OBJECTIVE: The purpose of this retrospective study is to review the clinical results, fusion rate, quality of reduction and stabilization and effects of cages in the intervertebral space in spondylolisthesis. METHODS: Authors reviewed retrospectively 30 patients who were treated with instrumentation and posterior lumbar interbody fusion(PLIF) between April 1996 to December 1997. RESULTS: Among 30 patients, 13 patients were degenerative type and 17 were isthmic types. The most commonly involved level was L4-5(16cases, 53.3%). Fusion was obtained in 29 patients(96.7%). Clinically, 14 of 17 patients(82.3%) showed excellent or good results in isthmic group, and 11 of 13 patients(84.6%) showed excellent or good results in degenerative group. Postoperative complications developed in three cases(10%), wound infection two cases(6.6%), cage retrodisplacement one case(3.3%). CONCLUSION: PLIF combined with transpedicular instrumentation in lumbar spondylolisthesis showed in all clinical results and fusion rate.
Humans ; Postoperative Complications ; Retrospective Studies ; Spondylolisthesis* ; Wound Infection

Comprehensive prevention and treatment of burn infection should be further enhanced, as monotonous treatment is prone to fail to get satisfying curative effects. In the articles to be published in this issue, causative factors for burn infection are analyzed in depth and discussed from different angles, and they will lay the foundation for the comprehensive prevention and treatment of burn infection.
Burns ; complications ; prevention & control ; therapy ; Humans ; Infection Control ; methods ; Wound Infection ; etiology ; prevention & control

PURPOSE: Resection of the bowel or solid organs may be required for pelvic tumor surgery. The present study was performed to assess combined surgical procedures and determine the role of the general surgeon in gynecologic oncology surgery METHODS: We performed a retrospective study of 135 patients with gynecologic malignancy who underwent a combined operation with a general surgeon between January 2000 and December 2005 at Asan Medical Center. The purpose of the combined operation was categorized into 3 groups: a tumor debulking operation, a resolution of intraoperative complications by a gynecologic surgeon, or an intraoperative diagnostic change. RESULTS: The incidence of combined operations for debulking, resolution of intraoperative complications, and intraoperative diagnostic changes were 103 cases (76.3%), 22 cases (16.3%), and 10 cases (7.4%), respectively. Ovarian cancer was the most common gynecologic malignancy (74.1%) and the rate of a combined operation with a general surgeon in ovarian cancer was 18.5% during the time period. Colorectal resection was the most common procedure by a colorectal surgeon (61.5%). Twenty four patients (17.8%) experienced postoperative complications, including ileus, wound infection, pancreas leakage, and stomal necrosis, with no significant differences according to the purpose of combined operation, pathologic diagnosis, or bowel preparation. The rate of a preoperative consultation to a general surgeon by gynecologic surgeons in cases with colorectal or solid organ invasion preoperatively was 53.2%. CONCLUSION: A general surgeon is an important consultant in a debulking operation of gynecologic malignancies, especially ovarian cancer, or treatment of complications. Thorough preoperative evaluation, bowel preparation, and preoperative consultation to a general surgeon is important in gynecologic oncology surgery.
Consultants ; Humans ; Ileus ; Incidence ; Intraoperative Complications ; Necrosis ; Ovarian Neoplasms ; Pancreas ; Postoperative Complications ; Retrospective Studies ; Wound Infection

This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA, with deep partial-thickness and full-thickness injury, produced by exposure to a large-scale industrial electron accelerator. An open wound began to appear and enlarged gradually 10 weeks after the exposure. Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, pneumonia, respiratory failure, systemic inflammatory response syndrome, nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation. Skin grafts failed to survive, resulting in enlargement of the wound. After being treated with proper measures, including parenteral nutrition, respiratory support with a ventilator, appropriate antibiotics, steroid administration for nephropathy, deep debridement for wounds followed by skin grafting, the patient was cured and discharged after undergoing 15 operations in 500 days. The clinical condition of an extensive acute radiation burn is complicated. We should pay close attention to the changes in functions of organs, and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications. The control of the infection and the timely and effective repair of the wound are still the key points of the treatment of an extensive local radiation injury.
Acute Disease ; Adult ; Burns ; complications ; microbiology ; therapy ; Humans ; Male ; Radiation Injuries ; complications ; therapy ; Wound Infection ; therapy

