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척추관절경을 이용한 경피적 수핵제거술의 실패원인 및 합병증
이춘택,최용기,정창영,허정태,신권현 대한척추외과학회 1995 대한척추외과학회지 Vol.2 No.2
Form December 1992 to December 1994, 207 patients who had a contained lumbar disc herniation refractory to non-operative modalities were treated by Arthroscopic Microdiscectomy at Lee Chun Tek Hospital in Suwon Korea. The purpose of this study was to reduce the incidence of complications and failures following Arthroscopic disc surgery. The results were obtained as follows; 1) Evaluation was made with St. Luke system's criteria. 31 patients were considered to have failed; Fair 11(5.3%) Poor 20(9.7%). Outcome analysis demonstrated failure rate of 15% 2) No serious complication was encountered. 3) The common causes of the failure were inadequate decompression of nuclear material, non-con-tained disc herniation and lateral recess stenosis. Although laminectomy remains the conerstone of spinal surgery, the low incidence of failure and complication in this group of patients suggest that AMD offers an alternative method of treatment for symptom producing lumbar disc herniation.
( Jae Il Chung ),( Nayoung Kim ),( Min Sik Um ),( Kyung Phil Kang ),( Donghun Lee ),( Jong Chun Na ),( Eun Sil Lee ),( Yeon Mu Chung ),( Ji Yeon Won ),( Kwang Ho Lee ),( Tek Man Nam ),( Jung Hun Lee ) 대한소화기기능성질환·운동학회 2010 Gut and Liver Vol.4 No.1
Background/Aims: Colonoscopy training programs and the minimal experience with colonoscopy required to be considered technically competent are not well established. The aim of this study was to determine the colonoscopy learning curves and factors associated with this difficult procedure at a single center. Methods: A total of 3,243 colonoscopies were performed by 12 first-year gastroenterology fellows, and various clinical factors were assessed prospectively for 22 months. Acquisition of competence (success rate) was evaluated based on two objective criteria: (i) the adjusted completion rate (>90%) and (ii) cecal intubation time (<20 minutes). Results: The overall success rate in reaching the cecum in less than 20 minutes was 72.8%. The cecal intubation time was 9.34±4.13 minutes (mean±SD). Trainees` skill at performing cecal intubation in <20 minutes reached the requisite standard of competence after 200 procedures. Cecal intubation time decreased significantly from 11.3 to 9.4 minutes after 100 procedures and improved continuously thereafter. Female patients and advanced patient age (over 60 years) were associated with prolonged cecal intubation time (>20 minutes). Surgery of the uterus and ovaries was significantly correlated with delayed cecal intubation time, but not after sufficient colonoscopy experience. Conclusions: The minimum number of procedures to reach technical competence was 200. The cecal intubation time was longer in female and older patients. (Gut Liver 2010;4:31-35)
척추관절경하 경피적수핵제거술의 Uniportal 및 Biportal 방법의 비교
이춘택,최용기,정창영,최정기,박동욱 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.2
1. The prupose of our study is to compare the clinical results and radiological indications of the uniportal and biportal methods in percutaneous arthroscopic microdiscectomy in the patients who were failed to conservative treatments for lumbar disc herniation. 2. From December 1992 to March 1995, we performed 230 cases of percutaneous arthroscopic microdiscectomy for patients with lumbar disc herniation and compared the postoperative results between two methods. 3. The overall success rate of uniportal method was 85% and that of biportal method was 83%. 4. The disadvantages of the biportal method required more prolonged operation time, difficult technical demands, and additional instruments. There was more severe temporary back pain than uniportal method but biportal method is more effective due to direct decompression of offending disc by visualization curing procedure and the lower incidence of postoperative infection, bleeding and the remaining offending disc materials. 5. Uniportal method is primary method for the patients who are indicated with percutaneous microdiscectomy except particular cases which are required biportal approach.
최정기,손일진,이춘택,김성재,Choi Jeong-Ki,Son Il-Jin,Lee Chun-Tek,Kim Sung-Jae 대한관절경학회 2003 대한관절경학회지 Vol.7 No.2
Purpose : The purpose of this study was to evaluate the arthroscopic findings of the transplanted human allogenic meniscus including MRI changes at follow up. Materials and Methods : From Oct. 1999 to Jun. 2002, nine patients underwent arthroscopic evaluation at follow-up. We used nonirradiated cryopreserved meniscus allograft for 6 cases and fresh-frozen for 3 cases. We used bone-plug method for medial meniscus and bone-bridge method for lateral meniscus to fix the transplanted meniscus. The average follow-up time was 13 months. We evaluated the result by lysholm score, MRI and second-look arthroscopic finding. Results : The second-look arthroscopy after allogenic meniscal transplantation revealed that grafts were well incorporated with surrounding capsular tissue. But one case showed wear on the post horn and the other case which was operated at other local clinic showed tear of the anterior hem due to non-anatomic placement of bone bridge. There was improvement of average Lysholm score form 64 to 87. Conclusion : Second-look arthroscopy revealed excellent incorporation of the allograft with firm attachment and early clinical results are satisfactory. But further studies are necessary to assess whether meniscal transplantation can prevent progressive degenerative changes. 목적 : 반월상연골 동종 이식술을 시행 후 2차 관절경적 소견 및 자기 공명 영상을 통해 이식물의 관절 내 변화를 관찰 하고자 하였다. 대상 및 방법 : 1999년 10월부터 2002년 6월까지 반월상 연골 동종 이식술을 시행후 이차 관절경 검사를 9례를 대상으로 하였다. 6례에서 동결 보존(cryopreserved) 반월상 연골을, 3례에서 신선 동결(fresh-frozen)반월상 연골을 이식물로 사용하였다. 내측은 골편 고정술을, 외측은 골교 고정술을 사용하였다. 술후 평균13개월째 이차 관절경 검사를 시행 하였으며 임상적 평가는 lysholm score, 자기 공명 영상 및 이차 관절경 검사소견으로 평가 하였다. 결과 : 이식된 반월상연골은 변연부에 견고하게 고정되었고 혈관 증식 역시 양호하였다. 그러나 1례에서 후각부에 경도의 마모를 보였으며, 타원에서 시술 후 내원하였던 1례에서 비해부학적 위치에의 이식으로 인한 전각부에 파열소견이 관찰되었다. Lysholm score는 술전 평균64점에서 술후 87점으로 향상 되었다. 결론 : 2차 관절경검사상 이식한 반월상연골이 변연부에 견고하게 고정 되었음을 확인 할 수 있었으며 임상적으로도 증상이 호전되었으나, 향후 관절염의 진행을 예방 할 수 있는지의 여부는 보다 장기간의 추시관찰이 필요하리라 사료되었다.