• Title/Summary/Keyword: resection and anastomosis

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Single-Stage Repair of Coarctation of the Aorta and Ventricular Septal Defect in Infants Younger than 6 Months (생후 6개월 이하 환아에서 대동맥 축착증과 심실중격결손의 일차 완전교정)

  • 백만종;김웅한;이영탁;한재진;이창하
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.733-744
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    • 2001
  • Background: The optimal therapeutic strategies for patients with coarctation of the aorta(CoA) and ventricular septal defect(VSD) remain controversial. This study was undertaken to determine the outcome and the need for reintervention following single-stage repair of coarctation with VSD in infants younger than 6 months. Material and Method: Thirty three consecutive patients who underwent single-stage repair of CoA with VSD, from January 1995 to December 2000, at Sejong General Hospital were reviewed retrospectively. Mean age and body weight at repair were 54$\pm$37 days(12 days-171 days) and 3.9$\pm$1.1 kg(1.5~6 kg), respectively. The surgical repair of CoA was performed under deep hypothermic circulatory arrest(CA) in the early period of the study and under regional cerebral perfusion through a direct innominate arterial cannulation without CA in the later period. The technique used in the repair of the CoA was resection and extended end-to-end anastomosis(EEEA; n=16) and extended side-to-side anastomosis(ESSA; n=2) in the early period, and resection and extended end-to-side anastomosis(EESA; n= 15) in the later period. The simultaneous closure of VSD was done with a Dacron patch(n= 16) and autologous pericardium(n=17). Aortic arch hypoplasia was present in 29 patients(88%) and its types were distal(n=18), complete(n=5), and complex(n=6)

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Clinical Analysis of Acquired Tracheoesophageal Fistula (후천성 기관식도루의 임상적 고찰)

  • 백효채;김도형;조현민;이두연
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.61-65
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    • 2002
  • Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

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Anatomical Review of Radial Forearm Free Flap for the Oral Cavity Reconstruction (구강재건을 위한 요골전완 유리피판의 해부학적 고찰)

  • Kim, Soung-Min;Seo, Mi-Hyun;Kang, Ji-Young;Eo, Mi-Young;Myoung, Hoon;Lee, Suk-Keun;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.93-101
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    • 2011
  • Reconstruction following a resection of malignant oral cavity tumors is one of the most difficult problems in recent oral oncology. The radial forearm free flap (RFFF) is a thin, pliable soft tissue flap with large-caliber vessels for microvascular anastomosis. Its additional advantages include consistent flap vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with a tumor resection. For a better understanding of RFFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of RFFF in the Korean language.

Circunferential resection and direct end to end anastomosis of mediastinal trachea on a post tracheostomy stenosis (기관절개술후 종격동기관 협착증에 대한 기관절제 단단 문합술)

  • Kim, Se-Wha;Park, Hee-Chul;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.495-502
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    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

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Strangulating Large Colon Volvulus: A Diagnostic and Surgical Challenge in a Post-Partum Thoroughbred Mare

  • Jungho Yoon;Youngjong Kim;Jongyoung Park;In-Soo Choi;Peter Colket Rakestraw;Ahram Kim
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.405-410
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    • 2022
  • An 11-year-old thoroughbred post-partum broodmare presented with the symptoms of colic. The physical and clinical examinations indicated a large colon displacement or volvulus. Immediate surgical intervention was performed, and a strangulating large colon volvulus (LCV) was defined as a volvulus of >540° in the counterclockwise direction. After correcting and assessing the gut viability, approximately 80% of the entire large colon was resected and anastomosed using an end-to-end technique. With supportive care after surgery, the horse regained its appetite and vitality without significant clinical complications and was discharged on postoperative day 9. This report presents the first surgical correction using a large colon resection and anastomosis (LCRA) and the critical care for a strangulating LCV in a horse in Korea. This case enhances the current knowledge of clinical LCV and the related considerations for treatment.

