소아의 난소종양

백정흠(Jeong Heum Baek),정풍만(Poong Man Jung) 대한외과학회 1994 Annals of Surgical Treatment and Research Vol.46 No.3

40세 미만 대장암 환자의 생존율

조중연(Chung Yon Cho),백정흠(Jeong-Heum Baek),이정남(Jung Nam Lee),민승기(Seung Kee Min),이운기(Woon Ki Lee),박흥규(Heung Kyu Park),정민(Min Chung),이영돈(Young Don Lee),오재환(Jae Hwan Oh) 대한외과학회 2005 Annals of Surgical Treatment and Research(ASRT) Vol.69 No.4

Gastrointestinal autonomic nerve tumor in the lower rectum

Sung Won Park(박성원),Jung Nam Lee(이정남),Dong Hae Jung(정동해),Jeong-Heum Baek(백정흠) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.1

Gastrointestinal autonomic nerve tumor (GANT) in the rectum is a subset of gastrointestinal stromal tumor (GIST). It’s a very rare mesenchymal tumor with neuronal differentiation of gastrointestinal tract. We experienced a 34-year-old female patient with GANT in the lower rectum. She was referred to our hospital owing to rectal bleeding, but didn’t have other symptoms such as abdominal pain and constipation. On digital rectal examination, a round and smooth submucosal tumor at posterior wall of the rectum was palpated approximately 5 cm above the anal verge. The mass measured approximately 5 cm in diameter and was not fixed to the underlying structures. Colonoscopy, abdomino- pelvic computed tomography scan, and core needle biopsy were performed. Given the impression of GIST, it was assumed that the patient underwent low anterior resection with double stapling technique. The tumor, a yellow-grayish colored mass, was homogenous and didn’t have hemorrhagic necrosis. Diagnosis of GANT was based on histological, immunohistochemical staining, and electron microscopy. The patient did not receive any adjuvant therapy and was discharged without complications on the tenth postoperative day.

복부 자상의 치료 방법에의 접근

박지연 ( Ji Yeon Park ),정민 ( Min Chung ),이영돈 ( Yeong Don Lee ),이정남 ( Jung Nam Lee ),이운기 ( Woon Ki Lee ),박연호 ( Yeon Ho Park ),백정흠 ( Jung Heum Baek ),박흥규 ( Heung Gyu Park ),김건국 ( Keon Kuk Kim ),강진모 ( Jin M 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2

Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation. (J Korean Soc Traumatol 2010;23:134-141)

대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm(R) 과 Adept(R) 가 수술 후 장운동 회복에 미치는 영향에 대한 임상적인 비교

홍윤화 ( Yoon Hwa Hong ),이원석 ( Won Suk Lee ),백정흠 ( Jeong Heum Baek ),이정남 ( Jung Nam Lee ),이운기 ( Woon Ki Lee ),최상태 ( Sang Tae Choi ) 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2

목적: 대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm(R) 과 Adept(R) 의 임상 결과를 대조군과 비교하여 장유착으로 인한 술후 합병증을 줄이고 예방하고자 본 연구를 시행하였다. 방법: 2008년 2월부터 2010년 1월까지 가천의과대학교 길병원 외과에서 대장암 수술을 받은 454 명의 환자중 114명은 Seprafilm(R) 그룹으로, 180명은 Adept(R) 그룹으로, 160명의 환자는 아무 것도 사용하지 않은 대조군으로 분류되었다. 각 그룹간의 나이, 성별, 수술 시간은 유사하였다. 결과: 소장 폐쇄은 Adept(R) 그룹에서는 16명(8.9%), Seprafilm(R) 그룹에서는 5명(4.4%), 대조군에서 11명(6.9%)이 발생하였다. 특히, Adept(R) 그룹에서는 Seprafilm(R) 그룹과 대조군에 비해 통계적으로 상당히 높은 결과로 보고 되었다. (Adept(R) vs Seprafilm(R); P = 0.043 Adept(R) vs Control group, P = 0.002) 결론: 대장암 환자에서 Seprafilm(R) 의 사용이 대조군과 비교했을 때 술후 소장 폐쇄의 전체적인발생율은 감소시키지 못하고 Adept(R) 의 사용은 소장 폐쇄의 발생율을 현저히 증가시키므로 수술중 사용함에 있어서 신중히 고려되어야 할 것이다. Purpose: The purpose of this study was to compare the clinical outcomes between Seprafilm(R), Adept(R) groups and control group in colorectal surgery for colorectal cancer. Methods: we retrospectively reviewed the medical records of patients who had undergone a colorectal surgery between February 2008 and January 2010.The patient`s demographic and operative outcomes were also evaluated. Of the 454 patients, 114 patients received Seprafilm, 180 patients received Adept(R) and 160 patients in the no additive control group. The age, gender and operative times among three groups were similar. Results: Small bowel obstruction developed in 16 patients in the Adept(R) group (8.9%), in Seprafilm(R) group 5 patients (4.4%), in the control group 11 patients (6.9%) had small intestinal obstruction. The overall incidence was significantly higher in Adept(R) group than in the Seprafilm(R) group and the control group with statistical significance (Adept(R) vs Seprafilm(R); P = 0.043 Adept(R) vs Control group, P = 0.002) Conclusion: The application of Seprafilm(R) did not reduce the rate of small bowel obstruction in patients undergoing colorectal surgery for colorectal cancer as compared with no additive group and the application of Adept(R) increased the rate of small bowel obstruction. Thus, it should be considered when using of Adept(R) in colorectal cancer operation as an adhesion reduction agents.

