• Journal of Chest Surgery
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• 제52권6호
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• pp.385-391
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• 2019

Background: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. Methods: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. Results: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. Conclusion: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

• 대한족부족관절학회지
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• 제14권1호
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• pp.66-72
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• 2010

Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.75-79
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• 2015

Background: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. Methods: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. Results: We found that bone union was achieved in all patients, and the mean union periods were $20.7{\pm}3.34$ and $20.3{\pm}3.91$ weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were $91.4{\pm}7.97$, $33.4{\pm}1.15$, and $90.8{\pm}2.23$ for group 1, and $95.2{\pm}1.53$, $33.3{\pm}1.43$, and $90.17{\pm}1.85$ for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. Conclusions: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.

• Journal of Chest Surgery
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• 제39권3호
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• pp.255-259
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• 2006

식도암의 수술은 일반적으로 개흉술과 개복술이 동시에 시행되며 경우에 따라 경부절개까지 추가되므로 다른 수술에 비해 이환율과 사망률이 상대적으로 높다. 수술에 따른 합병증을 최소화하고 빠른 회복을 유도하기 위하여 최근에는 양성 질환뿐만 아니라 악성 종양의 수술에도 저 침습적인 방법이 많이 시행되고 있으나, 식도암에는 적극적으로 적용되고 있지는 않으며 아직 국내보고도 없다. 최근 저자들은 8예의 식도암 환자에게 저 침습 수술을 적용하였기에 수술 기법을 중심으로 보고하는 바이다.

• Journal of Gastric Cancer
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• 제21권4호
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• pp.352-367
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• 2021

Purpose: Minimally invasive gastrectomy is a promising surgical method with well-known benefits, including reduced postoperative complications. However, for total gastrectomy of gastric cancers, this approach does not significantly reduce the risk of complications. Therefore, we aimed to evaluate the incidence and risk factors for the severity of complications associated with minimally invasive total gastrectomy for gastric cancer. Materials and Methods: The study included 392 consecutive patients with gastric cancer who underwent either laparoscopic or robotic total gastrectomy between 2011 and 2019. Clinicopathological and operative characteristics were assessed to determine the features related to postoperative complications after minimally invasive total gastrectomy. Binomial and multinomial logistic regression models were used to identify the risk factors for overall complications and mild and severe complications, respectively. Results: Of 103 (26.3%) patients experiencing complications, 66 (16.8%) and 37 (9.4%) developed mild and severe complications, respectively. On multivariate multinomial regression analysis, independent predictors of severe complications included obesity (OR, 2.56; 95% CI, 1.02-6.43; P=0.046), advanced stage (OR, 2.90; 95% CI, 1.13-7.43; P=0.026), and more intraoperative bleeding (OR, 1.04; 95% CI, 1.02-1.06; P=0.001). Operation time was the only independent risk factor for mild complications (OR, 1.06; 95% CI, 1.001-1.13; P=0.047). Conclusions: The risk factors for mild and severe complications were associated with surgery, indicating surgical difficulty. Surgeons should be aware of these potential risks that are related to the severity of complications so as to reduce surgery-related complications after minimally invasive total gastrectomy for gastric cancer.

• Journal of Chest Surgery
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• 제56권5호
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• pp.336-345
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• 2023

Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

• 전자통신동향분석
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• 제36권5호
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• pp.9-20
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• 2021

A technology to replace the traditional blood sampling method for glucose monitoring has been sought for a long time. It is now possible to measure the blood glucose change rate continuously for more than 24 hours using a minimally invasive method that does not involve blood collection. Furthermore, various technology development efforts are being made for innovative diabetes management through intermittent or continuous blood glucose monitoring in a non-invasive manner. In this paper, we present an overview of diabetes and the need for continuous blood glucose measurement techniques., and then introduce various non-invasive blood glucose measurement techniques currently being studied. In addition, through research and analysis of the recent commercialization development status of minimally invasive, non-invasive, and wearable continuous blood glucose measurement technologies, we examine global development trends of future technologies.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.371-374
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• 2014

Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1015-1018
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• 1997

개심술 특히 판막 질환의 수술에 있어서 정중 흉부 절개의 방법은 현재까지 가장 널리 사용되는 절개 방 법이다 그러나 최근 들어 판막 질환의 수술시 우측 흉골외측 절개를 이용하여 절개부위를 최소화함으로서 많은 장점을 가질 수 있는 방법이 보고되고 있다. 고려대학교 부속 구로병원에서는 우측 흉골외측 절개와 심방 중격 절개를 이용하여 1례의 승모판막 치환 술을 시행하였는데, 이 방법의 사용시 기존의 정중 흉부 절개의 방법과 비교하여 특이한 합병증이나 어려움 을 경험할 수는 없었고,훌릉한 수술 시야를 확보할 수 있었으며,환자는 수술 절개 부위에 대하여 미용적인 면에서 매우 만족하였다.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.245-250
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• 2007

Tubular retractor system as a minimally invasive surgery (MIS) technique has many advantages over other conventional MIS techniques. It offers direct visualization of the operative field, anatomical familiarity to spine surgeons, and minimizing tissue trauma. With technical advancement, many spinal pathologies are being treated using this system. Namely, herniated discs, lumbar and cervical stenosis, synovial cysts, lumbar instability, trauma, and even some intraspinal tumors have all been treated through tubular retractor system. Flexible arm and easy change of the tube direction are particularly useful in contralateral spinal decompression from an ipsilateral approach. Careful attention to surgical technique through narrow space will ensure that complications are minimized and will provide improved outcomes. However, understanding detailed anatomies and keeping precise surgical orientation are essential for this technique. Authors present the technical feasibility and initial results of use a tubular retractor system as a minimally invasive technique for variaties of spinal disorders with a review of literature.