scoring system with numbers from 0 to 10 ('none' to 'worst'). Results The median NRS score of pain was reduced by 62.3% from the start to the end of LDM treatment (p<0.001). Further, the NRS score of discomfort with contracture was reduced 66.0% (p<0.001). There was no complication related to the LDM treatment. Conclusion Dual-frequency ultrasound LDM can be an effective therapeutic option for persisting pain after breast reconstruction surgery. It was also effective in improvement of discomfort with contracture and erythema of the surgical wound.

The Domestic Trends of Treatments on Postoperative Rotator Cuff Tear (회전근 개 파열로 인한 수술 후 처치에 관한 국내 연구 동향)

  • Lee, Chung-Hee;Kim, Yeon-Hee;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.27 no.2
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    • pp.1-10
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    • 2018
  • Objectives : The purpose of this study is to investigate the latest trend of studies on treatments of postoperative rotator cuff tear patients which are published in Korea. Methods : We investigated the studies on the treatments of postoperative rotator cuff tear patients via searching 6(six) Korean web databases(NSDL, RISS, Korean traditional knowledge portal, OASIS, KISTI, KCI). As a result, 16(sixteen) studies were found. We classified the papers by publication date, published journal, method of study, type of treatment, evaluation scale and referencing research ethics. Results : 16(sixteen) papers were published from 2006 to 2017. The papers were published in The journal of Korean shoulder & elbow society, The journal of korean acupuncture & moxibustion medicine, etc. 5(five) randomized controlled trials, 5(five) non-randomized controlled trials, 4(four) case reports and 2(two) Retrospective report have been found. For types of treatment, 6(six) exercise therapies, 3(three) Korean medicine treatments and 7(seven) other treatments have been found. Main evaluation tools were VAS, ROM, NRS and Muscle strength. Conclusions : In this study, we analyzed the latest trend of studies on treatments of postoperative rotator cuff tear patients. Reviewing the international trends of studies on treatments for postoperative rotator cuff tear are essential for the future studies.

Evaluation of the effects of mandibular angle sagittal ostectomy and botulinum toxin type A treatment using facial golden mask (황금마스크를 이용한 하악각시상골절제술과 보툴리눔독소 치료법의 평가)

  • Shin, Seung-Kyu;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Jun-Ho;Ahn, Ki-Young
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.469-474
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    • 2009
  • Purpose: A lower facial contouring surgery has become a commonly performed procedure in Asia. Currently, mandibular angle sagittal ostectomy and botulinum toxin type A treatment are main procedures for aesthetic correction of a broad lower face. There are a few date to show the differences in the mandibular contouring changes between mandibular angle splitting ostectomy and botulinum toxin type A treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective for evaluation of facial contour analysis. This study was designed specifically to compare the changes in lower face width after two different forms of lower facial contouring procedure using facial golden mask. Methods: Seventeen patients, aged 18 to 55 years (mean, 28.6 years), 15 women and 2 men, consented to the study and receive a contouring procedure of lower face. The patients were classified in to 2 groups. In group A, the sample consisted of 10 patients with a prominent squared mandibular angle and mandibular angle splitting ostectomy was performed. In group B, the sample consisted of 7 patients with masseteric hypertrophy and botulinum toxin type A treatment was performed. Photographs of the face were taken to record the facial change at preoperative and postoperative. The postoperative photographs were taken to considered maximal effect at 2 years after surgery in group A and 4.8 months after treatment in group B. The authors applied the facial golden mask to preoperative and postoperative photographs and horizontal ratio, which compares facial width with golden mask width, were calculated. We made an analysis of the result of horizontal ratio using SPSS. Results: Overall average horizontal ratio of pre- and postoperative photos of group A were 1.24 and 1.11, whereas overall average horizontal ratio of pre- and postoperative photos of group B were 1.19 and 1.12. The horizontal ratio decreased 10.24% in group A and 5.93% in group B. There was a statistically significant change in before and after treatment, but there was no significant change in comparing the group A and group B. Conclusions: The result from this study suggest that mandibular angle sagittal ostectomy and botulinum toxin type A treatment showed relatively satisfactory clinical effects on lower facial contouring treatment. There was no statistical significant difference within two lower facial contouring treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective, so we think that facial golden mask is a good method for evaluation of lower facial contouring treatment.

