• Journal of Yeungnam Medical Science
• /
• v.35 no.1
• /
• pp.7-16
• /
• 2018

Oronasal bleeding that continues despite oronasal packs or recurs after removal of the oronasal packs is referred to as intractable oronasal bleeding, which is refractory to conventional treatments. Severe craniofacial injury or tumor in the nasal or paranasal cavity may cause intractable oronasal bleeding. These intractable cases are subsequently treated with surgical ligation or endovascular embolization of the bleeding arteries. While endovascular embolization has several merits compared to surgical ligation, the procedure needs attention because severe complications such as visual disturbance or cerebral infarction can occur. Therefore, comprehensive understanding of the head and neck vascular anatomy is essential for a more effective and safer endovascular treatment of intractable oronasal bleeding.

• Journal of Chest Surgery
• /
• v.26 no.12
• /
• pp.915-919
• /
• 1993

The management of Patent Ductus Arteriosus[PDA] with heart failure and cardiac cachexia in premature infants have been a disturbing and controversial problem in the field of pediatric cardiovascular surgery.We analysed our experiences to determine the rationale of surgical closure of PDA in infants . During a period of 7 years from January 1986 to December 1992, 12 infants under 2 months of age underwent operations for "hemodynamically significant" PDA which had caused severe heart failure.There were 6 male and 6 female patients. Their mean gestational age was 33.8 weeks and their mean body weight was 1990 g. ranged from 710 g. to 2900 g. Mean age at operation was 28.5days. Seven patients had history of Indomethacin trial. All patients were operated with double ligation technique under general anesthesia.There was no mortality and blood transfusion was not necessary in any patient during the operation.In all cases, we could confirm the complete closure of PDA after operation by follow-up echocardiography.Two patients died during their hospital stay and 1 patient died at 6 months after operation. The causes of death were sepsis with congestive heart failure, necrotizing entero colitis and pneumonia respectively.We can not detect any operation related complication which resulted in permanent sequelae as well as delayed complications related to nerve damage. These results indicate that surgical ligation of PDA in infants with severe heart failure is relatively safe and effective.effective.

• Journal of Korean Neurosurgical Society
• /
• v.46 no.1
• /
• pp.71-73
• /
• 2009

In surgical planning of the parasagittal meningioma, invasion and occlusion of the superior sagittal sinus are important factors. When tumor is located within anterior 1/3, or when angiographic finding shows total occlusion of superior sagittal sinus, it is regarded that the ligation of superior sagittal sinus is safe. We report a case of parasagittal meningioma in 59-year-old male patient with complete occlusion of superior sagittal sinus which was confirmed by preoperative angiography, who developed temporary neurologic deterioration after superior sagittal sinus ligation and resection.

• Journal of Trauma and Injury
• /
• v.29 no.3
• /
• pp.89-92
• /
• 2016

Non-surgical traumatic chylothorax following blunt chest trauma is rare, with only a few cases having been reported. In general, conservative treatment measures are recommended as initial management of traumatic chylothorax; these include closed thoracostomy, dietary restriction, and parenteral nutrition. There are few reports of surgery for traumatic chylothorax. We report our experience with thoracic duct ligation using video-assisted thoracoscopic surgery in a patient with chylothorax following blunt chest injury with associated fractures of the thoracic spine.

• Journal of Chest Surgery
• /
• v.24 no.4
• /
• pp.390-396
• /
• 1991

From July 1984 to September 1990, 316 patients of congenital heart diseases were operated and 15 patients died. Hospital mortality was 4.75%. Five patients of 73 PDA had residual shunt after operation: 4 were ligated under support of Dacron patch, 1 was closed through the pulmonary arteriotomy under CPB. 3 patients were reoperated. No patient had residual shunt or reopening among the patients of simple ligation or division and suture. During the ligation of PDA, Dacron patch for protection from tearing may disturb the complete interruption of shunt. If the tissue around the ductus arteriosus looks weak or fragile, division and suture may be more reliable other than ligation with supporting patch. If the septal leaflet of tricuspid valve is adherent around the VSD, remained opening of VSD may be closed with simple suture directly. In these cases, the incidence of postoperative residual shunt is as high as the incidence of more large VSD closed with patch [10.9%: 9.6%]. During the direct closure of remained opening of VSD, another leaking route should be looked for carefully beneath the septal leaflet of tricuspid valve.

• Archives of Craniofacial Surgery
• /
• v.25 no.1
• /
• pp.44-47
• /
• 2024

Recurrent parotid sialocele is rare and challenging to treat. Treatment options are limited for cases of parotid sialocele that recur despite ductal ligation. This case study presents a patient who underwent wide excision of the right buccal mucosa due to squamous cell carcinoma. During the wide excision, a segment of the parotid duct was excised, and ductal ligation was performed to prevent the occurrence of a sialocele, followed by reconstruction using a folded anterolateral thigh free flap. Twenty-two days after surgery, parotid sialocele occurred despite the initial ductal ligation and subsequent ductal ligation was performed; however, the sialocele recurred. As an alternative therapeutic option, a transdermal scopolamine patch was applied for 3 weeks, with one patch used every 3 days. The results were encouraging, with complete resolution of the sialocele. A transdermal scopolamine offers a noninvasive, convenient method of treating parotid sialocele with minimal side effects. The successful outcome of this case suggests that a transdermal scopolamine can be an effective therapeutic option for recurrent parotid sialocele in conjunction with surgical treatment.

• Annals of Hepato-Biliary-Pancreatic Surgery
• /
• v.27 no.3
• /
• pp.227-240
• /
• 2023

Hilar cholangiocarcinomas are highly aggressive malignancies. They are usually at an advanced stage at initial presentation. Surgical resection with negative margins is the standard of management. It provides the only chance of cure. Liver transplantation has increased the number of 'curative' procedures for cases previously considered to be unresectable. Meticulous and thorough preoperative planning is required to prevent fatal post-operative complications. Extended resection procedures, including hepatic trisectionectomy for Bismuth type IV tumors, hepatopancreaticoduodenectomy for tumors with extensive longitudinal spread, and combined vascular resection with reconstruction for tumors involving hepatic vascular structures, are challenging procedures with surgical indications expanded. Liver transplantation after the standardization of a neoadjuvant protocol described by the Mayo Clinic has increased the number of patients who can undergo operation.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.10
• /
• pp.1200-1209
• /
• 2001

Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

• Journal of Chest Surgery
• /
• v.26 no.5
• /
• pp.403-408
• /
• 1993

The atrioventricular node reentrant tachycardia[AVNRT] is a common type of supraventricular tachycardias. Recently we experienced two cases of AVNRT. One is AVNRT with severe aortic regurgitation[grade IV] and the other is AVNRT with patent ductus arteriosus. Dissection of perinodal tissue has been successfully carried out in the beating heart under the normothermic cardiopulmonary bypass, and aortic valve replacement and ligation of patent ductus arteriosus were also performed, respectively. Postoperatively, permanent atrioventricular block was not occured and AVNRT was not developed during the follow up. We propose that the surgical dissection of perinodal tissue is a simple and effective treatment for the patient with refractory AVNRT.

• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.169-173
• /
• 2017

Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.