• 제목/요약/키워드: Surgical Management

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On Establishing a New Fee Schedule for General Surgical Procedure Using Fuzzy MCDM

  • Hung, Chih-Young;Huang, Yuan-Huei;Chang, Pei-Yeh;Wang, Kuei-Ing;Chang, King-Jen;Liu, Yi-Hsin
    • Industrial Engineering and Management Systems
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    • v.4 no.2
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    • pp.218-227
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    • 2005
  • In this research a model for establishing a new, rational fee schedule for general surgical procedures in a national health insurance program is developed. A fuzzy multiple criteria decision-making (FMCDM) model is proposed. The relative values of eleven surgical procedures were obtained through an empirical study based on the FMCDM model. Consequently, a new fee schedule obtained from the FMCDM model. This new fee schedule is more convincing than previous schedule and more persuasive to the references for the policy setting.

Needle aspiration as therapeutic management for suppurative cervical lymphadenitis in children

  • Baek, Mee-Young;Park, Kyung-Hee;We, Ju-Hee;Park, Su-Eun
    • Clinical and Experimental Pediatrics
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    • v.53 no.8
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    • pp.801-804
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    • 2010
  • Purpose: This study aimed to evaluate the usefulness of the needle aspiration alternative to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage. Methods: From January 1998 to June 2008, we retrospectively reviewed 38 children treated with needle aspiration as management with suppurative cervical lymphadenitis instead of open surgical drainage. Results: All 38 children underwent only 1 puncture. Two patients (5.2%) out of 38 patients experienced reformation of an abscess and all recovered completely after re-treatment with antibiotics. Minor complications were detected in 2 patients (5.2%). One complication originated from remnant necrotic tissue and the other involved formation of a small scar in two patients, which resolved spontaneously. There were no major complications. Conclusion: Needle aspiration can be a simple, safe, and effective alternative procedure to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage.

Surgical Management of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증의 수술적 치료)

  • Min, Yang-Gi;Rhee, Chae-Seo
    • Sleep Medicine and Psychophysiology
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    • v.1 no.2
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    • pp.117-124
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    • 1994
  • Obstructive Sleep Apnea Syndrome(OSAS), that is a complex disease of neuromuscular, respiratory and cardiovascular system, can be cured by various treatment such as weight control, medical and surgical intervention. As most of OSAS may be caused by various anatomical abnormalities, preoperative evaluation for exact anatomical site of obstruction must be needed. And various diagnostic procedures such as fiberoptic nasopharyngoscopy, Mueller test, cinefluoroscopy, cephalometry, computerized tomography, polysomnography would be used for this purpose. Uvulopalotopharyngplasty is currently the most popular method for the patient with OSAS among various surgical maneuvers and is very effective for the relieving the symptoms as like snoring, daytime somnolence, and nocturnal restlessness etc. Although subjective improvement is not compatible with it's objective assessment in postoperative evaluation for it's results, uvulopalatopharyngoplasty could be a recommandable surgical procedure because of it's ample effectiveness in promoting symptom improvement without any risk of serious complications.

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Outcomes of Surgical Management of Metopic Synostosis : A Retrospective Study of 18 Cases

  • Elhawary, Mohamed E.;Adawi, Mohammed;Gabr, Mohamed
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.107-113
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    • 2022
  • Objective : To describe the surgical management and postoperative outcomes in infants with metopic synostosis. Methods : We conducted a 5 years retrospective chart review of patients who underwent surgical correction of metopic synostosis at two university hospitals in Egypt during the period between June 2014 and June 2019. The study is conducted to 18 children. The type of surgical procedures and postoperative outcomes were assessed in all patients. Results : Five cases (27.8%) underwent endoscopic-assisted suturectomy, 10 cases (55.6%) underwent craniofacial reconstruction, and three cases (16.6%) underwent open burring of the metopic ridge. Fifteen patients underwent one surgery and three patients (16.6%) who need second operation. Ten patients (55.6%) had class I Whitaker classification. Conclusion : Regardless of type of surgery, the outcomes of surgical correction of metopic synostosis are excellent with only a few patients require revision or develop major complications.

Instrumental perforation of the esophagus the results of delayed surgical drainage more than 24 hours (식도질환의 기계적 처치후 발생한 식도파열 치험 -외과적 처치가 지연되었던 6예-)

  • 이두연
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.744-749
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    • 1986
  • Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.

