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소아 충수염의 복강경충수절제술 및 개복충수절제술의 비교
이세경,이철구,서정민,이석구,Lee, Se-Kyung,Lee, Cheol-Gu,Seo, Jeong-Meen,Lee, Suk-Koo 대한소아외과학회 2007 소아외과 Vol.13 No.1
Pediatric laparoscopic appendectomy is controversial particularly in complicated appendicitis. We evaluated the outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) in simple appendicitis and complicated appendicitis respectively. Since June 2004, initial LA has been our policy in all appendicitis including complicated ones. A total of 160 patients were included in this study, consisting of 80 OA (August 2001 - August 2003) and 80 LA (June 2004 - June 2006). We compared the operating time, the length of hospital stay, the length of antibiotics use, and the postoperative complications between LA and OA. In simple appendicitis (73), there were no differences between LA and OA. However in the 87 patients with complicated appendicitis, the operating time was longer in LA (64.8 min vs. 50.2 min) but the length of hospital stay was shorter in LA than OA (8.5 days vs. 9.6 days). There was one complication in simple appendicitis group and six in complicated appendicitis group (3 cases in LA, 3 cases in OA). There was no difference in the results of LA versus OA in simple appendicitis. Therefore for simple appendicitis, LA is recommended in consideration of the cosmetic effect (fewer scar). In complicated appendicitis, early discharge was an advantage and there were no differences in complications in LA despite a longer operative time. So we conclude LA can be considered as the first choice of treatment for all pediatric appendicitis including complicated appendicitis. To confirm our impressions, more well controlled randomized prospective studied need to be done.
Ultrasonically Activated Shears를 이용한 갑상선 수술에 대한 전향적 연구
김완욱,허성모,김성훈,이세경,임혜인,최재혁,김상민,이정언,김정한,김지수,남석진,양정현,최준호,Wan Wook Kim,M.D.,Sung Mo Hu,M.D.,Sung Hoon Kim,M.D.,Se-Kyung Lee,M.D.,Hye In Lim,M.D.,Jae Hyuck Choi,M.D.,Sangmin Kim,Ph.D.,Jeong Eon Lee,M.D.,Jung 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.2
Purpose: Adequate hemostasis in thyroidectomy is important to reduce postoperative complications including bleeding and hematoma. The object of this study was to evaluate the utility of thyroidectomy using ultrasonically activated shears. Methods: This was a prospective randomized controlled study. It was conducted on 95 patients who underwent total thyroidectomy between January and March 2009. Patients were divided into two groups according to operation method used: group A (n=49) underwent total thyroidectomy using ultrasonically activated shears, group B (n=46) involved the conventional clamp and tie maneuver. Comparisons included operation time, drain amount, hospitalization, postoperative complications and off-thyroglobulin. Results: The two groups had no significant differences regarding drain amount, hospitalization, postoperative complications and off-thyroglobulin. Operation time was statistically shorter in group A than group B (96.6±22.7 min vs 114.6±24.3 min) (P=.00). Conclusion: Thyroidectomy using ultrasonically activated shears reduces operation time significantly, and enables a complete and safe operation without postoperative complications. We recommend the use of ultrasonically activated shears in thyroidectomy. (Korean J Endocrine Surg 2009;9:69-73)
한국인에서 다발성 내분비선종 증후군의 초기 증상 및 임상 양상
김기호,구민영,허성모,이세경,최준호,이정언,김지수,정재훈<SUP>1<.SUP>,남석진,양정현,김정한,Ki-Ho Kim,M.D.,Min-Young Koo,M.D.,Sung-Mo Hur,M.D.,Se-Kyung Lee,M.D.,Jun-Ho Choe,M.D.,Jeong Eon Lee,M.D.,Jee Soo Kim,M.D.,Jae-Hoon Chung,M.D.<SU 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.4
Purpose: Multiple endocrine neoplasia (MEN) syndrome is an inherited, autosomal dominant disease that presents as a combination of several endocrine tumors. Early diagnosis of this syndrome is difficult, because of the nonspecific symptoms and signs. This study analyzed early manifestations and clinical characteristics in patients with MEN syndrome. Methods: Medical records were retrospectively reviewed and telephone interviews were conducted with 35 patients diagnosed as MEN syndrome at Samsung Medical Center from December 1994 to December 2009. Results: The 35 patients had been diagnosed as MEN1 (n=14), MEN2A (n=19) and MEN2B (n=2). The early manifestations of the 14 MEN1 patients were related with hyperparathyroidism (n=5), pituitary tumor (n=3), and pancreatic endocrine tumor (n=2). There were tumors of the parathyroid gland in all 14 patients, anterior pituitary in eight patients, and pancreatic islet cells in seven patients. Four cases were incidentally detected during the screening examination. Six cases harbored a MEN1 gene mutation. The twenty-one patients diagnosed with MEN2 comprised medullary thyroid cancer (n=20), adrenal pheochromocytoma (n=15), and hyperparathyroidism (n=4). The MTC-related symptoms in the 21 MEN2 patients included neck mass or discomfort in 12 patients and pheochromocytoma-related symptoms in seven patients. Two cases were detected through familial genetic screening test. The RET gene mutationwas detected in 19 cases. Conclusion: Early manifestations of MEN syndrome were very different between the types of MEN and the types of its presenting tumor. The early diagnosis and proper management of MEN requires awareness of the clinical characteristics of each expressed tumor and is influenced by genetic screening methods. (Korean J Endocrine Surg 2010; 10:266-275)
원발성 알도스테론증으로 부신 절제술 받은 환자의 수술 후 결과에 대한 분석
류재민,정승필,이정희,김지영,최민영,이세경,길원호,최준호,이정언,김지수,남석진,양정현<SUP>1<.SUP>,김정한,Jai-Min Ryu,M.D.,Seung-Pil Jung,M.D.,Jeong-Hee Lee,M.D.,Ji-Yeong Kim,M.D.,Min-Yeong Choi,M.D.,Se-Kyung Lee,M.D.,Won-Ho Kil,M.D.,Jun-Ho C 대한갑상선-내분비외과학회 2011 The Koreran journal of Endocrine Surgery Vol.11 No.4
Purpose: Primary aldosteronism (PA) is characterized by hypertension (HTN), hypokalemia, suppressed plasma renin activity, and inappropriate aldosterone secretion. The purpose of this study was to analyze postoperative results on blood pressure (BP), and to determine the factors associated with resolution of HTN after adrenalectomy for PA. Methods: One hundred eight patients (66 females and 42 males) with a mean age of 46 years underwent adrenalectomy for PA between January 1, 1996 and September 30, 2009. Their clinical characteristics and biochemical parameters were reviewed retrospectively. Results: All patients had HTN preoperatively and 20 patients (18.1%) had uncontrolled HTN. Hypokalemia was evident in 89.1% of patients, cardiovascular events in 4.5% and cerebrovascular events in 8.2%. There was a significant decrease in both systolic BP and diastolic BP postoperatively, as compared with that before operation. Median systolic BP decreased from 150 mmHg to 125 mmHg at the last follow-up (P<0.01), and median diastolic BP decreased from 93.5 mmHg to 81.5 mmHg (P<0.01). Sixty two (57.4%) patients were cured of HTN and did not require any hypertensive agent, and 38 (35.1%) patients had an improvement in BP control, whereas 9 (8.3%) patients had no change in BP. Univariate analysis showed that duration of HTN and more than two HTN treatment agents were independent factors predicting sustained hypertension after surgery. Conclusion: The duration of HTN and the severity of HTN are factors influencing persistence of HTN after operation for a PA. (Korean J Endocrine Surg 2011;11:276-282)