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One-stage Laparoscopic Repair of Morgagni and Inguinal Hernias in a Two-month Old Male
배미주,이호석,김대환,정연주,김영대,조정수 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.6
The development of Morgagni hernias is related to malformations of the embryologic septum transversum after failure of the sternal and costal fibrotendinous elements of the diaphragm to fuse. The overall incidence of Morgagni hernias among all congenital diaphragmatic defects is 3% to 4%. Inguinal hernias are the most common hernias in males and females (25% and 2%, respectively). An inguinal hernia is defined as a protrusion of the abdominal cavity contents through the inguinal canal. The combination of Morgagni and inguinal hernias is rare, and treatment using laparoscopic surgery has not been previously reported. This case presents a one-stage laparoscopic repair of Morgagni and inguinal hernias in a 2-month-old male.
Bypass Surgery in Arterial Thoracic Outlet Syndrome
배미주,정성운,이충원,최진석,김민수 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.2
Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of allTOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displayingsymptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffuselydamaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompressionof subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenousvein was performed.
Avoiding Venous Anastomotic Dehiscence of an Arteriovenous Graft in a Super-Obese Patient
배미주 대한흉부외과학회 2020 Journal of Chest Surgery (J Chest Surg) Vol.53 No.6
Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels, cannulation complications, and inconsistent outcomes. We describe placing an arterio- venous polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein to avoid these complications. A 39-year-old super-obese woman with end-stage renal disease had undergone several hemodialysis access procedures on both arms. We traced the course of the arteriovenous graft course with the patient sitting and lying down. The ideal course was more accurate with the patient sitting; thus, the patient sat when the course was drawn, before lying on the operating bed. The PTFE graft was placed between the right brachial artery and axillary vein, according to the course in the opposite arm. No anastomotic dehiscence or pseudoaneurysm has taken place during 2 years of follow-up. In super-obese patients, the ideal course for arteriovenous grafts should be drawn while they are sitting, avoiding skin folds. This tip could avoid anastomotic dehiscence and pseu- doaneurysm between the axillary vein and a PTFE graft.
The Factors Affecting Recurrence of Symptoms after Infrainguinal Arterial Endovascular Angioplasty
배미주,이종근,이충원,김창원,정성운 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.6
Background: This study reports the result of endovascular treatment for arterial occlusive disease limited to femoropopliteal lesions, focusing on the recurrence of symptoms instead of patency. Methods: This was a retrospective, single-center study. From April 2007 to November 2011, 48 limbs in 38 patients underwent endovascular stenting or balloon angioplasty to treat femoropopliteal arterial occlusive disease. The factors affecting the recurrence of symptoms were analyzed. Results: The mean age of the patients was 69.60±7.62 years. Among the baseline characteristics of the patients, initial hyperlipidemia was the most important factor affecting the recurrence of symptoms (relative risk=5.810, p=0.031). The presence of a dorsal arch was also a significant factor (relative risk=0.675, p=0.047). Conclusion: The major factors that affect the recurrence of symptoms after endovascular treatment for femoropopliteal arterial occlusive lesions are hyperlipidemia and the presence of a dorsal arch. Therefore, the usage of lipid-lowering agents after endovascular treatment and taking the presence of a dorsal arch into consideration are important elements of managing the recurrence of symptoms.
Duodenal Perforation Caused by an Inferior Vena Cava Filter
배미주,정성운,이충원,김상필,송승환 대한흉부외과학회 2012 Journal of Chest Surgery (J Chest Surg) Vol.45 No.1
The inferior vena cava (IVC) filter is known as an effective and safe method for preventing fatal pulmonary thromboembolism in patients with deep vein thrombosis. Usually, the remaining IVC filters are asymptomatic and do not cause clinical problems. We report a case of duodenal perforation caused by a remaining IVC filter.
배미주,정성운,이충원,최진석,송승환,김상필 대한흉부외과학회 2015 Journal of Chest Surgery (J Chest Surg) Vol.48 No.4
Background: Upper limb ischemia is less common than lower limb ischemia, and relatively few cases have been reported. This paper reviews the epidemiology, etiology, and clinical characteristics of upper limb ischemia and analyzes the factors affecting functional sequelae after treatment. Methods: The records of 35 patients with acute and chronic upper limb ischemia who underwent treatment from January 2007 to December 2012 were retrospectively reviewed. Results: The median age was 55.03 years, and the number of male patients was 24 (68.6%). The most common etiology was embolism of cardiac origin, followed by thrombosis with secondary trauma, and the brachial artery was the most common location for a lesion causing obstruction. Computed tomography angiography was the first-line diagnostic tool in our center. Twenty-eight operations were performed, and conservative therapy was implemented in seven cases. Five deaths (14.3%) occurred during follow-up. Twenty patients (57.1%) complained of functional sequelae after treatment. Functional sequelae were found to be more likely in patients with a longer duration of symptoms (odds ratio, 1.251; p=0.046) and higher lactate dehydrogenase (LDH) levels (odds ratio, 1.001; p=0.031). Conclusion: An increased duration of symptoms and higher initial serum LDH levels were associated with the more frequent occurrence of functional sequelae. The prognosis of upper limb ischemia is associated with prompt and proper treatment and can also be predicted by initial serum LDH levels.
A Comparative Study of Abdominal Aortic Aneurysm: Endovascular Aneurysm Repair versus Open Repair
배미주,정성운,이충원,송승환,김은지,김창원 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.4
Background: Endovascular aneurysm repair (EVAR) has dramatically changed the management of abdominal aortic aneurysms (AAAs) as the number of open aneurysm repairs have declined over time. This report compares AAA-related demographics, operative data, complications, and mortality after treatment by open aneurysm repair or EVAR. Methods: We retrospectively reviewed 136 patients with AAAs who were treated over an 8-year time period with open aneurysm repair or EVAR. Results: The mean age of the EVAR group was higher than that of the open repair group (p=0.001), and hospital mortality did not differ significantly between groups (p=0.360). However, overall survival was significantly lower in the EVAR group (p=0.033). Conclusion: Although EVAR is the primary treatment modality for elderly patients, it would be ideal to set slightly more stringent criteria within the anatomical guidelines contained in the instructions for use of the EVAR device when treating younger patients.