대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm<SUP>Ⓡ</SUP>과 Adept<SUP>Ⓡ</SUP>가 수술 후 장운동 회복에 미치는 영향에 대한 임상적인 비교

홍윤화(Yoon-Hwa Hong),이원석(Won-Suk Lee),백정흠(Jeong-Heum Baek),이정남(Jung-Nam Lee),이운기(Woon-Ki Lee),최상태(Sang-Tae Choi) 대한종양외과학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2

목적 : 대장암 환자의 수술에서 장유착 방지제로 사용된 Seprafilm<SUP>ⓡ</SUP> 과 Adept<SUP>ⓡ</SUP> 의 임상 결과를 대조군과 비교하여 장유착으로 인한 술후 합병증을 줄이고 예방하고자 본 연구를 시행하였다. 방법 : 2008년 2월부터 2010년 1월까지 가천의과대학교 길병원 외과에서 대장암 수술을 받은 454 명의 환자중 114명은 Seprafilm<SUP>ⓡ</SUP> 그룹으로, 180명은 Adept<SUP>ⓡ</SUP> 그룹으로, 160명의 환자는 아무 것도 사용하지 않은 대조군으로 분류되었다. 각 그룹간의 나이, 성별, 수술 시간은 유사하였다. 결과 : 소장 폐쇄은 Adept<SUP>ⓡ</SUP> 그룹에서는 16명(8.9%), Seprafilm<SUP>ⓡ</SUP> 그룹에서는 5명(4.4%), 대조군에서 11명(6.9%)이 발생하였다. 특히, Adept<SUP>ⓡ</SUP> 그룹에서는 Seprafilm<SUP>ⓡ</SUP> 그룹과 대조군에 비해 통계적으로 상당히 높은 결과로 보고 되었다. (Adept<SUP>ⓡ</SUP> vs Seprafilm<SUP>ⓡ</SUP>; P = 0.043 Adept<SUP>ⓡ</SUP> vs Control group,P = 0.002) 결론 : 대장암 환자에서 Seprafilm<SUP>ⓡ</SUP>의 사용이 대조군과 비교했을 때 술후 소장 폐쇄의 전체적인발생율은 감소시키지 못하고 Adept<SUP>ⓡ</SUP>의 사용은 소장 폐쇄의 발생율을 현저히 증가시키므로 수술중 사용함에 있어서 신중히 고려되어야 할 것이다. Purpose : The purpose of this study was to compare the clinical outcomes between Seprafilm<SUP>ⓡ</SUP>, Adept<SUP>ⓡ</SUP> groups and control group in colorectal surgery for colorectal cancer. Methods : we retrospectively reviewed the medical records of patients who had undergone a colorectal surgery between February 2008 and January 2010.The patient’s demographic and operative outcomes were also evaluated. Of the 454 patients, 114 patients received Seprafilm, 180 patients received Adept<SUP>ⓡ</SUP> and 160 patients in the no additive control group. The age, gender and operative times among three groups were similar. Results : Small bowel obstruction developed in 16 patients in the Adept<SUP>ⓡ</SUP> group (8.9%), in Seprafilm<SUP>ⓡ</SUP> group 5 patients (4.4%), in the control group 11 patients (6.9%) had small intestinal obstruction. The overall incidence was significantly higher in Adept<SUP>ⓡ</SUP> group than in the Seprafilm<SUP>ⓡ</SUP> group and the control group with statistical significance (Adept<SUP>ⓡ</SUP> vs Seprafilm<SUP>ⓡ</SUP>; P = 0.043 Adept<SUP>ⓡ</SUP> vs Control group, P = 0.002) Conclusion : The application of Seprafilm<SUP>ⓡ</SUP> did not reduce the rate of small bowel obstruction in patients undergoing colorectal surgery for colorectal cancer as compared with no additive group and the application of Adept<SUP>ⓡ</SUP> increased the rate of small bowel obstruction . Thus, it should be considered when using of Adept<SUP>ⓡ</SUP> in colorectal cancer operation as an adhesion reduction agents.

