• 제목/요약/키워드: Surgical procedures, operative

검색결과 262건 처리시간 0.025초

Priority Setting in Damage Control Surgery for Multiple Abdominal Trauma Following Resuscitative Endovascular Balloon Occlusion of the Aorta

  • Heo, Yoonjung;Lee, Seok Won;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.181-185
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    • 2020
  • Damage control surgery (DCS) is an abbreviated laparotomy procedure that focuses on controlling bleeding to limit the surgical insult. It has become the primary treatment modality for patients with exsanguinating truncal trauma. Herein, we present the case of a 47-year-old woman with liver, kidney, and superior mesenteric vein (SMV) injuries caused by a motor vehicle collision. The patient underwent DCS following resuscitative endovascular balloon occlusion of the aorta (REBOA). In this case report, we discuss the importance of priority setting in DCS for the treatment of multisystem damage of several abdominal organs, particularly when the patient has incurred a combination of major vascular injuries. We also discuss the implications of damage control of the SMV, perihepatic packing, and right-sided medial visceral rotation. Further understanding of DCS, along with REBOA as a novel resuscitation strategy, can facilitate the conversion of uniformly lethal abdominal injuries into rescuable injuries.

Chronic dislocation of temporomandibular joint persisting for 6 months: a case report

  • Kim, Chul-Hwan;Kim, Dae-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.305-309
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    • 2012
  • Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

폐 aspergillosis의 외과적 치료 - 5예 보고 - (Surgical Treatment of Pulmonary Aspergillosis - 5 Cases -)

  • 신형주
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.64-71
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    • 1991
  • Pulmonary aspergillosis is a rare disease, most commonly presenting pre-existing cavitary disease. In Department of thoracic and cardiovascular surgery, Chonbuk National University, 5 patients have been recognized as having this disorder from 1988 to 1990, June. Of the 5 patients, three were female and two were male. Age ranged from 30 to 53 years, the average age was 38.4 years. The most common presenting symptoms were blood-tinged sputum, hemoptysis, coughing, and chest pain Pulmonary tuberculosis occupied 8-% of underlying pulmonary disease. The locations of lesion were right upper lobe in 3 cases, left upper lobe in 1, and right lower lobe in l. All of these patients were treated by surgical resection. The operative procedures were as follows: lobectomy, 3 cases; segmentectomy, 1 case; lobectomy and segmentectomy, 1 case. There was no death in early and late postoperative period. Empyema and dead space developed in two cases, respectively. The postoperative empyema was treated with open thoracostomy and the dead space was carefully observed. During follow-up, there was no recurrence.

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Treatment of acute high-grade acromioclavicular joint dislocation

  • Jeong, Jeung Yeol;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • 제23권3호
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    • pp.159-165
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    • 2020
  • Acromioclavicular (AC) joint dislocations account for about 9% of shoulder injuries. Among them, acute high-grade injury following high-energy trauma accounts for a large proportion of patients requiring surgical treatment. However, there is no gold standard procedure for operative treatment of acute high-grade AC joint injury, and several different procedures have been used for this purpose in clinical practice. This review article summarizes the most recent and relevant surgical options for acute high-grade AC joint dislocation patients and the outcomes of each treatment type.

Recent advances in minimally invasive surgery for gynecologic indications

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • 제35권2호
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    • pp.150-155
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    • 2018
  • Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

Early Surgery in Valvular Heart Disease

  • Kim, Dae-Hee;Kang, Duk-Hyun
    • Korean Circulation Journal
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    • 제48권11호
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    • pp.964-973
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    • 2018
  • The burden of valvular heart disease (VHD) is increasing with age, and the elderly patients with moderate or severe VHD are notably common. When to operate in asymptomatic patients with VHD remains controversial. The controversy is whether early surgical intervention should be preferred, or a watchful waiting approach should be followed. The beneficial effects of early surgery should be balanced against operative mortality and long-term results. Indications of early surgery in each of the VHD will be discussed in this review on the basis of the latest American and European guidelines.

Lymphaticovenular Anastomosis: Superficial Venous Anatomical Approach

  • Winaikosol, Kengkart;Surakunprapha, Palakorn
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.689-695
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    • 2022
  • Background Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results.

