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일차성 하지 정맥류 치료에서 광투시 전동형 정맥적출술과 고식적 수술의 비교
백광재,김만우,김호성,배국현,최상용,박신희,이광찬,김진승 대한외과학회 2003 Annals of Surgical Treatment and Research Vol.65 No.5
Purpose: This study was designed to compare Transilluminated Powered Phlebectomy (TIPP) with conventional surgical treatment (high ligation of the greater saphenous vein and above knee stripping with varicosectomy). Methods: 428 cases of varicose veins, managed surgically at our hospital, were reviewed. A retrospective review of clinical records, between November 2000 an March 2003, was performed. The patients were divided into one of two groups: TIPP or a conventional operation. All the patients had at least a C2 CEAP disease. Results: The demographics, hospital stays and operating times for the two groups were similar. However, a TIPP was associated with significantly fewer incisions (4.4±1.5 vs 8.2±3.9; P<0.001) and recurrence (n=14, 6% vs n=24, 12%; P=0.003). The incidence of a postoperative hematoma developing was more common with TIPP (n=20, 9% vs n=1, 0.5%; P=0.023). The problem of a hematoma formation in TIPP was solved by the insertion of a small closed suction drain. Skin perforation and wrinkling, and dermatosclerosis, were only complicated in the TIPP. The mean pain scores (out of 10) for the TIPP and conventional operation groups, at 2 and 7 days and 4 weeks, were 4.8, 1.4 and zero, and 4.8, 2.8 and zero, respectively. The cosmetic satisfaction score was higher in the TIPP group (8.7 vs 5.7; P<0.001). Conclusion: With respect to pain, cosmetic satisfaction and residual varicose, the outcomes in the TIPP group were significantly better than those in the conventional operation group. (J Korean Surg Soc 2003;65:452-456)
최상용,김종태,윤석진,김진승,배국현 대한외상학회 1999 大韓外傷學會誌 Vol.12 No.1
Serial abdominal CT studies are an integral part of the non-operative treatment of blunt hepst- ic injuries and seem to be useful in monitoring resorption of hemoperitoneum and the healing pattern of intrahepatic hematomas and lacerations. The current study was conducted to evaluate the safety of non-operative management of blunt hepatic trauma in hemodynamically stable patients regardless of injury severity. Twenty five cases of hepatic injury caused by blunt abdominal trauma during 1993-1997 are reviewed. The mean age was 24 with a range of 3 to 58; 68% were male and 28% were children. The most frequent etiologic factor was traffic accidents(76%). Abdominal CT scan, AST/ALT level and vital signs were using the initial diagnostic modality in all patients. With using Injury Severity Scale of American Association for the Surgery of Trauma(AAST), 13 cases(52%) were Grade I, 7 cases(28%) were Grade II, 5 cases(20%) were Grade 3. We transfused the packed RBC in 6 cases. Most cases had shown high serum aminotrans- ferase which were normalized after 2-3 weeks. The severity of abdominal CT-Grading system was not statistically correlated with the prognosis of hepatic injured patients(p$gt;0.05). Non-operative management in blunt hepatic trauma could be considered in most hemodynamically stable patients without evidence of other intraabdominal injuries, regardless of the injured CT-Grading system and trasfusion amount.