• 제목/요약/키워드: Preoperative planning

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족근 골 결합 (Tarsal Coalitions)

  • 박용욱;서일우
    • 대한족부족관절학회지
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    • 제16권3호
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    • pp.141-147
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    • 2012
  • A tarsal coalition is an abnormal union between 2 or more tarsal bones of the hind- and midfoot, which can be congenital or acquired. The documented overall incidence of tarsal coalition is 1% or less. The resulting abnormal articulation leads to accelerated degeneration within adjacent joint. Pain is often diffuse, exacerbated by strenuous activity or following an ankle sprain. The findings on physical examination is protruded mass, diminished range of motion of the involved joint. It is possible to identify of tarsal coalitions with conventional radiography, but CT scanning necessary to evaluate of the size, location, characteristic and preoperative planning of tarsal coalitions. The initial treatment for a tarsal coalition is conservative, but tarsal coalitions unresponsive to conservative treatment, are managed by coalition resection, or arthrodesis in case of presence of degenerative changes.

How to optimize aesthetic outcomes in implant-based breast reconstruction

  • Nava, Maurizio Bruno;Catanuto, Giuseppe;Rocco, Nicola
    • Archives of Plastic Surgery
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    • 제45권1호
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    • pp.4-13
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    • 2018
  • The evolution of breast reconstructive surgery keeps pace with the evolution of breast oncologic surgery. The reconstructive choice should always balance the optimal local control of disease and the best cosmetic result, reflecting an informed decision that is shared with the patient, who is always at the center of the decision-making process. Implant-based breast reconstruction following mastectomy represents a complex choice. In order to obtain optimal results, the following considerations are mandatory: thorough preoperative planning, a complete knowledge of the devices that are used, accurately performed surgery, and appropriate follow-up.

Retroperitoneal Yolk Sac Tumor in Adult Woman Presenting as Spinal Cord Compression and Fatal Pulmonary Tumor Embolism

  • Yi, Hyeong-Joong;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • 제39권4호
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    • pp.296-299
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    • 2006
  • A 35-year-old woman, previously treated for systemic metastases from retroperitoneal yolk sac tumor, presented with progressive painful paraparesis. Preoperative images showed severe cord compression by the metastatic infiltration of the lumbar vertebrae and epidural mass as well as a huge retroperitoneal mass. While performing unremarkable surgery in prone position, the patient abruptly fell into hypoxic insults and circulatory arrest. Intraoperative pulmonary tumor embolism was deemed a cause of death. When planning operative procedure for this dangerous malignancy, scrupulous manipulation is mandated and the possibility of fatal pulmonary tumor embolism should also be addressed and fully discussed preoperatively.

Distally-based free anterolateral thigh flap with a modified vena comitans

  • Kang, Chan-Su;Kim, Tae-Gon
    • Archives of Plastic Surgery
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    • 제46권1호
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    • pp.84-87
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    • 2019
  • With the recent development in microsurgery, the use of a perforator flap has been widely implemented. If the length of the ALT flap pedicle is insufficient despite adequate preoperative planning, pedicle length extension is necessary. We planned for a reverse ALT free flap using the distal vessel of the descending branch for pedicle length extension in the case of ALT perforator branch originating from the proximal portion of the descending branch. For the management of venous congestion, the distal venae comitantes were anastomosed to the proximal venous stump in an antegrade manner, successfully resolving the venous congestion. Modified reverse-flow ALT free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch, unlike the initial surgical plan.

Uncommon configuration of intercostobrachial nerves, lateral roots, and absent medial cutaneous nerve of arm in a cadaveric study

  • Rosemol Xaviour
    • Anatomy and Cell Biology
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    • 제56권4호
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    • pp.570-574
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    • 2023
  • The intercostobrachial nerve (ICBN) originates from the second intercostal nerve's lateral cutaneous branch, while the median nerve (MN) typically arises from the brachial plexus's lateral and medial roots. The medial cutaneous nerve of the arm, a branch of the medial cord of the brachial plexus, often connects with the ICBN. Variations were observed during the dissection of a 50-year-old male cadaver, including MN having two lateral roots (LR), LR1 and LR2, joining at different levels. Three ICBNs innervated the arm in this case, with the absence of the medial cutaneous nerve of the arm compensated by branches from the medial cutaneous nerve of the forearm. Understanding these anatomical variations is crucial for surgical procedures like brachioplasty, breast augmentation, axillary lymph node dissection, and orthopedic surgery. Surgeons and medical professionals must be aware of these variations to enhance preoperative planning, minimize complications, and improve patient outcomes in these procedures.

Arthroscopic Latarjet procedure: current concepts and surgical techniques

  • Sang-Jin Shin;Jae Hyung Kim;Jonghyun Ahn
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.445-454
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    • 2023
  • The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.

Surgical management of hilar cholangiocarcinoma: Controversies and recommendations

  • Suvendu Sekhar Jena;Naimish N Mehta;Samiran Nundy
    • 한국간담췌외과학회지
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    • 제27권3호
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    • pp.227-240
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    • 2023
  • Hilar cholangiocarcinomas are highly aggressive malignancies. They are usually at an advanced stage at initial presentation. Surgical resection with negative margins is the standard of management. It provides the only chance of cure. Liver transplantation has increased the number of 'curative' procedures for cases previously considered to be unresectable. Meticulous and thorough preoperative planning is required to prevent fatal post-operative complications. Extended resection procedures, including hepatic trisectionectomy for Bismuth type IV tumors, hepatopancreaticoduodenectomy for tumors with extensive longitudinal spread, and combined vascular resection with reconstruction for tumors involving hepatic vascular structures, are challenging procedures with surgical indications expanded. Liver transplantation after the standardization of a neoadjuvant protocol described by the Mayo Clinic has increased the number of patients who can undergo operation.

