http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
복강경 대장 절제술의 초기 시행 시 고려점(대장내시경 문신술의 가치와 전직장간막 절제술의 완전성 평가를 중심으로)
오유진,임영철,최대화,차희정 대한내시경복강경외과학회 2009 Journal of Minimally Invasive Surgery Vol.12 No.1
Purpose: Laparoscopic colectomy is technically demanding. Here we share of experience with laparoscopic procedures with focusing on (1) preoperative localization by a colonoscopic tattoo and (2) comparing the laparoscopic total mesorectal excision (lapaTME) with the conventional TME (openTME) according to microscopic examination. Methods: We retrospectively collected 112 cases of laparoscopic colectomy that was performed for treating colorectal cancer during the past 6 years. Preoperative colonoscopic tattoo was done by using india ink. The tattoo cases were compared with the non-tattoo cases. Comparison between 13 cases of lapaTME and 15 cases of openTME was assessed by both gross and microscopic examination in the 28 cases for 9 months. The lapaTME and openTME were applied to mid-rectal cancer and mid & low rectal cancer, respectively. Results: Tattoo was carried out for the Tis (100%), T1 (92%), T2 (72%), T3 (36%) cases. Of the significant cases, T3 lesion was not identified at laparoscopic colectomy. LapaTME grossly showed a greater incidence of defect than that of openTME, but there was no difference microscopically between lapaTME and openTME. Conclusion: A tattoo was useful for early lesion and it should be considered for advanced lesion. LapaTME for mid-rectal cancer can be done without compromising the principles of TME.
만성 폐쇄성 폐질환을 동반한 위암 환자에서의 복강경 위 절제술
김종진,박도중,이혁준,김형호,양한광,이문수,이주희 대한내시경복강경외과학회 2009 Journal of Minimally Invasive Surgery Vol.12 No.2
Purpose: The aim of this study was to evaluate the safety of laparoscopic gastrectomy for gastric cancer patients with chronic obstructive pulmonary disease (COPD). Methods: The medical records of 863 patients who underwent gastrectomy for gastric cancer from January 2007 to December 2008 at Seoul National University Bundang Hospital were retrospectively reviewed. One hundred forty five patients with COPD were divided into the laparoscopic gastrectomy or open gastrectomy groups. The 362 patients who underwent laparoscopic gastrectomy were divided into the COPD or the non-CODP groups. Comparative analysis between each of the two groups was done. Results: Out of 145 patients with COPD, eighty seven patients (60.0%) underwent laparoscopic gastrectomy and 58 patients (40.0%) underwent open gastrectomy. Comparing the laparoscopic gastrectomy group with the open gastrectomy group, there was no significant differences in age, gender, the body mass index, the smoking history, the preoperative general condition, the operation time, the estimated blood loss and the preoperative pulmonary function tests (p>0.05). The postoperative hospital stay was longer in the open gastrectomy group than that in the laparoscopic gastrectomy group (9.1 days vs. 6.8 days, respectively, p<0.001). One patient in the laparoscopic gastrectomy group (1/87, 1.1%) had postoperative pulmonary complications and 6 patients in the open gastrectomy group (6/58, 10.3%) had pulmonary complications (p=0.017). On comparing the COPD with the non-COPD groups for the 363 patients who underwent laparoscopic gastrectomy, there were significant differences in gender, age, a history of tuberculosis, a smoking history, the American Society of Anesthesiologists (ASA) class and the cancer stage. Yet there was no significant difference of the postoperative pulmonary complications (p=1.000) between the groups. Conclusion: Laparoscopic gastrectomy can be performed safety for gastric cancer patients with mild COPD and it should be considered as a primary treatment method.
고도 비만 환자에서 시행한 복강경 루와이 위우회술과 동반한 식도열공 탈장 교정술 1예
이홍찬,박인수,김응국 대한내시경복강경외과학회 2009 Journal of Minimally Invasive Surgery Vol.12 No.2
Obesity is one of the most significant causes of GERD. Nissen fundoplication is a surgical procedure that's performed world widely for treating patients with GERD and a hiatal hernia and who are intractable to medical therapy. However, Nissen fundoplication may have technical difficulties in morbidly obese patients due to the huge perigastric, intraabdominal fat tissue and hepatomegaly. During the laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedure, the stomach was divided into the gastric pouch and the remnant stomach by vertiacally stapling at the angle of His. The posterior gastric wall and hiatus were easily exposed even when there was huge deposits of perigatric and intraabdominal fat tissue. We report here on a case of concomitant hiatal hernia repair with LRYGB in a morbidly obese patient.