• 제목/요약/키워드: surgical area

검색결과 1,043건 처리시간 0.028초

두경부 영역에서의 로봇 수술 (Robotic Surgery in Head and Neck)

  • 태경;신광수
    • 대한기관식도과학회지
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    • 제16권1호
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    • pp.27-32
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    • 2010
  • Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

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Incidentally detected odontoma within a dentigerous cyst

  • Kim, Kwang Seog;Lee, Han Gyeol;Hwang, Jae Ha;Lee, Sam Yong
    • 대한두개안면성형외과학회지
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    • 제20권1호
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    • pp.62-65
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    • 2019
  • Odontoma is an asymptomatic slow-growing odontogenic tumor. It is usually found by chance in the maxilla or mandible on radiography, or when it deforms the adjacent teeth. It is commonly found in patients who are 30 years of age or younger. We report our encounter with an odontoma within a dentigerous cyst found incidentally in a 56-year-old man. He presented with abnormal fullness in the right infraorbital area of the cheek. During the evaluation of the mass, we incidentally detected the odontogenic tumor within a dentigerous cyst in the patient's maxilla. Under general anesthesia, complete surgical drainage of the infraorbital cystic mass was performed. Enucleation of the odontogenic tumor and a bone grafting from the iliac bone were also performed. The final diagnosis was odontoma. After 2 years of follow-up, there was no sign of recurrence of the tumor. In case of odontogenic tumors, even in old patients, it is important to suspect an odontoma. When odontoma accompanies a dentigerous cyst, surgical excisional biopsy should be performed to rule out malignancy. In case of a large bony defect after enucleation, autogenous bone grafting is essential for reconstruction.

Does reduction of the oncologic safety margin for facial basal cell carcinoma result in higher recurrence rates?

  • Kim, Eon Su;Yang, Chae Eun;Chung, Yoon Kyu
    • 대한두개안면성형외과학회지
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    • 제22권3호
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    • pp.135-140
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    • 2021
  • Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins. Methods: We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up. Results: We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2±10.2 years and 29.3±13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins. Conclusion: In this large cohort study, we found 2-3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.

흉부 외과 영역에서의 개인용 컴퓨터의 이용 (Use of personal computer in thoracic and cardiovascular surgery section: proposal for computerization of patient data management system and unification of diagnosis and operation coding system)

  • 이정렬;김응중
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.342-351
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    • 1990
  • In recent years there are so many medical informations that surgeons should know to handle or analyze their large amount of surgical cases. Proper use of computer system offers new opportunities for the storage and manipulation of their hospital informations. But little is reported about which system, is appropriate, how much can we do with such a system, or what kind of work can be done with that, especially in the area of Thoracic and Cardiovascular Surgery section. Authors designed a computer-based patient file management system using 16 Bit AT IBM personal computer and dBASE IV program, and developed a coding system for the diagnosis and operation name, which offers the basis for the classification of the surgical patient data. And the result of some experiences which was got from the total surgical cases of Thoracic and Cardiovascular Section, Seoul District Armed Forces General Hospital during past 5years, was described.

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심부 매복 정중 과잉치 수술 시 마취방법 선택 (CONSIDERATIONS OF ANESTHETIC METHOD OF DEEP IMPACTED MESIODENS)

  • 민수영;송제선;이제호;최형준;손흥규;김성오
    • 대한소아치과학회지
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    • 제39권1호
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    • pp.90-96
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    • 2012
  • 정중 과잉치(mesiodens)는 대개 상악 절치부에서 발견되며, 주로 구개측에 위치하는 경향이 있다. 정중 과잉치의 자연맹출 가능성이 관찰되면, 주기적으로 검사하여 구강내로 충분히 맹출한 후에 단순발치를 시행한다. 주기적 검사에서 자연맹출 소견이 보이지 않거나, 형태이상 혹은 맹출방향의 이상으로 구강 내로 자연맹출 할 가능성이 없으면, 수술적 제거방법을 고려해야 할 것이다. 특히, 인접한 중절치나 측절치의 맹출을 방해하고 있는 상황이 관찰된다면, 빠른 시일 내에 과잉치 제거를 위한 수술적 방법을 시도하는 것이 타당하다. 한편, 외과적 수술의 시기를 늦추는 것을 고려해야 하는 경우도 있다. 정중과잉치가 인접하여 발육중인 정상 치아의 맹출을 방해하지 않는 경우이다. 이때, 삼차원 CT사진을 촬영하여보면, 과잉치 주변으로 영구절치의 치배가 근접하여 성곽처럼 둘러싸고 있는 것을 볼 수 있다. 미성숙한 치배가 둘러 싸고 있는 상황에서, 무리하게 과잉치를 제거하려고 시도할 경우 인접 치배를 손상시킬 가능성을 배제하기 어렵다. 이 점을 고려 한다면, 가급적 인접한 치아의 치근이 보다 발육한 후에 수술을 시도하는 것이 바람직할 것이다. 초등학교 2학년 이상의 어린이들은 외래에서 국소마취하 제거하는 수술방법에 대개 잘 적응하며 고학년이 될수록 보다 수월해진다. 수술시기를 너무 늦추거나, 과잉치가 너무 늦게 발견된 경우 구개측 심부로 깊이 이동한 것을 볼 수 있다. 때로는 과잉치의 위치가 처음부터 심부에 매복되어 있을 수 있다. 이와 같은 경우, 전신마취방법을 생각해 볼 수 있을 것이다. 본 증례는 상악 정중부의 깊은 부위에 역위 매복된 과잉치를 외래에서 국소마취하에 치료를 시도할 때 관찰되는 문제점을 고찰하였고, 전신마취방법을 결정하기 위한 기준을 제시하였다. 심부 매복된 치아의 외과적 발거시 어린이의 행동조절이 가장 큰 문제였으며, 방사선 소견상 과잉치 치관의 위치가 절치의 치근단보다 상방에 위치할 경우 전신마취로 전환 하는 것이 바람직 할 것으로 사료된다.