술전ㆍ후 상악동염환자와 정상인의 상악동 크기 및 골벽두께에 관한 전산화단층방사선학적 연구 (A Computed Tomographic Study on the Size and Bone Wall Thickness of the Maxillary Sinus in Normal, Preoperative and Postoperative Maxillary Sinusitis Patients)

  • 최선영;이상래;고광준
    • Imaging Science in Dentistry
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    • 제30권2호
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    • pp.109-116
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    • 2000
  • Purpose : To compare the size and bone wall thickness of the maxillary sinus in normal, preoperative and postoperative maxillary sinusitis patients. Materials and Methods : The author analyzed CT images of both left and right maxillary sinuses in 357 patients who visited Chonbuk National University Hospital between January 1997 and December 1998. The size and bone wall thickness of the maxillary sinus of normal, inflammatory and post-Caldwell-Luc groups were compared. Results: The significant differences of transverse, maximum medio-lateral, maximum supero-inferior dimensions and medio-lateral dimension at nasal floor level between normal and post-Caldwell-Luc groups were found (P<0.05). And the significant differences of antero-posterior dimensions between inflammatory and post-Caldwell-Luc group were found (P<0.05). But, no significant differences of vertical height dimensions between groups was found (P>0.05). The significant differences of postero-lateral, infero-lateral and medial wall thickness between normal and post-Caldwell-Luc groups were found (P<0.05). Conclusion : The results of this study will aid in the diagnosis and treatment of maxillary sinus diseases and post operative treatment planning.

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갑상전 절제술시 동결절편조직검사의 유용성에 대한 평가 (Validity of Frozen Biopsy during Thyroidectomy)

  • 김성렬;김중규;최영식
    • 대한두경부종양학회지
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    • 제14권1호
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    • pp.81-87
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    • 1998
  • Fine needle aspiration cytology was used widely to select thyroid nodules for surgery. The result could be highly reliable for most malignancies and for benign nodules. The purpose of this study was to determine the value of frozen biopsy by directly comparing the results of preoperative fine needle aspiration cytology to frozen biopsy examination. In our university hospital, 103 patients with thyroid nodule were operated during the years 1996 through 1997. A comparison of accuracy of the fine needle aspiration cytology with frozen biopsy was made for 85 patients who underwent both procedures. The 85 patients were separated into two groups. The group I included 65 patients, whose preoperative fine needle aspiration cytology results were reported as benign or malignant lesion definitely. The group II included 85 patients, the patients whose reported fine needle aspiration cytologic result was suspicious for malignancy were regarded .as malignant lesion and results for follicular neoplasm were regarded as benign lesion. The accuracy of both procedures was compared on two group also. The sensitivity, specificity, and accuracy of frozen biopsy were 76.7%, 93.5%, and 85.2% in group I and 75.6%, 95.5%, and 85.9% in group II, respectively, compared with 63.3%, 87.1%, and 75.4% in group I and 65.4%, 81.8%, and 72.9% in group II for fine needle aspiration cytology. On benign lesion, the accuracy was 95.5% in frozen biopsy and 68.2% in fine needle aspiration cytology, 75.6% in frozen biopsy and 53.7% in fine needle aspiration cytology on malignant lesion. We conclude that although fine needle aspiration cytology is the reliable diagnostic test in the evaluation of thyroid nodule, frozen biopsy should be performed intraoperatively, because fine needle aspiration cytology is insufficiently sensitive for reliable surgical planning.

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Three-Dimensional Surface Imaging is an Effective Tool for Measuring Breast Volume: A Validation Study

  • Lee, Woo Yeon;Kim, Min Jung;Lew, Dae Hyun;Song, Seung Yong;Lee, Dong Won
    • Archives of Plastic Surgery
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    • 제43권5호
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    • pp.430-437
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    • 2016
  • Background Accurate breast volume assessment is a prerequisite to preoperative planning, as well as intraoperative decision making in breast reconstruction surgery. The use of three-dimensional surface imaging (3D scanning) to assess breast volume has many advantages. However, before employing 3D scanning in the field, the tool's validity should be demonstrated. The purpose of this study was to confirm the validity of 3D-scanning technology for evaluating breast volume. Methods We reviewed the charts of 25 patients who underwent breast reconstruction surgery immediately after total mastectomy. Breast volumes using the Axis Three 3D scanner, water-displacement technique, and magnetic resonance imaging (MRI) were obtained bilaterally in the preoperative period. During the operation, the tissue removed during total mastectomy was weighed and the specimen volume was calculated from the weight. Then, we compared the volume obtained from 3D scanning with those obtained using the water-displacement technique, MRI, and the calculated volume of the tissue removed. Results The intraclass correlation coefficient (ICC) of breast volumes obtained from 3D scanning, as compared to the volumes obtained using the water-displacement technique and specimen weight, demonstrated excellent reliability. The ICC of breast volumes obtained using 3D scanning, as compared to those obtained by MRI, demonstrated substantial reliability. Passing-Bablok regression showed agreement between 3D scanning and the water-displacement technique, and showed a linear association of 3D scanning with MRI and specimen volume, respectively. Conclusions When compared with the classical water-displacement technique and MRI-based volumetry, 3D scanning showed significant reliability and a linear association with the other two methods.