• Title/Summary/Keyword: surgical procedures

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A Comparison Study of the Surgical Outcome According to the Surgical Technique (설소대단축증의 수술적 방법에 따른 비교)

  • 홍원표;서용석;송미현;양해동;김성수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.10-15
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    • 2003
  • Background and Objectives : Ankyloglossia, commonly known as tongue-tie, is the result of a short, fibrous lingual frenulum or highly attached geioglossus muscle. This condition may cause sucking and swallowing problems, articulation disorders, interference with the tongue's cleansing action, increased the potential for caries, and inability to lick the lips, play a wind instrument, and 'french kiss' Treatment is surgical procedure. In the most cases, horizontal sectioning and mucosal suture(the conventional procedure) is preferred, but in some cases, the Z-plastic procedure is effective. This study is aimed to compare the result of the two procedures. Materials and Methods : Twenty tongue-tie patients underwent operation. Ten patients were treated with the Z-plastic procedure and ten patients were treated with the conventional method randomly. We checked preoperative mobile tongue length, postoperative mobile tongue length, operation time and postoperative wound states. Results : Among the 20 cases of tongue-tie, 2 cases are excepted due to pre-operative state, thus we compared 18 cases of tongue-tie patients. There is no statistically significant difference between the two procedures except in operation time. The Z-plastic procedure apparently needs a little more operating time. Conclusion : Patients treated with the Z-plastic procedures appeared to have better outcomes, but the data shows no statistical significance except in operating time. Consequently, the Z-plastic procedure is indicated in a limited amount of cases.

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Totally Laparoscopic Total Gastrectomy Using Intracorporeally Hand-Sewn Esophagojejunostomy

  • So, Kwang-Oh;Park, Jong-Min
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.206-211
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    • 2011
  • Purpose: Laparoscopic total gastrectomy (LTG) for gastric cancer is still uncommon because of technical difficulties, especially in esophagojejunostomy (EJ). There are many reports for various laparoscopic procedures of EJ using linear or circular staplers. On the other hands, there has been no report for hand-sewn anastomosis. We report successfully performed intracorporeally hand-sewn EJ after LTG. Materials and Methods: The clinicopathologic data and short-term surgical outcomes of 6 patients who underwent totally laparoscopic total gastrectomy for upper gastric cancer from December 2010 and July 2011 were retrospectively reviewed. Results: The mean age was 66.5 years and mean body mass index (kg/$m^2$) was 24.6. All patients had medical comorbidities. The mean patient ASA score was 2.17. Among the 6 patients, previous abdominal operation was performed for 2 patients and combined operation was performed for 3 patients. The mean blood loss, operation time, and EJ anastomosis time was 130 ml, 379.7 minutes, and 81.5 minutes, respectively. The mean time to first flatus, first oral intake, and postoperative hospital stay was 3.0, 3.0, and 12.5 days, respectively. There was no 30-day mortality case. Postoperative aspiration pneumonia and multiple periventricular lacunar infarctions developed in 1 patient. There were no anastomosis-related complications and other major surgical complications. Conclusions: When the intracorporeal anastomotic technique becomes popular in LTG the intracorporeally hand-sewn EJ may be accepted as one method among the various laparoscopic procedures of EJ.

Clinical Characteristics of Cervical and Thoracic Radiculopathies: Non-Invasive Interventional Therapy (목 및 가슴신경뿌리병증의 임상적 고찰: 비침습적 중재시술치료)

  • Roh, Hakjae;Lee, Sang-Heon;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.10 no.2
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    • pp.83-97
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    • 2008
  • Cervical and thoracic radiculopathies are among the most common causes of neck pain. The most common causes are cervical disc herniation and cervical spondylosis in patients with cervical radiculopathy, and diabetes mellitus and thoracic disc herniation in thoracic radiculopathy. A thorough history, physical examination, and testing that includes electrodiagnostic examination and imaging studies may distinguish radiculopathy from other pain sources. Although various electrodiagnostic examinations may help evaluate radiculopathy, needle electromyography is the most important, sensitive, and specific method. Outcome studies of conservative treatments have shown varying results and have not been well controlled or systematic. When legitimate incapacitating symptoms continue despite conservative treatment attempts, more invasive spinal procedures and intradiscal treatment may be appropriate. Surgery has been shown to have excellent clinical outcomes in patients with disc extrusion and neurological deficits. However, patients with minimal disc herniation have fair or poor surgical outcomes. In addition, conventional open disc surgery entails various inadvertent surgical related risks. Although there has not yet been a non-surgical interventional procedure developed with the therapeutic efficacy of open surgery, conservative procedures can offer substantial benefits, are less invasive, and avoid surgical complications. While more invasive procedures may be appropriate when conservative treatment fails, prospective studies evaluating cervical and thoracic radiculopathies treatment options would help guide practitioners toward optimally cost-effective patient evaluation and care.

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STANDARD OPERATING PROCEDURES OF HARD TISSUES SUCH AS FEMORAL HEAD, ALLOGRAFTS OBTAINED FROM LIVING DONORS (생존 기증자로부터 채취된 경조직(대퇴골두 등)의 조직은행 술식)

  • Lee, Eun-Young;Kim, Kyung-Won;Um, In-Woong;Ryu, Ju-Youn
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.406-413
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    • 2004
  • Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.