Generalized Meconium Peritonitis Diagnosed with Antenatal Ultrasonography (산전 초음파검사로 진단된 범발성 태변성 복막염 2예보고)

  • Kim, Soong-Chul;Hwang, Shin;Yoo, Shi-Joon;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.59-62
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    • 1995
  • Meconium peritonitis is defined as an aseptic, chemical or foreign-body peritonitis caused by spill of meconium in the abdominal cavity related to the prenatal perforation of the intestine. Perforation is usually caused by obstruction from meconium ileus, intestinal atresia, stenosis, volvulus, internal hernia, congenital peritoneal bands, intussusception, or gastroschisis. Less commonly, no evidence of distal obstruction exists. Here, we present two cases of generalized meconium peritonitis of antenatal diagnosis. The first case, detected at 8 months of gestational age, had a perforation of the proximal blind pouch of jejunal atresia, associated with respiratory distress due to severe abdominal distension. This case was successfully treated with resection and anastomosis and brief period of postoperative ventilatory support. The second case had a distal ileal perforation with thick meconium in the terminal ileum. In this case, there was no dilatation of ileum proximal to the perforation site. Resection and anastomosis was performed and postoperative course was uneventful.

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Surgical Management of Rectal Prolapse in an Elk Bull

  • Hyohoon Jeong;Young-Sam Kwon
    • Journal of Veterinary Clinics
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    • v.40 no.1
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    • pp.73-77
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    • 2023
  • Rectal prolapse is encountered in all domestic animal species but clinical report regarding the condition in the elk is limited. A 10-year-old elk bull weighing 400 kg was referred to the Large Animal Hospital of Kyungpook National University with clinical signs including intermittent tenesmus related to rectal prolapse and anorexia for the previous 5 days. Type II rectal prolapse was diagnosed based on the history and clinical signs. An emergency resection and anastomosis including a purse string suture was performed under general intravenous (IV) anesthesia in field to prevent injury of the patient and the staff. The patient recovered uneventfully after the surgery without excitement. A systemic antibiotic and an anti-inflammatory drug were given to prevent postoperative complication and relieve pain. The follow up on the patient after 4 weeks of the surgery showed that the prolapse recurred due to intermittent straining after 2 weeks of the surgery. The patient was on the glucocorticoid for the following 3 days but was finally euthanized owing to the exacerbation of the prolapse 1 week after the recurrence. This report describes a rare case of rectal prolapse in an elk bull and the clinical outcome of the surgical repair in detail.

Congenital Esophageal Stenosis (선천성 식도 협착증)

  • Lee, Seong-Cheol;Han, Won-Shik;Kim, Ki-Hong;Jung, Sung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.40-44
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    • 2000
  • Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

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Surgical Treatment of Coarctation of Aorta -The Report of Two Cases- (대동맥 축착증 수술치험 2례)

  • Park, Cheol-Ho;U, Jong-Su;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.567-573
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    • 1988
  • Coarctation of the aorta is classically a congenital narrowing of the upper descending thorac aorta adjacent to the site of attachment of the ductus arteriosus which is sufficiently severe that there is a pressure gradient across the area. Recently we have experienced two cases of coarctation of the aorta and successfully performed resection of the sites of coarctation and end to end anastomosis of the aorta. The first case was a juxtaductal type of coarctation of the aorta with PDA and the pathology of the lesion was a diaphragm with central narrow opening. And the resection length was about 0.5cm and aortic clamping time was 20 minutes. The second case was also juxtaductal type coarctation of the aorta with mild tubular hypoplasia of aortic isthmus, left SVC and the pathology was also a diaphragm with central narrow opening. And the resection length was about 0.5cm and aortic clamping time was 29 minutes. Both postoperative course was uneventful and the patients were discharged two weeks after operation.

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Endobronchial Hamartoma -One Case Report- (기관지내 발생한 과오종 -1례 보고-)

  • 이원진
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1178-1182
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    • 1995
  • We experienced one case of endobronchial hamartoma on left lower lobar bronchus in sixty year old male patient. Less than 1 % of lung tumors are benign, and the prevalence of endobronchial hamartoma is reported to be from 3 % to 40 %. The mean age was 52.9 years, and equal gender prevalence.Symptoms were related to intraluminal growth, including fever, chill, productive cough, hemoptysis, exertional dyspnea, recurrent pneumonia and so on. Bronchoscopic finding was tumor present as polypoid mass in the lumen of a left main stem bronchus,distal to 3 cm from carina. Biopsy was done. The histopathologic pattern showed several nodules of loose myxoid tissue and islands of cartilage. We performed partial resection of the affected bronchus,1cm anterior to the superior segmental bronchial opening to just distal from superior segmental orifice. Including superior segmentectomy, partial resection of the left lower lobar bronchial resection and end-to-end anastomosis with 4-0 Poly dioxanone sutere materials interruptedly. We report this case with the brief review of literatures.

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