Septotomy를 행한 염전치의 교정치험예 (A CASE REPORT OF SEPTOTOMY OPERATED AFTER TREATMENT OF ROTATED TEETH)

  • 양원식;김영복;김종태
    • 대한치과의사협회지
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    • 제16권11호통권114호
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    • pp.849-856
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    • 1978
  • Relapse following rotational movement of the tooth is a common problem in orthodontic practice. To overcome such relapse, many procedures have been advocated: prolonged retention, permanent retention, over-rotation, rotation of teeth at an early age, surgical procedures such as gingivectomy, redressement force, septotomy, et cetra. A 23-year-old woman presented with Angle's Class I malocclusion and extreme rotation of maxillary central incisors. After 15 months' active therapy, septotomy was performed on maxillary central incisors and Howley retainer was applicated for the purpose of overcoming rotational relapse. During the 1 year post-operative observation, negligible, if any, rotational relapse occurred.

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재발된 위암 환자에서 발생한 악성 장폐쇄증의 수술적 치료 (The Surgical Treatment of Malignant Bowel Obstruction Caused by Recurrent Gastric Cancer)

  • 유병은;박중민;장유진;김종한;박성수;박성흠;김승주;목영재;김종석
    • Journal of Gastric Cancer
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    • 제8권3호
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    • pp.148-153
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    • 2008
  • 목적: 위암의 재발로 발생한 악성 장폐쇄증은 치료의 효과와 생존율을 향상시키기 위하여 적합하게 치료되어야 한다. 본 연구에서는 위암으로 수술 후 재발되어 악성 장폐쇄증이 발생한 경우 수술 방법에 따른 치료 효과와 생존율의 차이를 알아보았다. 대상 및 방법: 1998년 1월부터 2008년 3월까지 위암의 재발로 악성 장폐쇄증이 발생하여 수술적 치료를 받은 환자들의 의무 기록을 후향적으로 분석하였다. 수술 방법은 절제술, 장루술, 우회술로 나누었고 치료의 성공은 유동식 이상의 경구 섭취가 가능한 것으로 보았다. 결과: 42명의 환자에 대해 46회의 수술이 시행되었으며 절제술이 12회, 장루술이 24회, 위회술이 10회이었다. 입원기간과 유동식 이상의 경구 섭취까지의 기간은 장루술이 가장 짧았다. 수술 후 합병증은 10예(21.7%)에서 있었고 수술 후 30일 이내에 사망한 경우는 4예(8.7%)이었다. 수술 방법에 따른 생존율의 차이는 없었다. 결론: 위암의 재발로 발생한 악성 장폐쇄증의 수술적 치료로 장루술은 입원일과 경구 섭취까지의 기간이 다른 수술법에 비해 짧기 때문에 일부 환자들에서 좋은 선택이 될 수 있다. 수술 방법에 따른 생존율의 차이는 없었으며 이는 악성 장폐쇄증의 경우 근치적 수술이 어려운 경우가 대부분이기 때문으로 생각된다.

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난관복원술전에 실시한 불임검사의 임신율 예측지표로서의 유용성에 관한 연구 (The Usefulness of Pre-operative Infertility Work-up in Assessing the Reversal Feasibility)

  • 강병문
    • Clinical and Experimental Reproductive Medicine
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    • 제20권1호
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    • pp.71-78
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    • 1993
  • Since the successful advent of IVF-ET, reproductive surgeons have been forced to compare pregnancy outcomes of surgical procedures for tubal infertility with those of IVF-ET. The current study was designed in an effort to determine the usefulness of pre-operative infertility work-up, especially diagnostic laparoscopy, in predicting the pregnancy rate and in assessing the reversal feasibility. 109 patients who underwent a microsurgical tubal reversal were reviewed. The patients were followed over one year. The total intrauterine pregnancy, spontaneous abortion, and ectopic pregnancy rates were 66.4%, 3.7%, and 7.3%, respectively. The result showed that the use of loupe might increase the chance of the ectopic pregnancy. I found that the final tubal length, especially the longest tubal length, the site of reanastomosis, and the methods of sterilization affected the pregnancy rates. A 85% intrauterine pregnancy rate was achieved in the patients with good preoperative assessments(Group II-1). There was only 10% incidence of intrauterine pregnancy in the patients with bad assessments(Group II-2). It is concluded that the pre-operative infertility work-up, especially diagnostic laparoscopy, is a good diagnostic tool in assessing the reversal feasibility.

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