PURPOSE: The authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients after surgery for colorectal cancer. METHODS: Three hundred fifty-two patients were enrolled prospectively. Nutritional risk screening 2002 (NRS 2002) score was calculated through interview with patient on admission. Clinical characteristics, tumor status and surgical procedure were recorded. RESULTS: The prevalence of patients at nutritional risk was 28.1 per cent according to the NRS 2002. The rate of postoperative complication was 27%. There was a significant difference in postoperative complication rates between patients at nutritional risk and those not at risk (37.4% vs. 22.9%, P = 0.006). Nutritional risk was identified as an independent predictor of postoperative complications (odds ratio, 3.05; P = 0.045). Nutritional risk increased the rate of anastomotic leakage (P = 0.027) and wound infection (P = 0.01). CONCLUSION: NRS may be a prognostic factor for postoperative complication after surgery for colorectal cancer. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces postoperative complication rates.
Anastomotic Leak ; Colorectal Neoplasms* ; Humans ; Malnutrition ; Mass Screening ; Postoperative Complications ; Prevalence ; Wound Infection

PURPOSE: Although hydrocelectomy is commonly performed in general urological practice, the incidence of complications and the outcomes of this procedure seem to be underreported in the literature. We evaluated the incidence of complications and the outcomes of patients who underwent hydrocelectomy. MATERIALS AND METHODS: Between January 1996 and December 2005, 289 patients with hydrocele were retrospectively assigned into three groups according to the degree of dissection or the amount of the excision of the hydrocele sac. Group 1 included 78 patients who were treated by dissection and excision of the entire hydrocele sac. Group 2 consisted of 149 patients who were treated by dissection and eversion of the hydrocele sac. The 62 patients in group 3 underwent operations in which there was little or no dissection of the hydrocele. We analyzed the complications, the effects of surgical treatment and the results according to the surgical techniques. RESULTS: The duration of recovery showed no differences among the three groups. The overall complication rate was 36.3%. Transient scrotal swelling occurred in 28.0% of the patients, hematoma in 2.7%, wound infection in 1.7%, and injury to the epididymis or testis, chronic pain and persistent swelling occurred in 1.3%. The overall incidence of postoperative complications was significantly lower among the patients in group 3. The rate of scrotal swelling was significantly correlated to the volume of the hydroceles and the amount of the excision of the hydrocele sac. CONCLUSIONS: The long term results of hydrocelectomy were good. The most common complications following scrotal surgery for hydroceles were scrotal swelling, hematoma, wound infection and injury to the epididymis and testis. Most of the complications were treated by conservative management.
Adult ; Chronic Pain ; Epididymis ; Hematoma ; Humans ; Incidence ; Male ; Postoperative Complications ; Retrospective Studies ; Testis ; Wound Infection

A new technique of nephrolithotomy was used to remove calyceal stone in seven cases. Key points of this technique are direct removal of stone through the calicopuncture by forceps without renal vascular clamping and Gelfoam Packing followed by compression with hands for control of bleeding. The results were s follow : 1. With the exception of a single small stone all the targeted calculi were removed (94% in completeness of stone removal). 2. This method did not have any significant renal parenchymal damage and there was no episode of postoperative urine leakage of delayed bleeding. 3. Postoperative complications were a case of urinary obstruction caused by slipped Gelfoam into calyx accidently, which was delivered spontaneously during the voiding on 2nd postoperative day and a case of wound infection. This new technique nephrolithotomy was seemed to be an useful and rapid surgical method of calyceal stone surgery in some situations such as in case of marked adhesion present around the pelvis, narrow infundibulum and failed stone removal during the performing pyelolithotomy.
Calculi* ; Constriction ; Gelatin Sponge, Absorbable ; Hand ; Hemorrhage ; Pelvis ; Postoperative Complications ; Surgical Instruments ; Wound Infection

