• 제목/요약/키워드: Surgical Operation

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만성 페색전증의 외과적 요법수술 및 수술 전후 문제 (Surgical Management of Chronic Pulmonary Embolism - Surgical treatment and perioperative problems -)

  • 김응수
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.139-147
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    • 1987
  • in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

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Maxillo-mandibular Contouring Surgery in Monostotic Fibrous Dysplasia Patients using Simulation Surgery

  • Kim, Dong-Young;You, Myoung-Sang;Ah, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • 제3권2호
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    • pp.60-63
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    • 2016
  • Fibrous dysplasia is quite a rare disease usually involving maxilla and mandible. Because of its benign clinical course, conservative contouring surgery has been recommended for facial deformity. 3D rapid prototype (RP) model gives a lot of informations before operation such as depth of drilling, area of resection and important anatomic structure. The purpose of this study was to report maxilla-mandibular contouring surgery in fibrous dysplasia patients. A total of 14 consecutive patients were included for surgical and esthetic evaluation. Among 14 patients, RP model study was performed in two patients with severe facial deformity. The other patients underwent contouring surgery under conventional methods. Surgical evaluation was performed with computed tomography scan before and after operation. Surgical resection was successful and patients were satisfied with the surgical results.

Implementation of Cervical Pedicle Surgical Guide for Safe Surgery

  • Kwak, Ho-Young;Huh, Jisoon;Lee, Won-Joo
    • 한국컴퓨터정보학회논문지
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    • 제22권12호
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    • pp.125-130
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    • 2017
  • Screw insertion surgery is frequently required among surgical procedures. Especially, very careful attention should be paid to the insertion of screw in the operation of the cervical vertebra. Therefore, there is a need for a guide that allows the surgeon to reliably and promptly perform treatment by calculating the desired insertion angle and length for screw insertion. In this study, the center and direction of the pedicle were calculated through 3D modeling and 3D vector numerical analysis using the CT or MRI image of the patient for the safe operation of the guide, and based on this, After that, we will implement surgical guide based on this.

흉부 대동맥류의 외과적 치료외과적 접근 및 술후 문제점 (Surgical Treatment of Thoracic Aortic Aneurysm - Surgical Approach and Perioperative Problems -)

  • 이준영
    • Journal of Chest Surgery
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    • 제21권1호
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    • pp.158-163
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    • 1988
  • 12 Patients with thoracic aortic aneurysm were operated between May 1985 to Sept. 1987 at the our department, Hanyang University Hospital. We retrospectively evaluated the surgical results and considered diagnosis, surgical approach and perioperative problems of thoracic aortic aneurysm. There are 9 males and 3 females in the patients. The age ranged from 23 to 61 years with the mean age at 40.6 years. The cause of the aneurysm was atherosclerosis in 5, Marfan`s syndrome in 4, syphilis In 1, trauma in 1 and annuloaortic ectasia in 1 case. According to DeBakey`s classification, Type I was 1 case, Type II was 5 cases and Type III was 6 cases. Among 6 patients with ascending aortic aneurysm, Bentall`s operation in 4 cases and ascending aorta reconstruction using to Dacron Tube Graft in 2 cases were performed successfully. 6 cases with descending aortic aneurysm were managed by prosthetic graft replacement. Chylothorax was observed in 1 patient and postoperative hemorrhage necessitating reopening of the chest occurred in 4 of operative survivors. There were 2 hospital deaths; one patient was dead during the operation and one patient was dead during the post-operative course due to low cardiac output syndrome

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수술용 최대혈액신청량(MSBOS)의 설정 (Guidline for the Maximum Surgical Blood Order Schedule (MSBOS) for Surgical Operations)

  • 신경아;최종태;김현수
    • 대한임상검사과학회지
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    • 제36권2호
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    • pp.153-157
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    • 2004
  • The aim of our study is to determine maximum surgical blood order schedule (MSBOS) in each surgical operation through analyzing usage of blood products at Bundang Jesaeng General Hospital. We investigated the amount of transfused red cells for each operation and calculated crossmatching-to-transfusion ratio (C/T ratio) and MSBOS. This was accomplished by referring to the Laboratory Information System program during 1 year from January through December 2003. Coronary artery bypass surgery and decompressive craniectomy showed the highest MSBOS in our hospital. The average C/T ratio was 3.2 and excessive reservations for blood products have been made for many operations. From this study, guidelines for the optimal blood ordering for each surgery were suggested.

