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      • KCI등재

        난소종양 1338 예의 임상병리학적 고찰

        김재호(Kim JH),마수영(SY Ma),신왕근(WG Shin),배석년(SN Bae),남궁성은(SE Namkoog),김승조(SJ Kim) 대한산부인과학회 1985 Obstetrics & Gynecology Science Vol.28 No.5

        A clinico-pathological survey was carried out on a series of 1338 ovarian tumors who were confimred with postoperative hisopathological study at Department of Obstetrics & Gynecology, in 7 affiliated hospitals of Catholic Medical Center during the period of 12 years from January 1, 1972 to December 31, 1983. The results were obtained as follows: 1. Among 1338 cases, the incidence of nonneoplastic ovarian cyst, benign ovarian tumors and malignant ovarian tumors were 39.7%(531 cases), 50.7%(679 cases) and 9.6%(128 cases) respectively. 2. The incidence of cystic teratoma, corpus luteal cyst, mucinous cystadenoma and simple cyst were 31.3%(419 cases), 13.2%(176 cases), 12.1%(162 cases) and 12.0%(161 cases) respectively. 3. The age distribution of ovarian tumor was 4~74 years old, and that of nonneoplastic ovarian cyste was 16~74 years old, and that of benign ovarian tumors was 4~71 years old, and that of malignant ovarian tumors was 17~70 years old. The mean ages of nonneoplastic ovarian cyst, benign ovarian tumors and malignant ovarian tumors were 33.1, 33.0 and 44.7 years old respectively. 4. In the incidence of ovarian tumors by age, the high incidence of nonneoplastic ovarian cyst and benign ovarian tumors showed in fertilized women(20~44 years old) as 87.8% and 79.5% respectively and that of malignant ovarian tumors showed in women over 45 years old as 50.8%. 5. The mean live births in patients of nonneoplastic ovarian cyst, benign ovarian tumors and malignant ovarian tumors were 1.7, 1.7 and 2.4 respetivley. 6. Menstrual pattern was regular in over 50%, and Menstrual amount was in normal range in 61.4% of nonneoplastic ovarian cyst, 53.6% of benign ovarian tumors and 38.1% of malignant ovarian tumors. 7. In benign ovarian tumors, abdominal pain and discomfort was present in 53.0 %, asymptomatic in 35.6%, lumbago in 27.8% and abdominal palpable mass in 27.1%. In malignant ovarian tumors, abdominal pain and discomfort was present in 63.3%, acdominal palpable mass in 49.2%, asymtomatic in 31.3% and lumbago in 29.7%. Weight loss was present in 0.4% of benign ovarian tumors and 9.4% of malignant ovarian tumors. 8. The mean size of tumors was 7.2cm in nonneoplastic ovarian cyst, 9.1cm in benign ovarian tumors and 11.9cm in malignant ovarian tumors. 9. Bilatrality of ovarian tumors was 13.9% in nonneoplastic ovarian cyst, 22.2% in benign ovarian tumors, 37.5% in malignant ovarian tumors, especially 40.4% in endometrial cyst, 47.6% in adenocarcinoma, 54.3% in serous cystadenocarcinoma and 75.0% in Krukenberg tumor.

      • KCI등재

        내시경하 질식 전자궁적출술 (LAVH) 200 예의 임상적 고찰

        정우길,서대원,정미나,이기만,조경호,김병석,신양호,손영남 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.4

