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- 저자 : 공태욱 ( Tae Wook Kong ) (검색결과 3 건)
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공태욱 ( Tae-wook Kong ),( Suk-joon Chang ),( Jiheum Paek ),( Hyogyeong Park ),( Seong Woo Kang ),( Hee-sug Ryu ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Objective: To evaluate the learning curve of laparoscopic radical hysterectomy (LRH) for gynecologic oncologists who underwent residency- and fellowship-training on laparoscopic surgery without previous experience in performing abdominal radical hysterectomy (ARH). Methods: We retrospectively reviewed 84 patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB cervical cancer who underwent LRH (Piver type III) between April 2006 and March 2014. The patients were divided into two groups (surgeon A group, 42 patients; surgeon B group, 42 patients) according to the surgeon with or without ARH experience. Clinico-pathologic data were analyzed between the 2 groups. Operating times were analyzed using the cumulative sum technique. Results: The operating time in surgeon A started at 5 to 10 standard deviations of mean operating time and afterward steeply decreased with operative experience (Pearson correlation coefacient=-0.508, P=0.001). Surgeon B, however, showed a gentle slope of learning curve within 2 standard deviations of mean operating time (Pearson correlation coefacient=-0.225, P=0.152). Approximately 18 cases for both surgeons were required to achieve surgical proaciency for LRH. Multivariate analysis showed that tumor size (>4 cm) was signiacantly associated with increased operating time (P=0.027; odds ratio, 4.667; 95% conadence interval, 1.187 to 18.352). Conclusion: After completing the residency- and fellowship-training course on gynecologic laparoscopy, gynecologic oncologists, even without ARH experience, might reach an acceptable level of surgical proaciency in LRH after approximately 20 cases and showed a gentle slope of learning curve, taking less effort to initially perform LRH.
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박진영 ( Jin Young Park ),이경미 ( Kyoung Mi Lee ),공태욱 ( Tae Wook Kong ),장칼리혜진 ( Kylie Hae Jin Chang ),주희재 ( Hee Jae Joo ),장석준 ( Suk Joon Chang ),유희석 ( Hee Sug Ryu ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.8
Leiomyomatosis peritonealis disseminata (LPD) is rare, typically benign condition characterized by multiple smooth muscle, myofibroblasticand fibroblastic nodules arising in the pelvic and abdominal cavities in women. LPD is observed in reproductive age group especially and often mimics carcinomatosis grossly but has benign histologic feature and good prognosis. We report a case of leiomyomatosis peritonealis disseminata arising after laparoscopic myomectomy with review of literature.
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저체중태아를 동반한 만기임신의 주산기 예후예측을 위한 제대동맥 도플러혈류속도 파형의 유용성
김호연 ( Ho Yeon Kim ),김행수 ( Haeng Soo Kim ),양정인 ( Jeong In Yang ),공태욱 ( Tae Wook Kong ),이경미 ( Kyoung Mi Lee ),장석준 ( Suk Jun Chang ),김용미 ( Yong Mi Kim ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.5
목적: 제대동맥 도플러혈류속도파형이 저체중태아를 동반한 만기임신의 주산기 예후예측에 유용한가를 살펴보고자 한다. 연구 방법: 임신 37주부터 41주 사이에 단태의 저체중태아를 분만한 산모와 신생아의 의무기록을 후향적으로 검토하였다. 총 381명의 단태임신 환자의 최고 수축기혈류속도 (S)에 대한 이완기 말 혈류속도 (D)의 비를 측정하여 S/D치 3.0 이하인 정상군(n=307)과 3.0 초과인 비정상군(n=74)으로 구분하여 산모의 임상적 특징 및 신생아 예후를 비교하였다. 결과: 두 군 모두에서 산모 연령, 분만 시 재태연령, 태아곤란증에 의한 제왕절개분만 빈도 등에서 차이를 보이지 않았다. 제대동맥 도플러지수가 비정상인군에서 산모의 고혈압성 질환의 빈도(12.3% vs. 25.0%, P=0.005)가 통계학적으로 유의하게 높았다. 신생아 출생체중(2,415.2±258.9 g vs. 2,296.7±325.0 g, P=0.003), 신생아의 중환자실 입원 빈도(27.0 vs. 51.3%, P<0.001) 및 중환자실 입원기간(2.7±5.9 vs. 5.7±8.8 days, P=0.005) 등은 유의한 차이를 보였으나, 7 미만의 낮은 5분 Apgar치, 기계적 호흡빈도, 주산기사망 및 신생아 합병증 등은 차이를 보이지 않았다. 선형회귀분석을 시행한 결과 고혈압성 질환의 빈도를 보정한 후에도 비정상 제대동맥 도플러지수와 작은 출생 시 신생아체중은 유의한 관계가 있었다(P<0.001). 결론: 제대동맥 도플러 혈류 파형이 만삭 임신에 동반된 저체중태아의 신생아 체중, 신생아 중환자실 입원빈도 및 입원기간 등을 예측하는데 유용한 독립인자로 작용하지만 그 외의 신생아 예후 예측에는 한계가 있으므로 자궁동맥혈류파형이나 정맥관, 중뇌혈관 등과 같은 다른 혈관의 도플러혈류파형 측정이나 생물리학적계수 등을 종합하여 주산기 합병증을 낮추도록 해야 할 것이다. Objective: To investigate whether umbilical artery Doppler blood flow velocity waveform is effective in predicting perinatal outcome of term pregnancies with small for gestational age (SGA). Methods: A total of 381 patients at 37~41 weeks of gestational age (GA) who received antenatal umbilical artery Doppler blood flow test and delivered singleton SGA infants. The ratio of peak-systolic to end-diastolic (S/D) blood flow velocities in the umbilical artery was measured in each patient. The patients were divided into a normal group (n=307) with a S/D ratio equal to or less than 3.0, and an abnormal group with a S/D ratio of greater than 3.0 (n=74). These groups were comparatively analysed with respect to maternal characteristics and neonatal outcomes. Results: There were no significant differences between the two groups in mean maternal age, gestational age at the time of delivery, and cesarean section rate due to fetal distress. There was significantly increased incidence of hypertensive disorders in pregnancy in the abnormal S/D ratio group. And the abnormal S/D ratio group showed lower neonatal birthweight, higher incidence of admission to neonatal intensive care unit (NICU), and longer stay in neonatal intensive care unit. According to linear regression, in pregnancies complicated by SGA, abnormal S/D ratio was still a risk factor for low birthweight even after controlling for the incidence of hypertension. Conclusion: In term pregnancies accompanied by SGA, abnormal umbilical artery S/D ratio is an independent predictor of neonatal birth weight, incidence of admission to NICU, and NICU stay.
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