충수돌기 종양의 임상적 치험

송슬기(Seul Ki Song),최상태(Sang Tae Choi),김건국(Keon Kuk Kim),이정남(Jung Nam Lee),오재환(Jae Hwan Oh),박연호(Yeon Ho Park),백정흠(Jeong Heum Baek),이운기(Woon Ki Lee),정민(Min Chung) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.73 No.1

Purpose: This study was undertaken to describe the clinicopathologic characteristics and evaluate the appropriate management of appendiceal tumors. Methods: During 5 years between Sep. 2000 and Sep. 2005, 28 appendiceal tumors were identified in a retrospective review of 3,744 cases of appendectomy or right hemicolectomy pathology. Results: Carcinoids were found incidentally as appendicitis. Mucinous cystadenomas were common in women older than 50 aged; half of the cases presented with appendicitis and the other half presented with non??specific abdominal symptoms such as palpable mass, intestinal obstruction and intussusception. Carcinomas were common in the older patients(mean age: 62.8 years) and this presented as periappendiceal abscess. Right hemicolectomy was undertaken when there was evidence of tumor spread beyond the resection margin, and carcinoma and tumors were located in the appendiceal base. Recurrence and metastasis were identified only in the carcinoma cases. Conclusion: Most appendiceal tumors presented with appendicitis and periappendiceal abscess. One stage curative resection was possible in more than 76% of the patients, and the prepoperative diagnosis rate was less than 35%. The preoperative diagnosis did not have much impact on the clinical course, and the postoperative pathology was important in determining the additional treatment. Close follow??up is needed for the early detection of recurrence, and all the carcinomas that were advanced as serosal involvement, peritoneal seeding and liver metastasis.

반복적인 투침으로 인해 인조혈관과 자가 정맥 사이에 발생한 의인성 동정맥루 환자들에서의 임상적 특징

최상태(Sang Tae Choi),김건국(Keon Kuk Kim),이운기(Woon Ki Lee),이정남(Jung Nam Lee),강진모(Jin Mo Kang),백정흠(Jeong-Heum Baek),이원석(Won Suk Lee),서우형(Woo Hyung Seo) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.78 No.1

Purpose: Failure of hemodialysis access is the main medical problem in chronic renal failure patients. This resulted from complications such as thrombosis, infection, pseudoaneurysm, steal syndrome and so on. This study was undertaken in an attempt to describe the clinical characteristics and significances of dialysis failure due to iatrogenic fistula between prosthetic graft and native vein at puncture site. Methods: During 5 years between Feb. 2005 and Feb. 2009, five Iatrogenic fistulas were identified in a retrospective review of 133 patients performed 220 times fistulography due to dialysis failure in PTFE (polytetrafluoroethylene) graft. Results: Overall incidence is 3.8 % in PTFE graft cases. Mean age is 50 (28~75) years, male to female ratio 2:3. Median 1st patency period is 20 months (6~36). All iatrogenic fistula is usually located in not venous but arterial limb of forearm loop, combined with the stenosis in venous limb and anastomosis site. More than 70% venous anastmotic stenosis in 4 cases (80%) and diffuse stenosis of venous limb in 3 cases (60%), revised concomitantly either by patch angioplasty or ballooning. Medial follow-up period is 8 months (5~12), graft occlusion occurred in one case. Conclusion: All iatrogenic fistula usually occurs in not venous but arterial limb of forearm loop graft. Most iatrogenic fistula is combined with the stenosis in venous limb and anastomosis sites, must be revised concomitantly either by patch angioplasty or ballooning. Close assessment to superficial vein and graft is needed for early detection. Fistulography is the most useful diagnostic tool. Careful cannulation method is required to prevent the occurrence of iatrogenic fistula in chronic renal failure patients.

복강경하 대장절제술의 조기 결과

백정흠,김혜경,이정남,오재환 대한대장항문학회 2004 Annals of Coloproctolgy Vol.20 No.1

주요 혈관 손상에 대한 치료

김혜경,박연호,이운기,박홍규,백정흠,이정남,오재환,정민,이영돈,민승기 대한혈관외과학회 2004 Vascular Specialist International Vol.20 No.1