        여수전남병원 내시경크리닉에서는 1996년 2월부터 1997년 12월까지 200예의 laparoscopic assisted vaginal hysterectomy를 시행하여 아래의 결과를 얻었다. 1) 환자의 평균 연령은 43.67세였고, 평균 출산력 은 3.03이었다. 2) 환자 중 54%에서 선행 수술의 기왕력이 있었 고, 수술 적응증으로는 복부 종괴가 91.5%로 가장 많았다. 3) 적출된 자궁의 평균 무게는 291 gm이었고, 수 술 시간은 평균 61.5분이었으며, 수술 전후의 혈색소 변화량은 평균 1.2 gm/dl였다. 4) 수술중 확인한 동반질환으로는 pelvic adhesion, endometriosis 등이 있었다. 5) 수술 후 병리조직검사 결과로는 자궁근종, 자 궁선근증, 경부상피내암, 및 두 가지 진단이 합병된 경우 등이 있었다. 6) 환자의 입원일수는 평균 4.27일 이었고, 합병증 은 5%에서 발생하였다. 내시경하 질식 전자궁적출술 은 복식수술에 비해 조직의 손상이 적고, 수술 후 유착 형성을 줄일 수 있으며, 통증과 유병률의 감소 를 기대할 수 있고, 미용 효과가 크며, 회복이 빠른 장점이있다. 내시경수술이 보편화되기 위해서는 수 술기구의 국산화 및 저렴한 수술 장비의 개발과 접 근이 용이한 수술 방법의 연구와 함께 집중적인 교 육을 통한 전문 인력의 양성이 필요할 것이다. Hysterectomy is one of the most frequently performed gynecologic surgical procedures worldwide. Laparoscopic hysterectomy, introduced by Reich et al. in 1989, has proven to be an effective alternative to abdominal hysterectomy, with advanced technologic development in laparoscopic instruments and improved skill in performing operative laparoscopy.During the period February, 1996 December, 1997, 200 woman underwent laparoscopic assisted vaginal hysterectomy (LAVH) at Yosu Chon-nam Hospital. This report is a retrospective review of 200 laparoscopic assisted vaginal hysterectomy. The mean age was 43.67±6.05 years. The mean parity was 3.03±1.09. The mean uterine weight was 291±187 gm. The mean operation time was 61.5±20.2 minutes. The mean hemoglobin change was 1.2±0.6 gm/dl. The mean hospital stay was 4.27±0.98 days. The common indications were myoma uteri (70.5%), adenomyosis (21%), and carcinoma in situ (4%). The complications were bladder injury (4 cases), rectum injury (1 case), trocar site bleeding (3 cases), and surgical emphysema (2 cases). In conclusion, hysterectomy can be safely performed vaginally assisted by operative laparoscopy.

      • KCI등재

        골반경수술 110 예에 대한 고찰

        박정근,김준영,나상,정종기,장진석,박원곤,이형근 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.7

        저자들은 1993년 9월부터 1995년 3월까지 본 병원 산부인과에서 110예의 골반경수술을 시행 한 결과 다음과 같은 결론을 얻을 수 있었다. 1. 골반경수술의 적응증은 총 110예중 자궁외임신이 43예(39%), 자궁근종이 26예(24%), 난소 종낭이 23예(21%)로서 대부분을 차지하였다. 2. 골반경수술의 방법은 총 110예중 난관절제술이 34예(32%), CISH LAVH operation 이 26예 (24%), 난소관절제술이 16예(15%), 난소절제술이 8예(7%) 및 난소낭종절제술의 8예(7%)순으 로 많았다. 3. 환자들의 연령분포는 21-40세가 78%였고 평균나이는 33.6세였다. 4. 환자들의 평균출산력은 1.52였다. 5. 입원기간은 수술후 1일에서 6일 사이였으며, 평균 입원기간은 3.57일이었다. 6. 수술시간은 30분에서 7시간까지 수술의 방법, 난이도에 따라 다양한 차이를 보였는데 근 래에 들어 많이 단축되었다. One hundred ten cases of pelviscopic operation were perfomed at Pusan Kwang-Hye General from September 1993 to March 1995. The common indication were ectopic pregnancy(39%) myoma uteri(24%) ovarian cyst(21%) and frequent types of surgery were salpingectomy(32%), CISH and LAVH operation (24%) , slapingoophorectomy(15%) oophorectomy(7%) and ovarian cystectomy(7%). The age of the patients ranged from 21 to 55 years and the mean age was 33.6 years and maen parity of the patients was 1.52 and mean duration of hospitalization was 3.57 days. The operation time was variable from 30 minutes to 7 hours because of operation method and difficulty, but was more shorter recently. In our conclusion, pelviscopic surgery makes minimal incision, minimal postoperative adhesion, and low morbidity rate, and early recovering brings short hospitalization, and reduction of medical cost. This pelviscopic surgery is simple and useful method of treatment in the community hospital.

