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케타민과 리도카인으로 시행한 소아 탈장 수술 2,230명
주종수,주현호,주인호,Joo, Jong Soo,Joo, Hyun Ho,Joo, In Ho 대한소아외과학회 2013 소아외과 Vol.19 No.2
Ketamine is a safe and effective drug for pediatric anesthesia, sedation and analgesia. We hoped to identify that surgeons could operate a pediatric hernia with the ketamine anesthesia without general anesthesia. The study was a consecutive case series of 2230 inguinal hernia patients aged 1 months to 17 years in a Joo's day-surgical clinic during 11-year period. The patients had pediatric inguinal hernia surgery without general anesthesia under the day-surgery system. We retrospectively analyzed the medical record of patients who were registered with the Diagnosis Related Group (DRG) system. All patients received ketamine (5mg/kg) and atropine (0.01mg/kg) intramuscularly before surgery. After anesthesia, we injected 1~2% lidocaine (Less than 5ml) subcutaneously at the site of incision and started operation. The surgical method was the high ligation method of the hernia sac.) In total 2230 patients, male were 1756 and female were 474. 2076 patients were a unilateral inguinal hernia at the time of surgery and 154 were bilateral hernia patients. Less than three months, depending on the age of the patients was 391, and less than 12 months the patient was 592 people (26.5%). After surgery, there were no accidents or long term complications associated with ketamine anesthesia. We think the surgeon can safely do the pediatric inguinal hernia surgery using ketamine and lidocaine without anesthesiologist through 11 years of our surgical experiences.
주종수(Jong Soo Joo),감봉수(Bong Soo Gam) 대한소화기학회 1991 대한소화기학회지 Vol.23 No.2
The congenital absence of the vagina results from failure of the vaginal plate to develop. The treatment of vaginal agenesis have many techniques of vaginal reconstruction. The ileal graft, one of the vaginal reconstructions, is that the ileum was resected about 10 cm in length and the mesentery was resected for blood supply of ileal graft. The resected ileum with mesentery was transported the space which was dissected between the bladder and the rectum already. The ileal graft was repaired the two end margins that the proximal portion was connected to the uterus and the distal portion was connected to the external orifice of vulva. This technique was known that was simple surgical technique, good functional result and little complication. In May 1987, at Gynecologic department of Inje University, the 13 year-old female was diagnosed imperforate hymen was done the hymenotomy two times. But she was not improved the lower abdominal pain and distension. So she was transfered to surgical department that was suspected vaginal defect. On exploration, she was confirmed complete vaginal agenesis without cervix. Therefore she was done surgical intervention-the ileal graft. We reported that this procedure was good result.
감봉수(Bong Soo Gam),주종수(Jong Soo Joo),김상효(Sang Hyo Kim),백낙환(Nak Whan Park) 대한두경부종양학회 1992 대한두경부 종양학회지 Vol.8 No.1
Branchial apparatus anomaly is rarely encountered congenital neck disease, it presents a palpable non-tender mass or fistulous opening existed at any site from external auditory canal or mandible angle to lower part of neck We have reviewed the records of 50 patients operated upon for branchial cleft anomaly, at Department of Surgery, Inje University Hospital, between 1981 and 1990, and the following results were obtained. 1) In the classificiation of branchial cleft anomaly, first branchial fistula was 1 case, second branchial cyst 32 cases, second branchial sinus 11 cases, second branchial fistula 5 cases and third branchial fistula 1 case. 2) There were 20 men and 30 women in this series and male to female ratio was 2:3. 3) The age at first clinical presentation was 1st decade 15 cases, 2nd decade 10 cases, 3rd decade 17 cases, 4th decade 5 cases and 5th decade 3 cases. The peak age incidence was 3rd decade in overall, but the cyst was most common in 2nd decade, and majority of sinus or fistula was seen below 10 years old age. 4) The prevalent side of this anomaly was right side in 19 cases, left side in 29 cases and bilateral 2 cases, and so left side was more common than right. 5) The clinical presentation was characterized by the lesion along anterior border of sternocleido muscle, non-tender palpable mass were 28 cases, drainage sinus 18 cases, recurrent abscess and drainage 5 cases and intermittent ear discharge 1 case. 6) The mean size of cyst was about 4cm that containing turbid white-yellowish fluid but discharge from sinus or fistula was clear mucoid. 7) The culture of cyst fluid was no bacteria, but 2 cases showed staphyloccoci suggesting secondary infection. 8) The surgical procedure were complete excision of cyst 32 cases, sinus excision 11 cases, fistula excision 6 cases and I&D 1 case. And the recurrent 1 case was that fistula tract could not be identified due to severe scar from previous several operations.