• Title/Summary/Keyword: Surgery-first approach

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Surgical Treatment of Thoracic Outlet Syndrome (Report of A Case) (흉곽출구 증후군 수술 치험 1례)

  • Ryu, Ji-Yun;Gang, In-Deuk;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.563-566
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    • 1988
  • Thoracic outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. it was previously designated according to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first thoracic rib syndromes. We experienced a case of thoracic outlet syndrome[costoclavicular syndrome] which was caused by posttraumatic left clavicular fracture. Patient had suffered from swelling and cyanosis of left forearm and hand. preoperative vascular doppler test, angiography and venography were performed. First rib resection was done with transaxillary approach. After operation preoperative cyanosis and swelling of left forearm and hand were disappeared. Postoperative course was uneventful.

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Expanded Endoscopic Transnasal Approach to the Chordoid Glioma of the Third Ventricle : The First Case Ever Reported

  • Zeinalizadeh, Mehdi;Sadrehosseini, Seyed Mousa;Meybodi, Keyvan Tayebi;Sharifabadi, Ali Heidari
    • Journal of Korean Neurosurgical Society
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    • v.59 no.6
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    • pp.643-646
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    • 2016
  • Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

Minimally Invasive Cardiac Surgery versus Conventional Median Sternotomy for Atrial Septal Defect Closure

  • Jung, Joon Chul;Kim, Kyung-Hwan
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.421-426
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    • 2016
  • Background: Median sternotomy is the standard approach for atrial septal defect (ASD) closure. However, minimally invasive cardiac surgery (MICS) has been introduced at many centers in adult/grown-up congenital heart patients. We retrospectively reviewed the results of right anterolateral thoracotomy compared with conventional median sternotomy (CMS) for ASD closure at Seoul National University Hospital. Methods: We retrospectively analyzed 60 adult patients who underwent isolated ASD closure from January 2004 to December 2013 (42 in the CMS group, 18 in the MICS group). Preoperative, operative, and postoperative data were collected and compared between the 2 groups. Results: The MICS group was younger (44.6 years vs. 32.4 years, p=0.002) and included more females (66.7% vs. 94.4%, p=0.025) than the CMS group. Operation time (188.4 minutes vs. 286.7 minutes, p<0.001), cardiopulmonary bypass time (72.7 minutes vs. 125.8 minutes, p<0.001), and aortic cross-clamp time (25.5 minutes vs. 45.6 minutes, p<0.001) were significantly longer in the MICS group. However, there were no significant differences in morbidity and mortality between groups. Only chest tube drainage in the first 24 hours (627.1 mL vs. 306.1 mL, p<0.001) exhibited a significant difference. Conclusion: MICS via right anterolateral thoracotomy is an alternative choice for ASD closure. The results demonstrated similar morbidity and mortality between groups, and favored MICS in chest tube drainage in the first 24 hours.

The First Living-Donor Lobar Lung Transplantation in Korea: a Case Report

  • Choi, Sehoon;Park, Seung-Il;Lee, Geun Dong;Kim, Hyeong Ryul;Kim, Dong Kwan;Jung, Sung-Ho;Yun, Tae-Jin;Kim, In Ok;Choi, Dae-Kee;Choi, In-Cheol;Song, Jong-Min;Hong, Sang-Bum;Shim, Tae Sun;Jo, Kyung-Wook;Lee, Sang-Oh;Do, Kyung-Hyun;Chae, Eun Jin
    • Journal of Korean Medical Science
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    • v.33 no.43
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    • pp.282.1-282.6
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    • 2018
  • Lung transplantation is the only treatment for end-stage lung disease, but the problem of donor shortage is unresolved issue. Herein, we report the first case of living-donor lobar lung transplantation (LDLLT) in Korea. A 19-year-old woman patient with idiopathic pulmonary artery hypertension received her father's right lower lobe and her mother's left lower lobe after pneumonectomy of both lungs in 2017. The patient has recovered well and is enjoying normal social activity. We think that LDLLT could be an alternative approach to deceased donor lung transplantation to overcome the shortage of lung donors.

Posterior maxillary segmental osteotomy for management of insufficient intermaxillary vertical space and intermolar width discrepancy: a case report

  • Baeg, SeungWoo;On, SungWoon;Lee, JeongKeun;Song, SeungIl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.28.1-28.6
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    • 2016
  • Backgrounds: Insufficient intermaxillary space is caused by non-restoration following tooth extraction in the past, and this involves eruption of the opposing teeth and changes of the arch structure. Such cases are difficult just by a simple prosthetic approach, and diversified treatment plans should be established. Among these, posterior maxillary segmental osteotomy (PMSO) is an efficient treatment option than extraction of opposing teeth as it surgically repositions multiple erupted teeth and alveolar bone. PMSO can preserve the natural teeth; therefore, it is being regarded as a treatment method which can improve insufficient intermaxillary space significantly. Case presentation: In this case report, the first patient received PMSO in order to place an implant in the mandibular edentulous space after decreased vertical dimension is restored, and the second patient received PMSO along with orthodontic treatment to obtain the intermaxillary space and balance the interarch molar width. Conclusion: PMSO is the treatment of choice when occlusion is compromised in the presence of decreased vertical dimension or arch length discrepancy.

