• Title/Summary/Keyword: combined surgery

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Traumatic Right Diaphragmatic Rupture Combined with Avulsion of the Right Kidney and Herniation of the Liver into the Thorax

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin;Ahn, Jae-Hong
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.76-79
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    • 2011
  • Right-sided diaphragmatic rupture is less common and more difficult to diagnose than left-sided lesion. It is rarely combined with the herniation of the abdominal organs into the thorax. High level of suspicion is the key to early diagnosis, and a delay in diagnosis is implicated with a considerable risk of mortality and morbidity. We experienced a case of right-sided diaphragmatic rupture combined with complete avulsion of the right kidney and herniation of the liver into the thoracic cavity.

Endoscopic Treatment of Chronic Subdural Hematoma Combined with Inner Subdural Hygroma

  • Yoon Hwan Park;Kwang-Ryeol Kim;Ki Hong Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.552-561
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    • 2023
  • Objective : A chronic subdural hematoma (CSDH) is a collection of bloody fluid located in the subdural space and encapsulated by neo-membranes. An inner subdural hygroma (ISH) is observed between the inner membrane of a CSDH and the brain surface. We present six cases of CSDH combined with ISH treated via endoscopy. Methods : Between 2011 and 2022, among the 107 patients diagnosed with CSDH in our institute, six patients were identified as presenting with CSDH combined with ISH and were included in this study. Preoperative computerized tomography (CT) and magnetic resonance imaging (MRI) were performed simultaneously, and endoscopic surgery for aspiration of the hematoma was performed in all cases of CSDH combined with ISH. Results : The mean age of patients was 71 years (range, 66 to 79). The patients were all male. In two cases, the ISH was not identified on CT, but was clearly seen on MRI in all patients. The inner membrane of the CSDH was tense and bulging after draining of the CSDH in endoscopic view due to the high pressure of the ISH. After fenestration of the inner membrane of the CSDH and aspiration of the ISH, the membrane was sunken down due to the decreasing pressure of the ISH. There was one recurrence in post-operative 2-month follow up. The symptoms improved in all patients after surgery, and there were no surgery-related complications. Conclusion : CSDH combined with ISH can be diagnosed on imaging, and endoscopic surgery facilitates safe and effective treatment.

Polydeoxyribonucleotide and Microlens Array-type, Nanosecond-domain Neodymium:Yttrium-aluminum-garnet Laser Treatment for Scars from Costal Cartilage Harvest Surgery: Case Series of 9 Patients

  • Ahn, Keun Jae;Kim, Do Yeon;Cheon, Gwahn-Woo;Park, Hyun Jun;Ahn, Tae Hwan
    • Medical Lasers
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    • v.10 no.2
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    • pp.90-95
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    • 2021
  • Background and Objectives Surgery for harvesting costal cartilage is often required for revision septorhinoplasty due to a lack of septal cartilage in patients with a severely contracted nose, and postoperative scarring on the anterolateral rib cage commonly requires additional treatment. This study aimed to evaluate the therapeutic efficacy and safety of combined polydeoxyribonucleotide (PDRN) and microlens array (MLA)-type nanosecond-domain neodymium (Nd):yttrium-aluminum-garnet (YAG) laser treatment for postoperative scars after costal cartilage harvest surgery. Materials and Methods Nine Korean patients with scars after costal cartilage harvest surgery treated with PDRN injections and MLA-type Nd:YAG laser treatments were retrospectively reviewed. Results Most of the scar lesions exhibited clinical improvement at 2 weeks after PDRN and MLA-type nanosecond-domain laser treatments, and the lesions further improved after adding more treatment sessions. The median Vancouver Scar Scale (VSS) score decreased from 6 (interquartile range [IQR]: 6-7) before combined intralesional PDRN injection and MLA-type, nanosecond-domain Nd:YAG laser treatments to 3 (IQR: 2-4) thereafter. Patient satisfaction after the combination treatments was rated as satisfactory. None of our patients reported major adverse events. Conclusion This case series study demonstrated that combined PDRN and MLA-type, nanosecond-domain Nd:YAG laser treatments are effective and safe for treating scars from costal cartilage harvest surgery.

A Combined Therapy of Steroid Injection, Silicone Gel Sheeting, and Laser for Hypertrophic Scar and Keloid (스테로이드 주사, 실리콘 겔 판, 레이져 병합요법을 이용한 부푼 흉터와 흉터종의 치료)

  • Choi, Sang Rok;Yoon, Min Ho;Dong, Eun Sang;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.700-705
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    • 2006
  • Purpose: For hypertrophic scars and keloids no universally effective treatment modality exists. Surgical revision, intralesional steroid injection, silicone gel sheeting, pressure, laser, and others have been used with variable success, but many treatments are associated with high recurrence rates. Although optimal treatment remains undefined, successful treatment can be obtained through a combined therapeutic approach. Methods: We used three therapeutic modalities in combination, which are intralesional injection of triamcinolone acetonide, silicone gel sheeting, and 585 nm flashlamp-pumped pulsed dye laser. Fifty-eight cases of hypertrophic or keloid scar were treated by combined therapeutic regimen for mean period of 18 months. The changes of thickness, color, and pliability of scars were evaluated with clinical photographs by grading scale. Results: As summing the grades and categorizing the result into three group, we obtained 28% good, 67% fair, and 5% poor results. There was a desirable improvement of scars with insignificant adverse effects. Conclusion: Combination of intralesional steroid injection, silicone gel sheeting, and pulsed dye laser can lead to successful treatment of hypertrophic scar and keloid.