Multimodal Treatment of Esophageal Cancer (식도암의 다원적 치료)

  • 조건현
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.707-714
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    • 1990
  • Despite of mortality and morbidity rates that are higher than other forms of therapy, surgical resection has been mainstay for the treatment of esophageal cancer because of a prompt completeness as well as a high possibility of cure. But a substantial numbers of patients are unsuitable for surgical treatment and those undergoing resection have still poor long term survival rate. With hopes of improving long term survival, we have attempted multimodal approach, composed of preoperative induction chemotherapy utilizing Cisplatin and 5 \ulcornerFU, surgery and postoperative loco-regional radiotherapy for the treatment of esophageal cancer since 1985. During the period of 1967 \ulcorner1985, 27 patients[group A] were treated by surgery only and during recent 5 years 28 patients[group B] by multimodal treatment, Clinical review and comparison between the two groups were as follows: l. Applied surgical procedures were hand-sewn esophagogastrostomy, esophagocologastrostomy and esophagojejunostomy in group A. In group B, only esophagogastrostomy was underwent using stapler mainly. 2. Incidence of peri and postoperative complication showed no remarkable differences between the two groups, but the occurrences of leakage from the anastomotic site were 5[19% ] out of group A and 1[4%] out of group B. 3. The response rate to induction chemotherapy was 36% in group B, 4. The number of local cancer recurrence at the site of anastomosis was 6[22%] out of group A, whereas 2[7%] out of group B. 5. Postoperative I year and 2 year survival were 61%, 15% in group A and 75%, 42% in group B.

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Surgical Results of Intramedullary Spinal Cord Ependymomas in Adults : Retrospective Analysis of 51 Cases

  • Son, Young-Je;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.164-168
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    • 2006
  • Objective : The goal of treatment for spinal cord ependymoma is complete removal without postoperative neurological deficit. The authors analyzed the surgical results and factors influencing the postoperative prognosis. Methods : Fifty-one cases of primary spinal cord ependymoma, surgically treated between 1979 and 2003, were retrospectively analyzed. The mean follow-up period was 44 months. Results : Gross total removal was achieved in 42 patients and incomplete removal in nine. The proportion of complete surgical removals was influenced by tumor location and histology. Disease progression was observed in five cases [9.8%], the mean progression free interval after surgical removal was 48 months and the 5-year progression free rate was 68%. Disease progression was found in none of the 42 cases who underwent complete removal, and in 5 of 9 cases who hadincomplete removal group [P<0.001]. Statistically significant disease-progression factors by multivariate analysis were the surgical extent of removal [P=0.012]. preoperative functional status [P=0.032] the presence of intratumoral cysts [P=0.007] and postoperative radiation therapy [P=0042]. Of those patients who underwent incomplete removal, radiation therapy was found to significantly improve the clinical result [P=0042]. Conclusion : In the surgical treatment of spinal cord ependymoma, preoperative functional status, the presence of intratumoral cysts, the extent of removal, and postoperative radiation therapy were found to be significant prognostic factors of postoperative outcome.

Can Capecitabine be used Instead of Concurrent Bolus 5-FU in Postoperative Chemoradiotherapy for Gastric Adenocarcinoma?