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Prevalence of surgical affections with their clinical management in crocodiles (Crocodylus porosus) in Bangladesh

  • Arif, Abu S.M.;Hashim, M.A.;Runa, R.A.;Chowdhury, E.H.;Rahman, Md Siddiqur;Song, Hee-Jong
    • Korean Journal of Veterinary Service
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    • v.33 no.3
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    • pp.313-317
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    • 2010
  • This study was conducted in the saltwater crocodile (Crocodylus porosus) for the occurrence of various surgical affections with their clinical management. During the period of January 2006 to June 2008, a total of 68 adult crocodiles were considered as reference population from the Reptiles Farm Ltd. at Bhaluka, Mymensingh. The occurrence of surgical affections of adult female (88.9%) was significantly (P<0.01) higher than male (11.1%). Prevalence of common surgical affections were wound: 72.2%, fibroma: 11.1% abscess: 5.6%, fracture: 5.6%, tail necrosis: 2.8%, myiasis: 2.8%. Wound was the highest among the affections. Among the identified wounds, biting wound was higher. In summer (57.7%) the occurrence of wound was higher compared to other seasons. In winter season (7.7%) the occurrence of abscess, myiasis, fibroma were higher compared to other seasons. Wounds and fibroma are the major surgical affections in salt water crocodile. The most common site of surgical affection was recorded in crocodile's tail (30.6%). It was suggested that minimal stress, allowing constant and easy access to water, removal of roots of the tree in the basking land of crocodiles pen, basking land of the pen is better filling up by sand, clinical surgical managements are essential for better health and production.

The Present and Future of Medical Robots: Focused on Surgical Robots (의료로봇의 현재와 미래: 수술로봇을 중심으로)

  • Song, Mi Ok;Cho, Yong Jin
    • Journal of Digital Convergence
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    • v.19 no.4
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    • pp.349-353
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    • 2021
  • This study is a review study attempted to analyze the current situation of surgical robots based on previous research on surgical robots in the era of the 4th revolution, and to forecast the future direction of surgical robots. Surgical robots have made full progress since the launch of the da Vinci and the surgical robot is playing a role of supporting the surgeries of the surgeons or the master-slave method reflecting the intention of the surgeons. Recently, technologies are being developed to combine artificial intelligence and big data with surgical robots, and to commercialize a universal platform rather than a platform dedicated to surgery. Moreover, technologies for automating surgical robots are being developed by generating 3D image data based on diagnostic image data, providing real-time images, and integrating image data into one system. For the development of surgical robots, cooperation with clinicians and engineers, safety management of surgical robot, and institutional support for the use of surgical robots will be required.

2018 심방세동 카테터 절제술 대한민국 진료지침: PART I

  • Park, Hyeong-Seop;Jeong, Dong-Seop;Yu, Hui-Tae;Park, Hui-Nam;Sim, Jae-Min;Kim, Ju-Yeon;Kim, Jun;Lee, Jeong-Myeong;Kim, Gi-Hun;No, Seung-Yeong;Jo, Yeong-Jin;Kim, Yeong-Hun;Yoon, Namsik
    • International Journal of Arrhythmia
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    • v.19 no.3
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    • pp.186-234
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    • 2018
  • Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

Surgical management of severe cherubism persisting into early adulthood: a case report and literature review

  • Youngwoong Choi;Jeong Min Ji;Choong Hyeon Kim;Ki Pyo Sung
    • Archives of Craniofacial Surgery
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    • v.25 no.1
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    • pp.38-43
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    • 2024
  • Cherubism is a rare fibro-osseous condition characterized by bilateral expansion of the mandible and maxilla. Due to its rarity, treatment guidelines for cherubism have not been clearly established. Observation without surgical intervention is typically recommended, as cherubism often regresses spontaneously after puberty. However, a surgical intervention may be necessary if aggressive lesions lead to severe complications. In this report, we present a case involving surgical management of cherubism that did not spontaneously regress until early adulthood. An 18-year-old man was diagnosed with cherubism, presenting characteristic upward-looking eyes and a swollen face. He strongly desired surgical management. Gross contouring of the mandible was performed using an osteotome. Subsequently, delicate contouring was performed by bone burring and curettage. The remaining multiple locular bony defects were filled with demineralized bone matrix. No major complications, including infection and hematoma, occurred during the 8-month follow-up period. The facial contour remained stable without the aggravation of cherubism. The patient was satisfied with the cosmetic results. Considering that cherubism is a rare disease globally, with few reported cases in Korea, and that treatment guidelines are not clearly established, we anticipate that the results of this case will contribute to the development of future protocols for treating cherubism.

Surgical Complication and Its Management in Ischemic Stroke (허혈성뇌졸중의 수술치료시 동반되는 합병증과 관리)

  • Kim, Dal Soo;Yoo, Do Sung;Huh, Pil Woo;Cho, Kyoung Suok;Kang, Joon Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1107-1112
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    • 2000
  • Recently various operative procedures including microsurgery or endovascular surgery have been increasing for the management of ischemic cerebrovascular diseases. Carotid endarterectomy(CEA), extracranial-intracranial(EC-IC) arterial bypass, embolectomy, decompressive craniectomy, arterial transposition, intravascular thrombolysis, and percutaneous transarterial angioplasty and stenting (PTAS) are available surgical modalities for ischemic stroke. This article focuses the complications and perioperative management of patients treated with CEA and carotid PTAS among various surgical managements for ischemic stroke.

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