• International Journal of Arrhythmia
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• 제19권3호
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• pp.285-339
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• 2018

Catheter ablation of atrial fibrillation (AF) is one of the most complex interventional electrophysiological procedures. The success of AF ablation is based in large part on freedom from AF recurrence based on electrocardiography (ECG) monitoring. Arrhythmia monitoring can be performed with the use of noncontinuous or continuous ECG monitoring tools. AF ablation is an invasive procedure that entails risks, most of which are present during the acute procedural period. However, complications can also occur in the weeks or months following ablation. Recognizing common symptoms after AF ablation and distinguishing those that require urgent evaluation and referral to an electrophysiologist is an important part of follow-up after AF ablation. This section reviews the complications associated with catheter ablation procedures performed to treat AF. The types and incidence of complications are presented, their mechanisms are explored, and the optimal approach to prevention and treatment is discussed. Finally, surgical and hybrid AF ablation technology and the indications for concomitant open or closed surgical ablation of AF, stand-alone and hybrid surgical ablation of AF are covered in this section.

• International Journal of Arrhythmia
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• 제19권3호
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• pp.186-234
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• 2018

Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

• Journal of Chest Surgery
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• 제29권12호
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• pp.1373-1376
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• 1996

1993년 10월부터 1996년 2월까지 9명의 Wolfr-Parkinson-White증후군을 가진 환자에서 우회로의 외과적 절제술을 시행하였다. 수술적응례를 살펴보면 도자절제술이 실패한 경우가 6례, 우회로가 2개 있었던 경우와 도자절제술중 도자 말단부위가 부러졌던 경우가 1례씩 있었으며, 나머지 1례는 승모판막재치환술이 필요했던 경우이다. 수술사망은 없었으며 술후합병증은심낭삼출액과 창상감염이 각각 1례씩 있었다. 모든 환자에서 술후 심전도검사 및 전기생리검사를 통해 우회로가 완전 절제되었슴을 확인할 수 있었으며 추적 관찰기간중 인맥을 보인 환자는 없었다. 이상의 결과로 Wolfr-Parkinson-White증후군에서 우회로의 외과적 절제는 도자절제술이 실패한 경우, 우회로가 여러개 있는 경우, 그리고 동반된 심질환의 교정을 요하는 경우로 국한되며 수술적응례에서 외과적 절제술은 비교적 안전하고 효과적인 치료방법으로 사료된다.

• Korean Journal of Radiology
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• 제1권4호
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• pp.175-184
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• 2000

Although surgical resection remains the best option as potentially curative therapy for hepatocellular carcinoma, radiofrequency thermal ablation has begun to receive much attention as an effective minimally invasive technique for the local control of unresectable malignant hepatic tumors. Most recent radiofrequency devices equipped with a powerful generator and larger needle electrode permit larger thermal lesions, up to 5 cm in diameter, with a single ablation. In this article, the author reviews the technical developments and early clinical results obtained with radiofrequency ablation techniques.

• 대한치과의사협회지
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• 제52권10호
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• pp.596-601
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• 2014

Computer-aided surgery is popular and useful in the field of oral and maxillofacial surgery, because of the possibility of simulation with a high accuracy. In all aspects of surgery, proper planning facilitates more predictable operative results, however before the use of virtual planning, much of this relied on 2-dimensional (2-D) imaging for treatment planning on a 3-dimensional (3-D) object and surgical trial and error. With real-time instrument positioning and clear anatomic identification, a computer-assisted navigation system (CANS) is exceptionally helpful in maxillofacial surgery. These techniques enable performing precise bony ablation and reconstruction, and also decrease surgical time and donor site defect.

• Journal of Chest Surgery
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• 제47권1호
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• pp.1-5
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• 2014

Background: Recently, a hybrid surgical-electrophysiological (EP) approach for confirming ablation lines in patients with atrial fibrillation (AF) was suggested. The aim of this approach was to overcome the limitations of current surgery- and catheter-based techniques to yield better outcomes. Methods: Ten consecutive patients with AF underwent total thoracoscopic ablation (TTA) following transvenous catheter EP ablation (residual gap and cavotricuspid isthmus [CTI] ablation). Holter monitoring was performed 6 months postoperatively. Results: Ten patients (90% with persistent AF) underwent successful hybrid procedures, and there was no in-hospital mortality. An EP study was performed in 8 patients and showed that successful antral ablation in all pulmonary veins was achieved in 7 of them. The median follow-up duration was 7.63 months (range, 6.7 to 11.6 months). Nine patients underwent Holter monitoring 6 months postoperatively, and the results indicated an underlying sinus rhythm without AF, atrial flutter, or atrial tachycardia lasting more than 30 seconds in all of the patients. There was no recurrence of AF during follow-up. Conclusion: A hybrid approach that consists of TTA followed by transvenous catheter EP ablation (residual gap and CTI ablation) yielded excellent outcomes in our patient population. A hybrid approach should be considered in patients with a high risk of AF recurrence.