Combined Bilateral Lung Transplantation and Off-Pump Coronary Artery Bypass

  • Do, Young Woo;Jung, Hee Suk;Lee, Chang Young;Lee, Jin Gu;Youn, Young-Nam;Paik, Hyo Chae
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.461-464
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    • 2016
  • Coronary artery disease has historically been a contraindication to lung transplantation. We report a successful combined bilateral lung transplantation and off-pump coronary artery bypass in a 62-year-old man. The patient had a progressive decline in lung function due to idiopathic pulmonary fibrosis and a history of severe occlusive coronary artery disease.

A CLINICAL STUDY OF THE NASAL BONE FRACTURES (비골 골절의 임상적 고찰)

  • Yang, In-Seok;Yeo, Hwan-Ho;Kim, Yong-Kyun;Byun, Woong-Rae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.419-427
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    • 1994
  • Because of the prominence of the nose and its central location, it is the most frequently encountered fractures in the face. Yet reports about the nasal bone fractures are virtually rare in the oral and maxillofacial surgical literatures. This is a retrospective study on 19 nasal bone fractures treated in Chosun university hospital Department of Oral & Maxillofacial Surgery from Jan. 1991 to Sep. 1993, under admission to our Dept. and the obtained results were as follows. 1. Of the 240 patients with facial bone fractures, 28 patients suffered nasal fractures(12%) and male to female ratio was 5.3:1. 2. The most frequent cause was traffic accidents(39%)m, the next fall down(36%), first blow(4%). 3. The age frequency was the highest in the fifth decade (32%). 4. Clinical classification of nasal fractures was simple fractures(74%), combined fractures(26%), and single fractures(37%), combined fractures(63%). 5. The most frequently combined site was maxilla(50%). 6. Treatments of nasal fractures were closed reduction(63%), open reduction(5%), and secondary rhinoplasty(32%). 7. The initial treatment time from accident was 1.7 days in single fractures, and 3.5 days in combined fractures, and the period of splint retained was about 8.2 days in single fracture, about 8.7 in combined fracture. 8. It was necessary to treat secondarily in delayed treatment, and all treatment methods showed relatively good prognosis. 9. Closed reduction was treated under local anesthesia, but open reduction & secondary rhinoplasty was treated under general anesthesia except 1 case. 10. The complications were disturbance of swellings 5 cases, ethetic problem 5 cases, epiphora 3 cases, abnormal sensation 6 cases in relation with other fractures.

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Surgical Treatment of Pulmonary Aspergillosis (폐국균증의 외과적 치료)

  • 하종곤
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.41-47
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    • 1991
  • From January, 1980, to August, 1989, 23 patients underwent thoracotomy for treatment of pulmonary aspergillosis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 12 male and 11 female patients ranging from 23 years to 61 years old[mean age, 40.7 years]. The main clinical symptoms were hemoptysis[91.3%], cough[65.2%], chest pain[34.5%]. Sixteen patients[69.6%] had simple aspergilloma and 7[30.4%] had complex aspergilloma. The most common indication for operation was a hemoptysis, indeterminate mass, chronic cough, or obstructed bronchus. Anatomical location of lesion was mainly located upper lobe [82.6%] and most of cases were managed by lobectomy. Postoperative pathologic findings showed that 13 case[56.5%] were combined with tuberculosis, two were combined with bronchiectasis and two were combined with lung tumor, but 6 cases were not combined with other disease. Early complications occurred in 33.5% of patients with simple aspergilloma and in 85.7% of patients with complex aspergilloma. But there was no hospital death.

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Combined Free Flap in Reconstruction of Lower Extremity with Large Soft Tissue Defect (복합 유리 피판을 이용한 광범위한 연부 조직 결손 하지의 재건)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kang, Ho-Jung
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.120-129
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    • 1999
  • There were many difficulties in the treatment of extensive, massive, and composite defect in the lower extremity until early 1980's. Recently, microscopic reconstruction of wide soft tissue defect is popularized. But, the combined flap, which requires wide coverage of lower extremity after soft tissue sarcoma excision or traffic accident, is still challenging to the orthopaedic surgeons. We experienced 12 cases of combined scapular and latissimus dorsi flap from 1983 to 1997 in the lower extremity reconstruction of soft tissue defect with satisfactory result. There were no serious donor site complications such as functional disturbance of shoulder joint.

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The effect of flap operation and metronidazole gel combined therapy on the treatment of the juvenile periodontitis (치은박리소파술시 metronidazole gel 병용이 유년성치주염 치료에 미치는 영향)

  • Shin, Dong-Hwan;Lee, Dong-Won;Moon, Ik-Sang
    • Journal of Periodontal and Implant Science
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    • v.31 no.4
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    • pp.765-775
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    • 2001
  • The aim of the study was to investigate the effect of surgical therapy combined with the usage of metronidazole gel in the treatment of juvenile periodontitis by comparing clinical indices of flap operation along with application of metronidazole gel and flap operation only. Comparing clinical indices of the baseline, 3 months after surgery, 6 months after surgery statistically, the results are as follows; 1. Bleeding on probing (BOP) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). BOP increased 0.9% in the control group 6 months after surgery, while in the experimental group, decreased 4.7% (p>0.05). However, there was no statistically significant difference in these groups (p>0.05). 2. Pocket probing depth (PPD) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). PPD increased 0.lmm in the control group 6 months after surgery, while in the experimental group, no increase of the depth could be observed (p>0.05). However, there was no statistically significant and difference in these groups (p>0.05). 3. Loss of attachment level(LOA) was decreased significantly both in the experimental group and the control group at 3 months after surgery (p<0.05). LOA increased 0.2mm in the control group 6 months after surgery, while in the experimental group, increased 0.3mm However, there was no statistically significant difference in these groups (p>0.05). In conclusion, flap operation was effective on the treatment of juvenile periodontitis. However, combined therapy of metronidazole gel could not give rise to any significant adjunctive effect on the treatment outcome.

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