      • KCI등재

        무월경 14 주에 동반된 속발성복강임신 1 예

        박정근,김준영,장미경,박원곤,이형근 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

        Abdominal pregnancy is very rare and potentially life-threatening variation of ectopic pregnancy. Early diagnosis is very difficult. In the last several decades prenatal care has improved and noninvasive procedures such as ultrasound scanning and fetal cardiotocography have led to us a better assessment of fetal and maternal disorders. In the last 30 years an increase of diagnosed ectopic pregnancies has been noted and attributed to the greater frequency of pelvic inflammatory disease. Although the incidence of ectopic pregnancy is rising, the incidence of abdominal pregnancy, which is primarily a sequel of a missed ruptured ectopic pregnancy, remains low. We presented a case of secondary abdominal pregnancy in 14 wks with its review of literature.

      • SCOPUSSCIEKCI등재
      • KCI등재

        골반경수술 583 예에 대한 고찰

        김준영(JY Kim),강승철(SC Kang),윤병목(BM Yoon),이형근(HG Lee),박원곤(WG Park),장미경(MK Chang),박정근(JK Park) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.10

        저자들은 1993년 9월부터 1997년 12월까지 본원 산부인과에서 583예의 골반경수술을 시행한 결과 자궁외임신이 204예(33%), 자궁근종이 201예 (32%), 난소낭종이 108예(21%)로서 대부분을 차지하였고, 각각을 비교 분석해 보았다. 골반경수술시 적절한 환자를 잘 선택해서 시술한다면 통증이 적고, 입원기간이 단축되고 회복기간이 빨라짐에 따라 경제적 절감 효과와 사회복귀에 부분적으로 도움 이 되리라고 생각되며 또한 Pelvic floor의 신경과 혈관 분포를 보존 하게 되어 성생활에도 많은 도움이 있을 것 으로 생각된다. 골반내시경을 시행하기 위해서는 수술기 구의 전반적인 파악과 고도의 숙련훈련이 필요하고, 수술기법과 의료장비의 발달, 환자의 호응도, 만족도가 증 가 하고 있어 일반 부인과적 수술은 개복수술보다 골반 내시경수술에 의해서 해결 되리라 생각되며, 고도로 숙련된 내시경 시술자들에 의해 적용범위가 더욱 광범위 해 지리라 기대된다. Five hundred eighty three cases of pelviscopic operation were performed at Kwang-Hye General Hospital from September 1993 to December 1997. The common indications were ectopic pregnancy (33%), myoma uteri (32%), ovarian cyst (21%) and types of surgery were salpingectomy (28%), Classical Intrafascial S.E.M.M Hysterectomy (CISH) and Laparoscopic Assisted Vaginal Hysterectomy (LAVH) (27%), salpingo-oophorectomy (17%), oophorectomy (8%) and ovarian cystectomy (8%). The age of the patients ranged from 21 to 55 years and the mean age was 37.6 years and mean parity of the patients was 1.66 and mean duration of postoperative hospitalization was 3.77 days. The operation time was varied from 30 minutes to 7 hours, mean time of CISH 112.34 minutes, ectopic pregnancy 67.45 minutes, ovarian cyst 69.37 minutes, but recently it was shorter than previously. In our conclusion, pelviscopic surgery makes minimal incision, minimal postoperative adhesion, and low morbidity , and early recovery brings short hospitalization, and reduction of medical cost. Pelviscopic surgery is effective and useful method of treatment in the community hospital.

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