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전자의무기록(EMR) 자료를 활용한 수술부위감염 관련요인 (Risk Factors for Surgical Site Infections According to Electronic Medical Records Data)

  • 김영희;염영희
    • 기본간호학회지
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    • 제21권2호
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    • pp.151-161
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    • 2014
  • Purpose: The purpose of this study was to identify the risk factors that influence surgical site infections after surgery. Methods: This study was a retrospective research utilizing Electronic Medical Records. Data collection targeted 4,510 adult patients who had 8 different kinds of surgery (gastric surgery, colon surgery, laparoscopic cholecystectomy, hip & knee replacement, hysterectomy, cesarean section, cardiac surgery) in 4 medical care departments, at one general hospital between January 2006 and December 2011. Multivariate logistic regression analyses were used to identify the risk factors affecting surgical site infections after surgery. Results: Risk factors for increased surgical site infection following surgery were confirmed to be age (OR=1.59, p<.001), BMI (Body Mass Index)(OR=1.25, p=.034), year of operation (OR=2.45, p<.001), length of operation (OR=3.06, p<.001), ASA (American Society of Anesthesiology) score (OR=1.36, p=.025), classification of antibiotic used (OR=2.77, p<.001), duration of the prophylactic antibiotics use (OR=1.85, p<.001), and interaction between classification of antibiotic used and duration of the prophylactic antibiotics use (OR=1.90, p=.016). Conclusions: Results suggest that risk factors affecting surgical site infections should be monitored before surgery. The results of this study should contribute to establishing effective infection management measures and implementing surveillance systems for patients who have actual risk factors.

후두격막의 새로운 치료법 (A New Surgical Technique of the Larygeal Web)

  • 안회영;여승근;박창식;이동엽;차창일
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.77-77
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    • 1993
  • 후두격막은 여러가지 원인으로 생기나 선천성의 경우를 제외하고는 비교적 두텁고 질긴 반흔 조직으로 그 상하면은 상피세포로 덮여 있다. 후두격막 치료의 궁극적 목표는 양측 성대의 전장이 상피 세포로 덮여져서 호흡 및 발성의 정상 기능을 찾게 하는 데 있다. 저자들은 최근 6예의 후두격막 환자에서 전신 경구삽관 마취하에 미세수술로 격막을 전후로 절개한 후 절개면의 상-하 상피층을 봉합하는 새로운 수술 방법을 고안하여 시도하였다. 보통의 후두미세술과 같이 익숙한 장비와 수술시야에서 격막 이외의 다른 부위에 손상을 주지 않고, 비교적 짧은 수술 시간 내에 한번의 수술로 별다른 합병증이 없고, 입원 시간도 짧은 등 장점이 있는 후두격막에 효과적인 치료법으로 생각되어 소개한다.

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시뮬레이션을 이용한 슬관절 수술 변수 결정 (Determination of Total Knee Replacement Parameter by Simulation)

  • 윤영수;박세형;이수홍;최귀원
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2005년도 춘계학술대회 논문집
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    • pp.881-887
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    • 2005
  • A total knee replacement is an extremely 'position-sensitive' operation; a malposition or a malalignment of the components will lead to a breakage of the component, a fracture around the knee prosthesis, and the limitation of range of the motion, etc. In a conventional total knee replacement, surgeons have to select an appropriate prosthesis according to the shape of the surgical region. A wrong selection may give rise to side effects or to need re-operation. Nevertheless, it is so difficult to choose the most proper prosthesis out of various kinds of prosthesis. This paper presents a surgical planning system for the total knee replacement with an operation simulating method in order to determine the parameters for the total knee replacement operation. We select an alignment axis and a resection angle as major operation parameters in the total knee replacement operation, and introduce the method to determine the major operation parameters with the operation simulator we developed. The simulator is used to determine operation parameters for optimized operations, to select the most appropriate prosthesis, and to analyze the prospective problems of the operation.

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구인두암의 절제 및 재건수술에서 하악골 절개 접근법과 하악골 보존 접근법의 임상적 비교 (Clinical Evaluation between Mandibulotomy and Mandible Sparing Approaches in Oropharyngeal Cancer Operation and Reconstruction)

  • 김정태;이정우;조동인;이혜민
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.152-158
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    • 2008
  • Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.

Photosensor를 이용한 재활 치료형을 위한 $CO_2$ laser 의 출력변동율 안정을 위한 실시간 제어특성 연구 (Real time control special quality research for $CO_2$ laser's output change rate stability for accumulation style surgical operation rehabilitation of ventriculus that use Photosensor)

  • 김휘영
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2006년도 하계종합학술대회
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    • pp.1015-1016
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    • 2006
  • The important parameters deciding the fluctuation of Accumulation style surgical operation of ventriculus laser beam are smoothing capacitor, frequency and he characteristics of laser resonator. In this thesis, we control the fluctuation of medical $CO_2C$ laser in realtime by changing Duty-Ratio of IGBT and switching frequency with fixed the smoothing capacitor to improve the fluctuation of laser beam. We detect the light on laser resonator using a CdS photo sensor to improve ripple factor of laser beam and feedback fluctuated signals refined by a band pass filter into the control circuit to stabilize fluctuation actively. There is much to be desired in the realtime controlling technique of the light on Accumulation style surgical operation of ventriculus laser discharge tube in electrical signal. We propose switching control technique with microprocessor and photo sensing technique by controlling switch devices optimum operation and feedback signals detected by a photo sensor into the laser power supply in order to improve ripple factor of the $CO_2$ laser beam.

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