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근치적 치골후 전립선 적출술 후 발생한 혜부 탈장에 대한 이전 절개창을 이용한 단일절개창 복강경 탈장 교정술, 초기 경험, 연속 증례
정재훈(Jae Hoon Chung),조정기(Jung Ki Jo),이정우(Jeong Woo Lee),이승욱(Seung Wook Lee) 대한비뇨기종양학회 2013 대한비뇨기종양학회지 Vol.11 No.3
Purpose: Inguinal hernia is one of the most common complications of radical prostatectomy which needs surgical repair. Surgical repair of inguinal hernia after prostatectomy cannot be avoid the additional scar on abdominal wall. However, in this study we evaluated the safety and feasibility of the inguinal hernia repair via previous prostatectomy wound without additional scar. Materials and Methods: Total four patients were enrolled who had developed inguinal hernia as a complication of retropubic radical prostatectomy. The repair of inguinal hernia was conducted transperitoneally using home-made glove single port through 2cm incision of the upper part of previous prostatectomy scar. The period between occurrence of inguinal hernia and radical prostatectomy and the operative time were evaluated. The follow-up time, and the complications of inguinal hernia repair were also evaluated. Results: The mean age of 4 patients was 67.25±7.5 and all the patients had no previous history of inguinal hernia. The inguinal hernia developed 4.25±2.63 months after retropubic radical prostatectomy. The mean operative time was 41.25±4.59 minutes. There was no surgical complication and recurrence of inguinal hernia during follow-up. Conclusions: This study showed the safety and feasibility of inguinal hernia repair using home-made glove single port via previous prostatectomy scar.
조우진,이경진,지철,박성찬,박해관,조정기,조경근,나형균,강준기,최창락,Cho, Woo Jin,Lee, Kyung Jin,Ji, Cheul,Park, Sung Chan,Park, Hea Kwan,Jo, Jung Ki,Cho, Kyung Keun,Rha, Hyung Kyun,Kang, Joon Ki,Choi, Chang Rak 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.8
Objectives : For Parkinsonian patients who had not reacted favorably on drug therapy are good candidate for ventroposterolateral pallidotomy, although not curative. We studied these patients after unilateral pallidotomy, to confirm the effectiveness and safety of this procedure. Methods : We evaluated the 17 patients with idiopathic Parkinson's diesease who had undergone unilateral posteroventral pallidotomy. All patients responded to levodopa initially. Mean age was 55 years(38-75years), and mean duration of disease was 9.8 years(3-20years). Pre-and postoperative evaluation at 3 month intervals included Unified Parkinson's Disease Rating scale(UPDRS) scoring, Hoehn and Yahr(H & Y) staging, and neuropsychological examinations. Results : Pallidotomy significantly improved parkinsonian symptom(tremor, rigidity, bradykinesia, dyskinesia, sensory symptom). Nine of 10 patients who showed dyskinesia preoperatively significant improvement. The mean dose of levodopa in 9 patients was lowered. The mean H & Y score and UPDRS score were improved in on and/or off time in 15 patients. Among patients who were not improved, one patient worsened, and the others showed no change. The mean overall UPDRS off score changed from 76 preoperatively to 44(33%) at 6 months and from 70 to 52(25%) at 1 year. Transient surgical morbidity was showen in four patients and included dysarthria, hypotonia and confusion. Conclusion : We conclude that pallidotomy is safe and effective in patients who have levodopa-reponsive parkinsonism with severe symptom fluctuation. Unilateral pallidotomy also considered helpful to ipsilateral symptom. Unilateral pallidotomy can improve all of parkinsonian's symptom and allow to reduce the levodopa medication. Most of patients show satisfactory results.