• 제목/요약/키워드: Surgery.

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Establishment of Minimally Invasive Thoracic Surgery Program

  • Cho, Jong Ho
    • Journal of Chest Surgery
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    • 제54권4호
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    • pp.235-238
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    • 2021
  • The establishment of minimally invasive surgery is a complex and difficult task. Video-assisted thoracic surgery (VATS) refers to a minimally invasive surgical technique that represents a less invasive approach to thoracic surgery using thoracoscopy. For lung cancer or esophageal cancer surgery, planning and establishing a team for minimally invasive surgery for the first time is not a simple task. Technical advances in surgical devices and the enhanced skill of surgeons are cornerstones of the development of minimally invasive surgery. Here, we review the meaning of minimally invasive thoracic surgery and discuss how to establish a team approach for VATS procedures.

Novel Repair of Clamshell Thoracotomy Sternal Dehiscence after Lung Transplant: A Case Report

  • John O. Barron;Nethra Jain;Mujtaba Mubashir;Haytham Elgharably;Daniel P. Raymond;Dean P. Schraufnagel
    • Journal of Chest Surgery
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    • 제57권2호
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    • pp.213-216
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    • 2024
  • Bilateral transverse thoracosternotomy, or "clamshell" thoracotomy, can be complicated by dehiscence. A 65-year-old male underwent lung transplantation via clamshell thoracotomy, with subsequent sternal dehiscence on postoperative day 11. Upon repair, the previous sternal wires had pulled through, so a Sternal Talon connected to a Recon Talon was utilized to re-approximate the inferior sternum. On follow-up at 3 months, the patient recovered well. Use of the Sternal Talon provides an effective technique for repairing transverse sternal dehiscence.

3차원 디지털 시스템을 이용한 턱교정 수술 (3D computer-assisted orthognathic surgery)

  • 김충남;김수호;임호경;이의석
    • 대한치과의사협회지
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    • 제57권2호
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    • pp.100-104
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    • 2019
  • Orthognathic surgery is designed to correct problems of the jaw and face and restore facial harmony. The limitations of orthognathic surgery occur at all steps of the surgical workflow: preoperative planning, simulation, and operation. Many studies have shown the accuracy and advantages of 3 dimensional computer-assisted program for orthognathic surgery. The purpose of this paper is to introduce the accuracy of the maxillary repositioning in patients who underwent orthognathic surgery using a 3 dimensional computer assisted surgery program. The reliability of computer guided orthognathic surgery using splint and surgical guide need to be improved further. The 3 dimensional computer assisted analysis seems to be more precise to interpret than two-dimensional analysis. High-precision planning of orthognathic surgery has predictable results. Three-dimensional computer assisted orthognathic surgery has the following advantages : planned surgical movement is possible, splints guide with CAD/CAM technology; and increase predictable results .Computer assisted simulation surgery ensures accuracy during surgery, thereby facilitating predictable results. It may provide solution that enables surgeon to perform planned surgery more accurately.

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Predicting Successful Conservative Surgery after Neoadjuvant Chemotherapy in Hormone Receptor-Positive, HER2-Negative Breast Cancer

  • Ko, Chang Seok;Kim, Kyu Min;Lee, Jong Won;Lee, Han Shin;Lee, Sae Byul;Sohn, Guiyun;Kim, Jisun;Kim, Hee Jeong;Chung, Il Yong;Ko, Beom Seok;Son, Byung Ho;Ahn, Seung Do;Kim, Sung-Bae;Kim, Hak Hee;Ahn, Sei Hyun
    • Journal of Breast Disease
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    • 제6권2호
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    • pp.52-59
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    • 2018
  • Purpose: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. Methods: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (${\geq}3cm$), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent >4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n=239) and was later validated with an independent validation cohort (n=123). Results: Small tumor size (p<0.001) at initial diagnosis, long distance from the nipple (p=0.002), high body mass index (p=0.001), and weak positivity for progesterone receptor (p=0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. Conclusion: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

  • Kim, Tae Sik;Na, Chan-Young;Oh, Sam Sae;Kim, Jae Hyun;Yie, Gil Soo;Han, Jung Wook;Chae, Min Cheol
    • Journal of Chest Surgery
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    • 제46권4호
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    • pp.256-264
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    • 2013
  • Background: Surgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery. Materials and Methods: From 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was $73.1{\pm}47.4$ months. Results: The surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072). Conclusion: In native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT

  • Hwang, Dae Seok;Seo, Jeong Seok;Choi, Hong Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.11.1-11.8
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    • 2020
  • Background: The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups. Results: The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months. Conclusion: In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.

Joint Statement of the Korean Society for Thoracic and Cardiovascular Surgery and the Korean Society for Coronary Artery Surgery on Chapter 7.1 in the 2021 American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions Guideline for Coronary Artery Revascularization

  • Chee, Hyun Keun;Kim, Ho Jin;Hwang, Ho Young;Kang, Joon Kyu;Hong, Soonchang;Kim, Jun Sung;Choi, Jin Ho;Youn, Young-Nam;Oh, Sang Gi;Kim, Wook Sung;Baek, Man-Jong;Choo, Suk Jung;Na, Chan-Young;Choi, Chang-Hyu;Kim, Kyung Hwan;Yoon, Jeong-Seob;Yoo, Kyung-Jong
    • Journal of Chest Surgery
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    • 제55권5호
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    • pp.361-363
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    • 2022