• Clinical and Experimental Reproductive Medicine
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• 제49권2호
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• pp.76-86
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• 2022

Ovarian cystectomy is the preferred technique for the surgical management of ovarian endometrioma. However, other techniques such as ablation or sclerotherapy are also commonly used. The aim of this review is to summarize information regarding the efficacy of ablation and sclerotherapy compared to cystectomy in terms of ovarian reserve, the recurrence rate, and the pregnancy rate. Several studies comparing ablation versus cystectomy or sclerotherapy versus cystectomy in terms of the serum anti-Müllerian hormone (AMH) decrement, endometrioma recurrence, or the pregnancy rate were identified and summarized. Both ablation and cystectomy have a negative impact on ovarian reserve, but ablation results in a smaller serum AMH decrement than cystectomy. Nonetheless, the recurrence rate is higher after ablation than after cystectomy. More studies are needed to demonstrate whether the pregnancy rate is different according to whether patients undergo ablation or cystectomy. The evidence remains inconclusive regarding whether sclerotherapy is better than cystectomy in terms of ovarian reserve. The recurrence rates appear to be similar between sclerotherapy and cystectomy. There is not yet concrete evidence that sclerotherapy helps to improve the pregnancy rate via in vitro fertilization in comparison to cystectomy or no sclerotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6637-6641
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• 2013

Background: To evaluate the results of various types of radiofrequency ablation (RFA) treatment of renal tumors in patients with excessive anesthetic and surgical risk. Materials and Methods: Data for RFA performed in in high risk patients were retrospectively evaluated. Other RFA applications in patients with no anesthetic and/or surgical risk were excluded. RFA was by ultrasound or CT guided percutaneous (USG/CT-PRFA) and retroperitoneally or transperitoneally laparoscopic (R/T-LRFA) techniques under general or local anethesia. Follow-up data of enhanced CT or MRI after 1, 3 and 6 months were analysed for twelve RFA applications. Results: The RFA applications included 4 (40%) left-sided, 5 (50%) right-sided and 1 (10%) bilaterally RFA (simultaneously 1 right and 2 left). The localizations of tumors were 2 (16.6%) upper, 5 (41.6%) mid and 5 (41.6%) lower pole. The RFA applications included 9 (75%) USG-PRFA, 1 (8.3%) CT-PRFA, 1 (8.3%) T-LRFA and 1 (8.3%) R-LRFA. The mean age was $65.3{\pm}8.5$ (52-76) years. The mean tumor size was $29.6{\pm}6.08$ (15-40) mm. No complications related to the RFA were encountered in any of the cases. Failure (residual tumour) was determined in 8.3% (1/12) of USG-RFA application. The success rate was thus 91.7% (11/12). Other 1st, 3rd and 6th months follow-up data revealed no residua and recurrence. Conclusions: RFA application appears to be safe as a less invasive and effective treatment modality in selected cases of small renal tumors in individuals with excessive anesthetic and also surgical risk.

• International Journal of Computer Science & Network Security
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• 제23권2호
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• pp.183-192
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• 2023

Radiofrequency ablation (RFA) is an alternative treatment for liver cancer to the surgical intervention preferred by surgeons. However, the main challenge remains the use of RF for the ablation of large tumours (i.e., tumours with a diameter of >3 cm). For large tumours, RFA takes a large duration in the ablation process compared with surgery, which increases patient pain. Therefore, RFA for large tumours is not preferred by surgeons. The currently materials used in RF electrodes, such as the nickeltitanium alloy (nitinol), are characterized by low thermal and electrical conductivities. On the other hand, the use of materials that have high thermal and electrical conductivities, such as titanium aluminide alloy (gamma titanium), produces more thermal energy for tumours. In this paper, we developed a cool-tip RF electrode model that uses nickel-titanium alloy and replaced it with titanium aluminide alloy by using the finite element model (FEM). The aim of this paper is to study the effect of the thermal and electrical conductivities of gamma titanium on the ablation volume. Results showed that the proposed design of the electrode increased the ablation rate by 1 cm³ /minute and 6.3 cm³/10 minutes, with a decrease in the required time ablation. Finally, the proposed model reduces the ablation time and damages healthy tissue while increasing the ablation volume from 22.5% cm³ to 62.5% cm³ in ten minutes compared to recent studies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권4호
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• pp.435-444
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• 2008

Purpose: Clinical study to evaluate the efficacy and the safety of various surgical treatments in snoring and obstructive sleep apnea. Methods and materials: We performed surgical treatments such as radiofrequency ablation, uvulopalatopharyngoplasty(UPPP) with tonsillectomy, uvulopalatopharyngoplasty with advancement genioplasty, orthognathic surgery(maxillomandibluar advancement), distraction osteogenesis device insertion. Diagnosis was performed with clinical examination, polysomnography, lateral cephalometric and computed tomography. 62(M : F = 45 : 17, mean age 41.5, mean follow-up 4 weeks) patients underwent radiofrequency ablation and 7 (M : F = 5 : 2, mean age 38.9, mean follow-up 19months)patients experienced uvulopalatopharyngoplasty with tonsillectomy. Uvulopalatophayngoplasty with advancement genioplasty was performed for 3 (M : F = 2: 1, mean age 30.2, mean follow-up 14 months)patients. The last 3(M : F = 2 : 1, mean age 21.5, mean follow-up 24 months)patients was treated with orthognathic surgery including distraction device insertion. The results was evaluated by questionnaires, polysomnography, investigation of complications. Results: Of the patients treated with radiofrequency ablation, 95% reported improvement of their symptom. 100% improvement was reported in patients treated with UPPP with tonsillectomy and UPPP with advancement genioplasty. The two of three patients who underwent orthognathic surgery showed the satisfactory of treatments. Dryness of mouth was the most common complication during short period in radiofrequency ablation and UPPP with tonsillectomy. Relapse complication was not found in any surgical treatments. Conclusion: Treatment for snoring and OSA is determined by severity degree of the physiologic derangements, predominant type of apnea and obstructive site. Accuracy diagnosis should be performed prior to treatment for satisfactory treatment result. This study demonstrates feasibility, safety and efficacy of surgical treatments in snoring and OSA.