Clinical evaluation of spontaneous pneumothorax:a review of 360 cases (자연기흉의 임상적 고찰:)

  • 장정수
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.267-273
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    • 1982
  • We have observed 360 cases of spontaneous pneumothorax from Jan. 1971 to Dec. 1981 at the department of Thoracic and Card iovascular Surgery, Yonsei University College of Medicine. The patients age ranged from 2 days to 95 year-old. The associated pulmonary lesions were shown pulmonary tuberculosis in 158 cases[43.9%], bullae in 35, pulmonary emphysema In 32, pneumothorax in 10, paragonimiasis In 7 and unknown underlying pathology in 109 patients. 70 [51.1 %] out of 1 37 cases who received conservative medical treatment Including thoracentesis were cured completely, but the 67 cases [48.9 %] of remaining uncured patients were treated by surgical procedures. The 290 patients who received surgical management were recovered without recurrent pneumothorax. The surgical procedures were closed thoracotomy drainage or explothoracotomy. The choice of treatment should be based on the extent of pneumothorax or the presence of underlying pulmonary disease. Tube thoracotomywas the most effective procedure in achieving the expansion of collapsed lung. On the other hand, open thoracotomy could be a good approach to recurrent pneumothorax, persistent air leakage, incomplete expansion of the lung and bilateral pneumothorax. The minithoracotomy Is the best procedure to recurrent pneumothorax.

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On Establishing a New Fee Schedule for General Surgical Procedure Using Fuzzy MCDM

  • Hung, Chih-Young;Huang, Yuan-Huei;Chang, Pei-Yeh;Wang, Kuei-Ing;Chang, King-Jen;Liu, Yi-Hsin
    • Industrial Engineering and Management Systems
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    • v.4 no.2
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    • pp.218-227
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    • 2005
  • In this research a model for establishing a new, rational fee schedule for general surgical procedures in a national health insurance program is developed. A fuzzy multiple criteria decision-making (FMCDM) model is proposed. The relative values of eleven surgical procedures were obtained through an empirical study based on the FMCDM model. Consequently, a new fee schedule obtained from the FMCDM model. This new fee schedule is more convincing than previous schedule and more persuasive to the references for the policy setting.

Inexpensive Materials for Microsurgery in Middle- and Low-Income Countries

  • Pedro Ciudad;Joseph M. Escandon;Edgar Llanos;Juan Ludena;Oscar J. Manrique;Jorge Castro;Rafael Rossi
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.121-124
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    • 2023
  • With the continuous incorporation of new technologies and advancements in surgical technique, microsurgical procedures around the world have generated a higher success rate and innovative procedures are now possible. In this setting, limitations regarding accessibility and acquisition of medical resources and equipment for these types of operations may be difficult in developing countries. We believe the dexterities of surgeons go beyond the surgical technique, meaning that we are able to use everyday materials to re-create affordable solutions that can be used during surgery in a safe way. This manuscript presents our experience with different surgical instruments and gadgets, developed out of necessity, to improve microsurgical interventions in developing countries.

Chronic Lateral Ankle Instability (만성 족관절 외측 불안정증)

  • Jung, Hong-Geun;Park, Jae-Yong;Park, Jong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.73-78
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    • 2012
  • Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Br$\ddot{o}$strom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.

Clinical Analysis of Atherosclerotic Obstructive Disease in the Lower Extremity -Surgical Expierence in 25 Cases- (폐쇄성 하지 동맥경화증의 임상적 고찰 -25례의 수술 치험-)

  • 김창수
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.274-279
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    • 1995
  • To evaluate clinical pattern and operative outcome of atherosclerotic obstructive disease in the lower extremity, surgical experience in 25 patients between September 1987 and June 1994 was analyzed. There were 24 male patients and 1 female patient. The age of the patients ranged between 36 and 77 years[mean:60.9 years . Disabing intermittent claudication, rest pain, or ischemic gangrene[or ulceration was the operative indication. The patients were classified into three groups according to the level of obstruction: Aortoiliac level[11 cases/44% , femoropopliteal level[6 cases/24% , and whole level[8 cases/32% . Anatomic bypass with prosthetic graft was performed in all cases: aortobifemoral or aortofemoral bypass in 15 procedures, iliofemoral bypass in 5 procedures, femoropopliteal bypass in 13 procedures. The perioperative mortality rate was 12%. Two patients received postoperative major amputation. Twenty two patients were followed-up for 1 to 70 months[mean: 21 months . Late graft obstruction occurred in two patients. The cumulative patency rate at 3 years was 69.5%. The cumulative limb salvage rate at 3 years was 92.0%.

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Breast Reconstruction with Lower Abdominal Tissue Free Transfer (하복부 조직 유리피판에 의한 유방재건술)

  • Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.68-79
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    • 2010
  • Lower abdominal tissue is regarded as an ideal donor site for the breast reconstruction because it provides large skin territory and huge amount of soft tissues enough to the breast size. However it is not easy for the surgeon to reconstruct the really natural breast, and needs the learning curve with long time experience. Author represent the various reconstruction procedures for the breast using lower abdominal tissue such as muscle sparing free TRAM, DIEP, and SIEA free flaps to reinsure like breast. Indications, and selection of reconstructive methods, surgical timing, selection of donor sites and recipient vessel of these flaps were reviewed. In addition, detailed procedures, surgical tips and secondary adjuvant procedures are described for more symmetry of reconstructed breast. The muscle sparing free TRAM, DIEP, and SIEA free flaps would be enough to provide supple, huge amount of well vascularized tissue for the breast, if these flaps were selected for the appropriate indication according to patient's general condition, obesity, the opposite breast and abdominal tissue condition. Lower abdominal tissue was able to provide versatile designs with sufficient adipose tissue without compromising the integrity of abdominal wall.

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