• Journal of Chest Surgery
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• v.45 no.6
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• pp.418-420
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• 2012

Pectus excavatum is rare, but it is the most common type of sternal congenital disorder. There are many surgical methods to correct pectus excavatum such as the Ravitch method, Wada method, Silastic mold method, and the Nuss operation. We report a case of minimal invasive surgery for pectus excavatum using a polyvinyl alcohol sponge.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.324-329
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• 2019

Background Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. Methods We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. Results From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was $56.28%{\pm}18.58%$ in the modified method group, and $44.23%{\pm}14.15%$ in the conventional method group. This difference was statistically significant (P<0.05). Conclusions The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.

• Journal of Gastric Cancer
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• v.19 no.2
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• pp.173-182
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• 2019

Purpose: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. Materials and Methods: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. Results: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted ${\kappa}$ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). Conclusions: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.35-39
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• 1982

Cold blood potassium cardioplegia, by two types of the infusion systems, was used in 45 patients who were undergone the open cardiac operation. Method A [in 25 patients] was the syringe infusion system and method B [in 20 patients] was the pump infusion system. Cold blood potassium cardioplegic solution was used less amount on method B than method A. Serum potassium was often increased significantly on method A as a result of excessive infusion of cold blood potassium cardioplegic solution. But method B, excessive infusion of cold blood potassium cardioplegic solution was prevented by reperfusion of the previous infused cold blood potassium cardioplegic solution through the recirculation system. Alteration of infused rate and concentration of potassium in cold blood potassium cardioplegic solution during infusion [which might be suggested on the method A] could be controlled on method B.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.251-256
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• 2006

This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at $16^{th}$ postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.172-178
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• 2017

Background: The conventional cervicofacial flap may cause the aesthetic problem of sideburns with a mismatched shape and arrangement. We developed a modified method with the goals of minimizing the destruction of the shape and arrangement of the sideburns and minimizing complications in comparison with the conventional method. Methods: The incision line was designed to descend just in front of the sideburns, without passing through them, and then to ascend with the sideburns posteriorly when a cervicofacial flap is performed, unlike the conventional method. Patients in whom this method was applied (group B) and patients who underwent surgery using the conventional method (group A) were investigated in a retrospective study. The method was evaluated by assessing changes in the arrangement of the sideburns and patients' satisfaction, and differences in the complication rate. Results: In group A, 23 of the 31 patients experienced changes in the arrangement of their sideburns. Most patients who experienced a change in the arrangement of their sideburns were dissatisfied with the change. The patients in group B did not experience such changes, and the defects were well reconstructed. Most of them were satisfied with the final sideburn arrangement. Conclusion: A novel method was used to preserve the sideburns while performing a cervicofacial flap. As a result, the appearance of the sideburns was well preserved and the satisfaction of patients was also high. Moreover, this technique could also prove useful for reconstruction without any increase in complications compared to the conventional method.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.174-179
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• 2015

Background: The endoscopic vein harvesting (EVH) method has been used in coronary artery bypass surgery in many countries. We started using the EVH method recently, and investigated the results during the early learning period. Methods: Between March 2012 and June 2014, 75 patients (31 patients in the EVH method group, and 44 patients in the open method group) who underwent isolated first-time coronary artery bypass grafting using vein grafts were retrospectively analyzed with respect to the early outcomes including graft patency and risk factors for leg wound complications. For assessing the patency of vein graft, we performed coronary computed tomography angiography during the immediate postoperative period and 6 months later. Results: Mean harvesting time of endoscopic method was about 15 minutes. Patency rate during the immediate operative period and the 6-month patency rate were similar between the two groups (postoperative period: EVH 100% vs. open method 94.4%, p=0.493; at 6 months: EVH 93.3% vs. open method 90.9%, p=0.791). Leg wound complications occurred more frequently in the open method group (EVH 3.2% vs. open method 13.6%, p=0.127). According to the analysis, age was an independent risk factor for leg wound complications. Conclusion: EVH is a feasible method even for beginners and can be performed satisfactorily during their learning period.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.125-132
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• 2011

The aim of this study was to compare peritoneal dialysis catheter insertion by the open method to the laparoscopic method. Twenty four laparoscopic and 10 open peritoneal dialysis catheter placements were performed in children between 2001 and 2008. Patient characteristics, operation related data, procedural complications and clinical outcome were compared. Although there were no cases of catheter obstruction, exit site infection or bleeding in the laparoscopic group, compared to the open method, there was no statistically significant difference between the two groups. Catheter removal rate due to complication was high in the open group and catheter survival rate was high in the laparoscopic group. We concluded that laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups with at least equivalent functional results compared to the open method. An advantage of laparoscopic catheter insertion is removal of the great omentum and easy fixation of the catheter to the abdominal wall.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.142-147
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• 2023

Some of Asian eyelids have double fold and some do not. Many people tend to prefer double eyelid in aesthetic and functional reasons. Since the mechanism of double eyelid is bonding the eyelid skin to the eye-opening tissue, the principle of double eyelid surgery is also connecting the eyelid skin to levator component. Double eyelids are differentiated by their shape according to the height and curvature. The double eyelid surgery procedure is divided into incision method and nonincision method. And the incision method is subdivided into double fold line design, skin and oculi muscle incision or excision, pretarsal or preaponeurotic soft tissue excision, fixation of posterior lamella to anterior lamella, and skin suture. The nonincision method is to connect the posterior lamella and the anterior lamella as a thread only without an incision. A successful double eyelid surgery creates a fold well-balanced in height, curvature, and depth of the fold based on patient's preference. In this article, the author's own methods of performing surgery are described, with a step-by-step guide and surgical tips.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.543-547
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• 2007

The lips and corners of the mouth are not only important for appearance but are also essential for facial expression, speech, and nutrition. Defects in these areas can be caused by congenital clefts of the lip and face, trauma, infection, cysts, and excision of benign or malignant tumors. Numerous techniques have been introduced for reconstruction of the lips and corners of the mouth, and in particular, techniques such as the Kazanjian Roopenian I and II, Converse method, Zisser method, Platz and Wepner method. Gillies and Millard method are commonly utilized for elongation and reconstruction of the mouth corner. Few reports exist in the oral and maxillofacial surgery literature regarding correction of microsomia and reconstruction of the corners of the mouth. As such, the authors report a case of the corners of the mouth elongation in a patient with burn-induced microstomia using the Converse flap which yielded a satisfactory outcome.