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- 저자 : 임동훈 ( Dong Moon Lim ) (검색결과 3 건)
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후복막강경 근치적 신적출술 : 개복 근치적 신적출술과의 비교
김경영,임동훈,문형윤,노준,김철성 朝鮮大學校 附設 醫學硏究所 2009 The Medical Journal of Chosun University Vol.33 No.S
Purpose: Although kidney is located in the retroperitoneal space laparoscopic radical nephrectomy is usually performed by the transperitoneal approach. At our institution the retroperitoneal approach is preferred. We evaluated the surgical outcomes, safety, oncologic outcomes, and compared with the results those of open radical nephrectomy in a contemporary cohort. Materials and Methods: Between January 2000 and December 2005 we performed retroperitoneal laparoscopic radical nephrectomy for renal cell carcinoma in 37 patients with clinical stage cT1 and cT2. Data from the these patients were retrospectively compaired with 30 contemporary cases treated with open radical nephrectomy. The clinical parameters including perioperative outcomes, complications, pathologic data, learning curve and recurrence were evaluated. Results: For the 37 retroperitoneal radical nephrectomies mean tumor size was 4.6cm (range 2.3 to 8.0), surgical time was 203.6min (range 110-410) and blood loss was 241.8cc. Mean specimen size was 10.4cm (8.7-14.4). Mean analgesic used day was 1.3 (0-4) and mean postoperative hospital stay was 4.2 days. minor complications occur in 16 cases and no major complications occurred. Surgical margins were negative for tumor in all patients. Variable parameters were comparable between patients undergoing laparoscopic and open radical nephrectomy. However, laparoscopy resulted in decreased blood loss, surgical times, analgesia use, time to oral intake, time to drain removal and postoperative hospital stay. No different complication rate is between two groups Conclusions: Retroperitoneal laparoscopic radical nephrectomy can be a safe and effective treatment in renal cell carcinoma. Although no long-term follow-up is available, our follow up to mean 31 months confirm the effectiveness of retroperitoneal laparoscopic radical nephrectomy in terms of surgical principles and oncological effectiveness.
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음낭외상시 고환파열에 대한 초음파 검사의 진단적 유용성
김경영,한동준,신대은,노준,문형윤,임동훈,김철성,박성운 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3
Purpose: We determined the use of scrotal ultrasonography in the initial diagnosis and management of testicular injuries due to blunt scrotal trauma. Mateiials and Methods: We reviewed 54 patients of scrotal trauma in the last 8 years. Forty patients were evaluated by ultrasonography preoperatively. A heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition was the basis for diagnosis of testicular rupture. Among them, 33 cases underwent scrotal exploration and 7 cases were managed conservatively. The remaining 14 patients were evaluated only by physical examination, 8 patients of them were explored immediately because of suspicious testicular mpture. The accuracy of ultrasonography were determined by comparing radiographic interpretations with intraoperative findings. Results: Among the 33 patients who were evaluated by ultrasonography and explored immediately, there were 26 suspected testicular ruptures on ultrasonography. Surgical exploration revealed testicular rupture in 23 and simple hematoma in 10. The testicular rupture was correctly diagnosed by ultrasonography in the 22 cases, and there were 4 false-positive and 1 false-negative diagnoses of testicular rupture. The sensivity and specificity for the diagnosis of testicular rupture are 96% and 60%, and the positive and negative predictive values are 85% and 86%, respectively, Conclusions: Scrotal ultrasonography, with the main radiographic finding of a heterogeneous echo pattern of the testicular parenchyma with loss of oval shape, contour definition, is highly sensitive on the diagnosis of testicular rupture. And it increases the salvage rate for testicular rupture with preservation of the testicular function and prevents delayed complications of chronic pain, atrophy and orchiectomy associated with missed testicular rupture.
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