The usability of Infraorbital Approach on the patients with Orbito-Zygomatic Fracture (안와-관골골절 환자에서 안와하 접근법의 유용성)

  • Yun, Chi Sun;Kim, Jong Hwan;Yang, Ho Jik
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.19-22
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    • 2009
  • Purpose: There are various approaches for open reduction surgery for orbitozygomatic fractures. After the incisions are performed, patients might have various complications. In this point of view, we conducted a retrospective study of the usability of infraorbital incision on elderly patients, generally more vulnerable to scleral show and ectropion. Methods: In this study, 20 patients who are relatively more vulnerable to scleral show and ectropion through snap-back test having infraorbital incision were reviewed. We monitored the duration of the surgery, and complications resulted from the incision. We evaluated the scars with the researcher's observations and with the patient's level of satisfaction on a scale of 1 to 5. Results: On average, 5 minutes was spent between the skin incision and the fracture exposure. No case of scleral show and ectropion occurred. One year follow-up observation revealed 4 cases of visible scars, 9 cases of barely visible scars, and 7 cases of invisible scars. The subjective satisfaction level of the patients' scar is an average of 4.0. Conclusion: Infraorbital incision has many advantages. First, it can reduce the complications such as scleral show and ectropion. Second, it can shorten the operation time. Third, it can diminish incision-related scars.

Diagnosis and Treatment of Unilateral Maxillary Sinus Hypoplasia (편측 상악동 저형성증의 진단과 치료)

  • Kim, Soung-Min;Kim, Min-Keun;Kwon, Kwang-Jun;Lee, Suk-Keun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.127-132
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    • 2012
  • Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.

Traumatic arterial thoracic outlet syndrome after multiple rib fractures not including the first rib in Korea: a case report

  • Seock Yeol Lee
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.158-160
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    • 2024
  • Arterial thoracic outlet syndrome (TOS) resulting from thoracic trauma is an exceedingly rare condition, typically caused by a fracture of the first rib or clavicle. In this report, the author presents a case of traumatic arterial TOS precipitated by multiple left rib fractures, notably excluding the first rib, following a fall from a 2-m high stepladder. The patient was treated successfully with first rib resection via a transaxillary approach, and the postoperative course was uneventful. The literature includes no known reports of traumatic arterial TOS in patients with multiple fractures that spare the first rib, making this the first documented case of its kind. In this instance, the patient sustained fractures to the fourth and fifth ribs. The TOS was likely not a direct result of the multiple rib fractures, which were located some distance from the thoracic outlet. Rather, it is hypothesized that the trauma from these fractures caused a soft tissue injury within the thoracic outlet, which ultimately led to the development of TOS.

Intracorporeal Anastomosis in Laparoscopic Gastric Cancer Surgery

  • Hosogi, Hisahiro;Kanaya, Seiichiro
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.133-139
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    • 2012
  • Laparoscopic gastrectomy has become widely used as a minimally invasive technique for the treatment of gastric cancer. When it was first introduced, most surgeons preferred a laparoscopic-assisted approach with a minilaparotomy rather than a totally laparoscopic procedure because of the technical challenges of achieving an intracorporeal anastomosis. Recently, with improved skills and instruments, several surgeons have reported the safety and feasibility of a totally laparoscopic gastrectomy with intracorporeal anastomosis. This review describes the recent technical advances in intracorporeal anastomoses using circular and linear staplers that allow for totally laparoscopic distal, total, and proximal gastrectomies. Data that demonstrate advantages in early surgical outcomes of a total laparoscopic method compared to laparoscopic-assisted operations are also discussed.

Giant sialolithiasis of the submandibular gland: a case report (악하선에서 발생한 거대 타석증: 증례 보고)

  • Choi, Woo-Sung;Yoon, Hyun-Joong;Lee, Sang-Hwa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.141-144
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    • 2010
  • Sialolithiasis is the common pathology of salivary gland. The size of sialoliths vary from 1 mm to a few cm, but most of that are less than 10 mm. Large sialoliths (larger than 15 mm) are extremely rare. It is called Giant sialolithiasis or megalith. Symptom of the giant sialolithiasis is similar to that of regular sialolithiasis. First choice of treatment is removal of the stone. Many literatures reported various methods to remove the sialoliths. For this case report, we accidentally found the giant sialolith on the computed tomography taken for dental implant, and successfully removed the stone by minimal invasive surgical approach. Base on this result, we report this case with literature reviews.