선상 낭포성 암종을 동반한 석회성 건막 섬유종의 치험예 (A CASE REPORT OF CALCIFYING APONEUROTIC FIBROMA ACCOMPANIED BY ADENOID CYSTIC CARCINOMA)

  • 김일규;오성섭
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권2호
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    • pp.195-201
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    • 1995
  • This is a case report of calcifying aponeurotic fibroma occurred in the right pterygopalatine fossa & ramus area accompanied by adenoid cystic carcinoma of the right sublingual gland of a 44-year-old female. Calcifying aponeurotic fibroma is benign tumor, but it is characterized by poorly marginated, infiltrated growth pattern and a stubborn tendency to local recurrence, but there is no record of malignant transformation or metastasis, and surgical management should be conservative(excision and reexcision). Most cases been reported at the hands and feet, but no reported case occuring in the head region is found in the literature. Adenoid cystic carcinoma is a slow-growing infiltrative tumor with high recurrence rate, and it's treatment requires radical excisin and radiotherapy. Wide surgical excision of tumor, RND and partial resection of mandible were done. And then, immediate mandibular reconstruction was performed by means of reimplantaion technique after autoclaving of the resected bone.

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하악골 Malunion에 따른 Transverse Mandibular Deficiency에 대하여 split and Replantation of Corticocancellous Bone Graft를 이용한 외과적 교정술의 증례보고 (Surgical Treatment of Transverse Mandibular Deficiency by using Split and Replantation of Corticocancellous Bone Graft)

  • 김진수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.249-254
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    • 1989
  • Transverse mandibular deficiency is rare maxillomandibular malrelationship. Most of this malrelationship is considered to be caused by loss of bone substances. This can be corrected by subapical osteotomy, midsagittal vertical osteotomy, midline horizontal L sliding osteotomy, etc., case by case. In these cases, malrelationship after malunion of mandibular fracture, combination of vertical osteotomy and sliding autogenous cortical bone graft was used and favorable results were obtained. Advantages over previous traditional surgical methods were as follows : 1. This method provided easy access and good visibility. 2. It provided broad bone contact area, thus no other operation to obtain bone graft was needed. 3. There were little circumstances to extract teeth. 4. There were no difficulty in tongue movement after operation.

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교합 및 외과적 치료를 이용한 악관적 내장증의 치험례 (Surgical and Occlusal Treatment of TMJ Internal Derangement)

  • 황경룡;안재진;장세홍
    • 대한치과의사협회지
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    • 제25권7호통권218호
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    • pp.657-664
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    • 1987
  • The purpose of this article is to report a case of internal derangement of TMJ which was successfully managed with surgical and occlusal treatment. The Obtained results were summarized as follow: 1. The patient surgically operated via high condylectomy with meniscoplasty to correct anteriorly displaced meniscus. 2. During operation, the junction area of bilamina zone and meniscus was easily identified and resected using microscopy. 3. The mandible was relocated into therapeutic position with occlusal splint. 4. The occlusal rehabilitation with selective grinding and prosthodontic treatment was done so that the new patient's intercuspal position should correspond to the therapeutic position.

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Ebstein씨 심기형에 동반된 Wolff-Parkinson-White 증후군 및 방실결절 회귀성 빈맥에 대한 수술치험 1례 보고 (Surgical Treatment of Wolff-Parkinson-White Syndrome Combined with AV Nodal Reentrant achycardia in a Patient with Ebstein`s Anomaly - A report of one case -)

  • 장병철
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.205-212
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    • 1990
  • A 17 year old female patient with Ebstein`s anomaly received surgical treatment for WPW syndrome and AV nodal reentrant supraventricular tachycardia[SVT] Electrophysiologic study revealed that an anomalous pathway was located in the right posterolateral portion and antegrade dual AV nodal pathway responsible for AV nodal reentrant tachycardia. The patient was underwent surgery on February 18, 1987. Intraoperative mapping was used to define the location of accessory pathway. The accessory pathway was cryoablated through the epicardium. Simultaneously discrete cryoablation around the perinodal area was performed to prevent AV nodal reentrant SVT. The atrialized right ventricle of Ebstein`s anomaly was plicated with 11 pledget mattress sutures under the cardiopulmonary bypass. Two and half years after surgery, the patient has no evidence of WPW syndrome or supraventricular tachycardia.

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신성고혈압을 동반한 Takayasu 동맥염의 수술치험 1 (Surgical Treatment of Takayasu`s Arteritis with Renovascular Hypertension)

  • 권우석
    • Journal of Chest Surgery
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    • 제20권1호
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    • pp.171-176
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    • 1987
  • Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

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