  • Yoney, Adnan;Isikli, Levent
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5127-5131
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    • 2013
  • Background: 5-fluoro-uracil (FU) is a common agent in postoperative chemoradiation in gastric adenocarcinoma. However, FU is not well tolerated in a significant proportion of patients. Capecitabine (CA) is an orally administered fluoropyrimidine carbamate which is preferentially converted to active 5-FU and is one of the agents used instead of FU in such cases. We compared the toxicity, local and distant control and survival rates with FU or oral CA during the course of concurrent radiotherapy to assess the role of CA used instead of FU. Materials and Methods: We conducted an analysis of survival, disease control and toxicity data in 46 patients treated with postoperative chemoradiation following total or subtotal gastrectomy for gastric adenocarcinoma with either FU or CA between January 2008 and December 2012. Results: Median follow-up was 19 months (range: 3-59), median survival time was 23 ({\pm}6.08) months and 1-3 years overall survival (OS) rates were 64.9-39% for all patients. Compared with the CA regimen, the incidence of treatment interruption was higher with FU (p=0.023), but no significant differences were seen in local control (p=0.510), distant recurrences (p=0.721) and survival rates (p=0.866) among patients. Conclusions: Concurrent CA with radiotherapy seems to be a more tolerable and an equally effective regimen for the postoperative treatment of gastric adenocarcinoma when compared to FU.

Korean Medicine Treatment for Extension Teardrop Fracture of C2 with Post-operative State of Cervical Spine: A Case Report (축추 신전형 소편골절을 동반한 하부경추유합술 시행 환자의 한의학적 치료: 증례보고)

  • Ka-Hyun, Kim;Ji-Eun, Koo;Ji-Won, Park;Jun-Hyo, Bae;Joo-Young, Yoon;Sung-Won, Choi;Hae-Won, Hong;Yong-Jun, Kim;Ji-Su, Ha
    • Korean Journal of Acupuncture
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    • v.39 no.4
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    • pp.199-204
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    • 2022
  • The objective of this study was to evaluate the effects of Korean medicine treatment (including acupuncture, herbal medication, and pharmacopuncture) for postoperative pain after cervical surgery in a patient with a cervical (C2) extension teardrop fracture. We measured the patient's cervical range of motion, neck disability index score and numerical rating scale score to evaluate the effects of Korean medicine treatment on postoperative pain after cervical surgery. After 43 days of inpatient treatment, the patient's neck disability index score decreased from 75.5 to 46.67 and the numerical rating scale decreased from 6 to 2. Furthermore, recovery was observed for cervical range of motion. In conclusion, this case suggests that Korean traditional medicine treatment may effectively reduce postoperative pain after cervical surgery for cerviecal extension teardrop fracture.

A Case Report of a Postoperative State Patient with Cervical Spinal Cord Injury due to Ossification of Posterior Longitudinal Ligament Treated by Korean Medicine (후종인대골화증으로 발생한 경추 척수손상 환자에 대한 수술 후 한방치료 증례보고 1례)

  • Jeong-rim Bak;Hyo-won Jin;Ji-hyun Hwang;Jung-ho Jo;Jungtae Leem;Jong-min Yun;Byung-soon Moon
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.968-978
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    • 2023
  • Objectives: The purpose of this study is to report the effectiveness of Korean medicine treatment on postoperative state patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Methods: A 55-year-old Korean male patient diagnosed with cervical spinal cord injury due to ossification of the posterior longitudinal ligament was treated in an inpatient setting with Korean medicine treatment consisting of herbal medicine, acupuncture, and others from May 22 to August 21. The outcome was evaluated with the American Spinal Injury Association Impairment Scale (AIS), Spinal Cord Independence Measure-III (SCIM-III), modified Japanese Orthopaedic Association scale (mJOA), Numeric Rating Scale (NRS) before and after, or during the treatment period. Results: After 92 days of treatment, the patient's scores on all scales improved. Conclusion: The results suggest that Korean medicine treatment may be effective for postoperative patients with cervical spinal cord injury due to ossification of the posterior longitudinal ligament. Further studies should be conducted on a larger number of patients.

Neoadjuvant Treatment for Gastric Cancer

  • Schuhmacher, Christoph;Reim, Daniel;Novotny, Alexander
    • Journal of Gastric Cancer
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    • v.13 no.2
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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.