PURPOSE: Malignant colorectal obstruction is a common emergency situation showing high morbidity and mortality because of the poor general condition of the patients, unprepared bowel and advanced diseases. Recently, the self-expandable colorectal stent has allowed an elective one-stage resection without the risk of an emergency operation and stoma formation. We evaluated the usefulness of the self-expandable metallic stent for a malignant colorectal obstruction in terms of the preoperative preparation of the patients. METHODS: Seventeen patients who underwent a surgical resection following self-expandable metallic stent insertion for a malignant colorectal obstruction were included in this study. The patients' characteristics, clinical courses, and complications after stent insertion, the changes in physical status of the patients, the operative method, and the postoperative complications were investigated. The APACHE II score was applied for evaluating the physical status of the patients. RESULTS: Obstructions were located at the transverse (n=1), the descending (n=3), and the sigmoid colon (n=6) and at the rectum (n=7). Stents were successfully inserted and obstructions were relieved in all patients. Preoperative evaluations were performed in all cases. Fourteen of the 17 patients (82.4%) showed abnormal laboratory findings on admission. The average APACHE II score was 10.6 on admission and decreased to 7.8 after stent insertion (P<0.05). Nine patients (52.9%) could resume oral feeding after stent insertion. There were 2 stent-related complications, one case of stent migration and one case of minor bleeding; both were managed conservatively. At an average of 9 days after the stent insertion, an elective radical resection was conducted in all cases. Laparoscopic resections were attempted in 7 (41.2%) patients and were successful in 6. In 15 cases (88.2%), resection with primary anastomosis was possible. Postoperatively, there were 3 cases of wound infections and a temporary ileus. The TNM stage was stage II in 9 patients (52.9%), III in 6 (35.3%), and IV in 2 (11.8%). The patients were discharged from the hospital at an average of 11 days postoperatively. CONCLUSIONS: Self-expandable colorectal stent insertion is a safe and effective treatment strategy and can change the emergency setting to permit an elective one-stage curative operation by allowing the general condition of a patient with malignant colorectal obstruction to recover.
APACHE ; Colon, Sigmoid ; Emergencies ; Hemorrhage ; Humans ; Ileus ; Mortality ; Postoperative Complications ; Rectum ; Stents* ; Wound Infection

Clinical analysis was performed on 660 cases of the intussusception treated at the Masan Fatima Hospital from January 1981 to December 1995. Also the frequency of the intussusception in the central area of Kyung Nam province from January 1991 to December 1995 was studied. The results were as follows. 1) The intusssusception was most commonly occured between 6 months to 9 months of age(28.6%). Male to female ratio was 2.06 : 1. 2) The frequent symptoms and signs were abdominal pain(80.9%), bloody stool(68.3%), vomiting(63.9%), and palpable abdominal mass(43.6%). 3) The incidence of types of intussusception were ileo-colic(50.0%), ileo-ileo-colic(41.2%), ileo-cecal(6.3%), colo-colic(2.1%) and ileo-ileal(0.4%) in order. 4) The chance of intestinal resection was increased in the case of symptom duration over 24 hours(P<0.01). 5) Barium reduction was attempted in 660 cases(100%) and achieved successful reduction in 364 cases(55.2%). Operative treatment was performed in 296 cases(44.8%), of which manual reduction was carried out in 267 cases(90.2%), intestinal resection in 17 cases(5.8%) and spontaneous reduction was noted in 12 cases(4.0%). 6) Wound infection developed in 12 cases(4.0%) was the most commonly observed postoperative complication. 7) The recurrent rates of the barium enema and operation were 9.1% and 7.1%, resepctively. 8) The operative mortality was 0.2%. 9) The incidence of intussusception in Kyung Nam central area from 1991 to 1995 were as followings : 5.55/1000 live birth in 1991, 5.65/1000 live birth in 1992, 5.03/1000 live birth in 1993, 5.00/1000 live birth in 1994 and 4.03/1000 live birth in 1995.
Barium ; Child* ; Enema ; Female ; Humans ; Incidence* ; Infant* ; Intussusception* ; Live Birth ; Male ; Mortality ; Postoperative Complications ; Wound Infection

BACKGROUND: Despite advances in surgical techniques, sterile protocols, and perioperative antibiotic regimens, surgical site infections (SSIs) remain a significant problem. We investigated the relationship between wound classification (i.e., clean, clean/contaminated, contaminated, dirty) and SSI rates in plastic surgery. METHODS: We performed a retrospective review of a multi-institutional, surgical outcomes database for all patients undergoing plastic surgery procedures from 2006-2010. Patient demographics, wound classification, and 30-day outcomes were recorded and analyzed by multivariate logistic regression. RESULTS: A total of 15,289 plastic surgery cases were analyzed. The overall SSI rate was 3.00%, with superficial SSIs occurring at comparable rates across wound classes. There were similar rates of deep SSIs in the clean and clean/contaminated groups (0.64%), while rates reached over 2% in contaminated and dirty cases. Organ/space SSIs occurred in less than 1% of each wound classification. Contaminated and dirty cases were at an increased risk for deep SSIs (odds ratios, 2.81 and 2.74, respectively); however, wound classification did not appear to be a significant predictor of superficial or organ/space SSIs. Clean/contaminated, contaminated, and dirty cases were at increased risk for a postoperative complication, and contaminated and dirty cases also had higher odds of reoperation and 30-day mortality. CONCLUSIONS: Analyzing a multi-center database, we found that wound classification was a significant predictor of overall complications, reoperation, and mortality, but not an adequate predictor of surgical site infections. When comparing infections for a given wound classification, plastic surgery had lower overall rates than the surgical population at large.
Demography ; Humans ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Surgery, Plastic ; Wound Infection