• 제목/요약/키워드: Total surgical resection

검색결과 340건 처리시간 0.022초

소아 궤양성 대장염의 수술적 치료 성적 (Surgical Treatment of Ulcerative Colitis in Children)

  • 김지훈;김현영;정성은;박귀원;김우기
    • Advances in pediatric surgery
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    • 제11권2호
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    • pp.141-149
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    • 2005
  • Ulcerative colitis, an inflammatory bowel disease, is primarily managed medically with a combination of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, indications and outcome of surgical management of 21 patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were reviewed. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management after diagnosis and 8 patients (38 %) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53 %) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure as a result of sclerosing cholangitis. In 8 patients who received surgical management, the indications for operation were, 1 patient sigmoid colon perforation and 7 patients intractability despite medical management. The perforated case had a segmental colon resection and the other 7 patients underwent total colectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. and 1 is still on medical management because of mild persistent hematochezia after surgery. Six other operated patients are doing well without medical therapy. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation are present. Total colectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.

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갑상선 질환의 외과적 절제술에 대한 국소적 합병증 (Local Complication after Surgical Resection for Thyroid Disease)

  • 조현진;조태형
    • 대한두경부종양학회지
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    • 제11권1호
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    • pp.9-17
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    • 1995
  • This study was retrospectively reviewed and analysis of postoperative local complication on all patient undergoing thyroid operation of 242 cases of thyroid disease, at Department of General Surgery, Chosun University Hospital from January 1988 to December 1992. The result were follow: Postoperative local complication are as follow; 52 cases of transient hypocalcemia, 7 cases of thansient hoarseness, 3 cases of permanent hypocalcemia, 2 cases of permanent hoarseness, and other local complication were postoperative bleeding with airway obstraction, hematoma, infection. In pathologic classification according to complicative patients; The most common frequency of complication in benign disease was Graves' disease with 13 cases(54.2%), and the most frequency of complication in malignance disease was follicalar adenocarcinoma with 7 cases(53.9%). The frequency of complication according to operation procedure were unilateral lobectomy in 31 cases(19.9%), subtotal thyroidectomy in 15 cases(39.5%), near total thyroidectomy in 12 cases (44.4%), and total thyroidectomy in 10 cases(55.6%). There was a significant relationship between extent of operative procedure and frequency of complication. The incidence of local complication after thyroid resection was 57 of 196(29.1%) in the benign disease that was 15 of 26(57.7 %) in the intrathyroidal carcinoma and 13 of 20(65.0%) in the extrathyroidal carcinoma. There was significant different in frequency of local complication according to invasion and malignance of pathologic lesion. The most frequent complication after thyroid resection is transient hypocalcemia ; 39 of 196(19.9%) in the benign disease, 7 of 26(26.9%) in the intrathyroida1 carcinoma, and 6 of 10(30.0%) in the extrathyroidal carcinoma. Their complication rate increased in direct relationship to the invasion and malignance of pathologic lesion, but there was no statistically significant. Transient hypocalcemia was encountered in 52 cases of the total 242 patient(21.9%) ; 29 of 156(18.6%) after unilateral lobectomy, 9 of 38(23.7%) after subtotal thyroidectomy, and 5 of 18(27.8 %) after total thyroidectomy. The relation ship between temporal hypocalcemia and the extent of surgery was not statistically significant.

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기관지 확장증의 임상적 고찰 (Surgical Consideration of Bronchiectasis An Analysis of 64 Cases)

  • 이두연;조범구;홍승록
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.187-192
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    • 1976
  • During the past fifteen and one half years, a total of 64 cases of bronchiectasis were treated by pulmonary resection. The diagnosis of bronchiectasis was made relatively easily and accurately with bronchography. The average age of onset in the present series was 21 years old. Preoperative bronchograms were taken in all cases and revealed involvement of the left lower lobe in 14 cases, the right lower lobe in one case, the right upper lobe in 3 cases, the left lower lobe anal lingular segment in 9 cases, and multilobar involvement in cases. Bronchographically 18 tubular and II saccular and 2 cystic and 2 saccular and tubular forms were noted. Various types of pulmonary resection were performed on 59 cases. Complication developed in two cases. One showed pulmonary vein bleeding and was treated completely by reoperation; the other case developed empyema.

