• Title/Summary/Keyword: Surgical ligation

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An analysis of adult patent ductus arteriosus (성인의 개방성동맥관에 대한 임상적 고찰)

  • 임승균
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.311-315
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    • 1982
  • Between 1973 and 1981 a total of 38 patients with a adult Patent Ductus Arteriosus, resulting from a congenital heart disease. There were 10 males and 28 females and most were in their twenties. In 21 cases, typical Patent Ductus Arteriosus without pulmonary hypertension and in 17, atypical Patent Ductus Arteriosus with pulmonary hypertension were noted. Methods of surgical treatment were division, double ligation, triple ligation, or wrapping with Teflon felt and ligation. The number of patients for each surgical treatment were 23 cases with double ligation, 4 cases with triple ligation, 3 cases of wrapping with Teflon felt and ligation and 8 cases with division. Surgical mortality occurred in one case[2.6%].

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Surgical Ligation of Patent Ductus Arteriosus Using the Descending Aortic Approach in Two Dogs

  • Kim, Dae-Hyun;Hong, Sung-Hwa;Myung, Hyunwook;Son, Dong-ju;Nam, Aryung;Jung, Sung-Yong;Hwang, Jung-Yeon;Jee, Hyun-Choul
    • Journal of Veterinary Clinics
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    • v.37 no.1
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    • pp.42-45
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    • 2020
  • Surgical ligation is the treatment of the choice in patients with patent ductus arteriosus (PDA). This case series presents two cases of PDA, one with and one without persistent left cranial vena cava (PLCVC), treated with surgical ligation through the descending aortic approach with mini-thoracotomy. There were no specific complications during the surgical procedures. The descending aortic approach would be an alternative method for dissection of the PDA.

Surgical Ligation on Significant Patent Ductus Arteriosus in Very Low Birth Weight Infants: Comparison between Early and Late Ligations

  • Lee, Jun Ho;Ro, Sun Kyun;Lee, Hyun Ju;Park, Hyun Kyung;Chung, Won-Sang;Kim, Young Hak;Kang, Jeong Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.444-450
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    • 2014
  • Background: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. Methods: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (<1,500 g) who underwent surgical PDA ligation. Results: The gestational age (GA) in the late ligation (LL) group was significantly younger than in the early ligation (EL) group (p=0.010). The other baseline characteristics and preoperative conditions did not differ significantly between the two groups. The intubation period before surgery (p<0.001) and the age at surgery (p<0.001) were significantly different. The postoperative clinical outcomes of the study patients, including major morbidity and mortality, are summarized. There were no significant differences in bronchopulmonary dysplasia, sepsis, or mortality between the EL and the LL groups. However, the LL group was significantly associated with an increased risk of necrotizing enterocolitis (p=0.037) and with a prolonged duration of the total parenteral nutrition (p=0.046) after adjusting for GA. Conclusion: Early surgical ligation for the treatment of PDA that failed to close after medical treatment or in cases contraindicated for medical treatment might be desirable to reduce the incidence of necrotizing enterocolitis and to alleviate feeding intolerance in preterm infants.

Ligation of Thoracic Duct Via Extrapleural Approach for the Treatment of Chylothorax - Report of 1 case- (유미흉에서 늑막외층 접근법을 통한 흉관 결찰술 -치험 1예-)

  • 김성완;김덕실
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.883-885
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    • 2003
  • Traditional surgical management of chylothorax refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy. A new surgical procedure of ligation of the thoracic duct via extrapleural approach is presented. Its advantages are less invasive, no need of a new drainage tube, and easier to expose the thoracic duct than the conventional transthoracic approach. We experienced a new surgical method in the treatment of the chylothorax and report it with literatures.

Surgical Treatment of Adult Patent Ductus Arteriosus (성인 동맥관개존증의 외과적 치료)

  • 김종호
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.989-993
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    • 1995
  • Patent ductus arteriosus in adult is frequently complicated with aneurysm, calcification and pulmonary hypertension. Therefore, surgical treatment of patent ductus arteriosus in adult has some differences from that of infants and children. We have experienced 25 cases of adult patent ductus arteriosus from July 1983 to December 1994. Mean age of the patients was 26.6 years[16-59 years . There were 12 males and 13 females. Exertional dyspnea was the most frequent clinical manifestation. Pulmonary hypertension was present in eight patients. Ligation was done in 20 cases and surgery using cardiopulmonary bypass was done in 5 cases. There was one hospital death, which had a 5x5cm sized main pulmonary artery aneurysm and was operated under cardiopulmonary bypass. Recanalization occured in one patient who received Teflon-felt supported ligation. Although one case of recannalization after ligation was present, we believed the fact that ligation was safe and simple method of operation in adult patent ductus arteriosus without calcification and aneurysm.

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Cavitary Pulmonary Tuberculosis Treated by Ligation and Division of Bronchus -Report of One Case- (기관지 분단결찰을 병행한 중증 폐결핵 1 치험예)

  • 지일성;주택소
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.141-146
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    • 1969
  • The importance of bronchial occlusion which occurs in the natural course of tuberculosis as an inconstant but very fortunate event became obscured with the popularity of resection therapy for pulmonary tuberculosis and the resectional surgery and thoracoplasty are the standard method of surgical procedure in the treatment of pulmonary tuberculosis. However in some cases of far advanced pulmonary tuberculosis, the need for another surgical methods arise when standard method is not indicated under the consideration of poor pulmonary function or operative and postoperative complications such as bronchial fistula. The ligation and division of bronchus draining the involved part of the lung is one of the applicable method among the another surgical procedures. The authors experienced one case of far advanced pulmonary tuberculosis who had a huge cavity in the right upper lobe and a small cavity in the superior segment accomanying with several nodular densities in the basal segment and contralateral left lung field, and treated with right upper lobectomy, ligation and division of the superior segmental bronchus and concomitant rib-resectional thoracoplasty in order to prevent postoperative bronchial fistula and to preserve maximal lung function. The postoperative course was smooth without complication regarding to bronchial ligation and division technique and the general condition has been excellent without symptoms. The postoperative sputum examination for AFB on smear and culture has been negative during the 11 month period of follow up, and X-ray of the chest including tomography demonstrated no evidence of residual cavity indicating succesful collapse of cavity.

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미숙아와 신생아의 동맥과 개존증에 대한 수술요법(소개흉 결찰술과 흉강경 보조하의 clipping과의 비교)

  • 장지원;한재진;원용순;원태희;안재호;박영식;최수승
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2000
  • Background: This study was aimed at analyzing the preoperative conditions post-operative results indication and methods of surgical closure of patent ducturs arterio년 in prematures low birth weight infants and neonates. Patients and Methods: We retro-spectively studied two groups of patients (prematures group and neonates group) who underwent surgical closure of the patent ductus arteriosus between March 1995 and June 1998. Results: The premature group consisted of 9 patients(3 males and 6 females) Their mean gestational period was 30.7 weeks(ranging from 26 weeks to 33 weeks) mean age 27.8 days(11 days to 55 days) and mean body weight 1.56 kg. Prominent preoperative symptoms were dependency on mechanical ventilation generalized edema and hepatomegaly. We performed PDA ligation via thoracotomy in all premature patients. The neonate group consisted of 16 patients and their mean body weight was 3.75 kg. Major symptoms of this group was tachypnea and intercostal retraction resistant to medical treatment. We performed video-assisted PDA clipping to them all. There were no postoperative complications or operation-related mortality in both groups. Comparing the ratio of size of PDA(mm)/body weight(kg) the ratio of premature group (ligation through thoracotomy) was higher than that of neonate group ( video-assisted clipping) that is 3,89:1.21(p=0.03) Conclusion : We conclude that the surgical closure of PDA can be a safe method of treatment for prematures low birth weight infants and neonates with compromised general conditions. Choice of surgical technique depends on the surgeon's preference but there was a tend-ency to choose the ligation method through thoracotomy for patients with small body weight and large PDA.

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The Change of Pulmonary Arterial Pressures after Left Lung Transplantation and Ligation of Right Pulmonary Artery in Dogs (황견에서 좌측 폐이식수술 및 폐동맥결찰 수술후 폐동맥압 변하에 관한 연구)

  • 이두연
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.345-352
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    • 1994
  • We have performed left lung transplantation followed by ligation of right pulmonary artery in 14 dogs at the Chest Disease Research Institute, Yonsei University College of Medicine from May 1992 to February 1994. Excised left lung was perfused with 1500cc of 4$^{\circ}$C cold Euro-Collin`s[E-C] solution at a pressure of 30cmH2O through main pulmonary artery and preserved in 4$^{\circ}$C cold E-C solution for one hour. Left lung transplantation were proceeded in order of left atrium, left main bronchus, left pulmonary artery and right pulmonary artery ligation as usual method. The femoral artery and pulmonary artery pressures were monitored for more than 5 hours after the transplantations in 14 dogs. Six recipient dogs had elevated mean pulmonary artery pressure to greater than 30mmHg after the left lung transplantation and ligation of right pulmonary artery. The cause of elevated mean pulmonary artery pressure was due to inadequate preservation resulting in ischemic damage to donor lungs in 3 cases, and inadequate surgical techniques in 3 cases. Two recipient dogs without surgical complications died immediate post-operatively due to hemorrhagic shock. The bleeding focuses were LA anastomotic site in one case and femoral artery puncture site in another case. The remaining 6 recipient dogs showed mean pulmonary arterial pressure less than 30mmHg. However, one dog had spontaneous pneumothorax in post-operative 4 days, and another dog had rejection phenomenon in post-operative 5 days which was confirmed by pathologic findings of extracted transplanted lung. One dog succumbed of severe hemoptysis which was due to lung abscess with pin point stenosis of bronchial anastomosis in post-operative 38 days. In conclusion, elevated mean pulmonary arterial pressure greater than 30mmHg in immediate postoperative period can be due to inadequate preservation of extracted lung or poor surgical techniques. And the two dogs succumbed of hemorrhagic shock even though the mean pulmonary arterial pressure was less than 30mmHg. It is thought that careful preservation of the extracted donor lung in 4oC E-C solution and complete surgical techniques are the most important factors early and late complications.

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Surgical Experiences of Ten Cases of Patent Ductus Arteriosus Ligation in Premature Infants (미숙아에서 시행된 동맥관 개존증 결찰술 10례에 대한 고찰)

  • 우건화;이홍섭
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.153-156
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    • 1996
  • Over a 3 year period, 10 premature infants with less than 37 weeks of gestational age underwent ductal ligation for patent ductus arteriosus. No patient died during operations which were done at a mean age of 30 days. One late death at 2 months after operation was not directly attributed to operative procedure. Follow-ups were done in 9 survived patients from 2 to 26 months. Results suggest that surgical ligation is a feasible and effective method for treating symptomatic premature infants with patent ductus arteriosus.

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Clinical Analysis of Radiocephalic Fistula Using Side-to-side Anastomosis with Distal Cephalic Vein Ligation

  • Hong, Sung Yong;Yoon, Young Chul;Cho, Kwang-Hyun;Lee, Yang-Haeng;Han, Il-Yong;Park, Kyung Taek;Ko, Seong-Min
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.439-443
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    • 2013
  • Background: The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.