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식도암의 임상적 고찰 (Surgical Treatment of Esophageal Cancer)

  • 최진호
    • Journal of Chest Surgery
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    • 제28권3호
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    • pp.287-292
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    • 1995
  • From March 1989 to June 1994, 24 casesof esophageal cancer were treated surgically. Among 24, male was 22 cases, female was 2 cases, and the age ranged from 46 to 75, the mean was 59.8. Symptoms were dysphagia[86.9% , weight loss[65.2% and retrosternal pain or discomfort[47.8% . The tumor was located cervical esophagus in two, upper esophagus in three, middle esophagus in 12 and lower esophagus in 7. Among 24 patients, 22 were curative resection, partial esophagectomy with esophagogastrostomy[18 cases or colon interposition [3 cases , with total esophagectomy with musculocutaneous flap[1 case , with feeding jejunostomy or gastrostomy in two cases.Postoperative complications revealed 10 patients[45.4% , as followed ; pleural effusion and pneumonia in 5, passage disturbance in 4, empyema and wound infection in 3, esophagopleural fistula and sepsis in 2, anastomotic site leakage and respiratory failure in each 1. The operative mortality was 13.6 % [3/22 and causes of death were respiratory failure in 1 case and sepsis in 2 cases.During follow-up work, 8 cases died during follow-up period, mean survival time was 15.2 months in curative resection group. One year survival rate was 55.3% in resected group. Also, cancer recurrence revealed in 1 cases.

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기관지확장증의 외과적 요법 (Surgical Treatment of Bronchiectasis)

  • 이영욱
    • Journal of Chest Surgery
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    • 제15권1호
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    • pp.15-20
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    • 1982
  • During the past ten years from 1972 to 1981, a total of 100 cases of bronchiectasis were treated by pulmonary resection at C.A.F.G.H. Pulmonary tuberculosis and frequent U.R.I. were the most frequent associated disease and encountered in 54% in this series. Various types of pulmonary resection were performed on 100 patients; left lower lobectomy in 40 cases, left lower lobectomy and lingular segmentectomy In 29 cases, right lower lobectomy in 12 cases, right middle and lower lobectomy in 12 cases, lingular segmentectomy in 3 cases, left pneumonectomy in 3 cases and both lower lobectomy in 1 case. Complications developed in 9 cases and 1 case among them died of sepsis following secondary opera-tion. Among complications of 9 cases, postoperative atelectasis showed in 4 cases, hemorrhage in 2 cases, bronchopleural fistula in 2 cases, pulmonary edema in 1 case. Complications were treated by conservative and secondary operative management with satisfactory result except one death. Remainders without complication showed good result without symptom in postoperative and follow-up periods.

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두개외 내경동맥 동맥류의 외과적 절제 -치 험 2례- (Surgical Resection of the Extracranial Internal Carotid Arterial Aneurysm -Report of two cases-)

  • 이문환;박주철;유세영
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.103-106
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    • 1996
  • 본논문은 포낭(saccular)형인 내경동맥 동맥류의 치험 2례를 기술하였다. 수술은 전신마취하에 내경동맥 동맥류 절제후 shunt없이 단단문합하였다. 환자들은 모두 신경학적 후유증없이 회복되었다.

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A Case of Brachial Plexus Schwannoma

  • Kim, Young-Woo;Ahn, Sung-Ki;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • 제39권5호
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    • pp.396-399
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    • 2006
  • Brachial plexus schwannoma is rare. A case of a 28-year old woman who complained of a palpable mass in the right axilla is presented. She had previous incisional biopsy on the axillary mass. Brachial plexus magnetic resonance imaging revealed a well circumscribed contrast enhancing mass on the right distal cord of the brachial plexus. EMG revealed normal. Tumor resection was performed with the transaxillary approach. Though dense granulation tissue obscured normal brachial plexus nerve anatomy, using the surgical microscope and nerve stimulator, grossly total tumor resection was performed. She is free of any neurologic symptom at three months postoperatively.

Alternative Treatment of Osteoma Using an Endoscopic Holmium-YAG Laser

  • Han, Ba Leun;Shin, Ho Seong
    • Archives of Plastic Surgery
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    • 제39권4호
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    • pp.422-425
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    • 2012
  • Osteoma is one of the most common tumors of the cranial vault and the facial skeleton. For osteoma in the facial region, endoscopic resection is widely used to prevent surgical scarring. Tumors in a total of 14 patients were resected using an endoscopic holmium-doped yttrium aluminium garnet (Ho:YAG) laser with a long flexible fiber. Aside from having the advantage of not leaving a scar due to the use of endoscopy, this procedure allowed resection at any position, was minimally invasive, and caused less postoperative pain. This method yielded excellent cosmetic results, so the endoscopic Ho:YAG laser is expected to emerge as a good treatment option for osteoma.

A comparison of delayed versus immediate reconstruction following lower-extremity sarcoma resection

  • Zhou, Sarah;Azzi, Alain J;Safran, Tyler;Zadeh, Teanoosh
    • Archives of Plastic Surgery
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    • 제47권1호
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    • pp.49-53
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    • 2020
  • Background Identifying patients who may be at high risk for wound complications postsarcoma resection and reconstruction is essential for improving functional outcomes and quality of life. Currently, the effect of timing on sarcoma reconstruction has been poorly investigated. The purpose of this study was to compare outcomes of delayed and immediate reconstruction in the setting of sarcoma resection requiring flap reconstruction in the lower extremity. Methods A retrospective review of the senior author's sarcoma reconstruction patients from January 2005 to July 2017 was completed. All patients undergoing flap reconstruction of the lower extremity were included. Complications in the early postoperative period were compared between delayed and immediate reconstructive procedures. Results A total of 32 patients (7 delayed, 25 immediate) were included in this study. There was a significantly increased rate of overall complications (100% vs. 28.0%, P=0.001) and rate of hematomas (28.6% vs. 0.0%, P=0.042) in the delayed reconstruction group. Other complications including dehiscence, seroma, infection, venous thrombosis, and total/partial flap loss were also increased in the delayed reconstruction group, but this was not considered to be significant. Conclusions This study suggests that delayed reconstruction following sarcoma resection of the lower extremity had a higher incidence of overall complications and hematoma formation. We emphasize the importance of early plastic and reconstructive surgeon referral and the necessity to closely monitor delayed reconstruction patients for complications.

Borrmann 제4형 위암의 치료성적 (Outcome of Surgical Treatment for Borrmann Type 4 Gastric Cancer)

  • 박성수;김성훈;김승주;김종석;목영재
    • Journal of Gastric Cancer
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    • 제3권4호
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    • pp.221-225
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    • 2003
  • Purpose: The prognosis for Borrmann type 4 gastric cancer is dismal although therapies for gastric cancer have been developed. We investigated the outcomes for Borrmann type 4 gastric cancers compared to those for other types of cancer. Materials and Methods: Between 1993 and 2000, 777 patients with advanced gastric cancer underwent surgical resection at the Department of Surgery, Korea University Hospital. The clinicopathologic features of 138 patients with Borrmann type 4 carcinomas of the stomach were retrospectively reviewed from the database of gastric cancer. The results were compared with those of 639 patients with other types of gastric carcinomas. Results: Patients with Borrmann type 4 carcinomas tended to be younger and to have larger tumors. The location, the depth of invasion, lymph node metastasis, and distant metastasis were significantly different between the two groups. Patients with Borrmann type 4 carcinomas had a more advanced stage than patients with other types of carcinomas. The analysis of the treatment factors revealed that total gastrectomies were more frequent in the group with Borrmann type 4 carcinomas and that the curative resection rate of patients with Borrmann type 4 gastric carcinomas was lower than that of patients with other types of gastric carcinomas (P<0.001). The 5-year survival rate for Borrmann type 4 gastric cancer was $19.4\%$ and that for other types was $52.9\%$ (P=0.001). In curative cases, the 5-year survival rates were $32.8 \%$ for patients with Borrmann type 4 gastric carcinomas and $63.4\%$ for other types of carcinomas (P=0.001). Conclusion: Borrmann type IV gastric cancer has more advanced features and a poorer prognosis than other types of gastric cancer. Improving the prognosis for patients with Borrmann type 4 gastric cancer requires early detection and a curative resection.

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