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

OBJECTIVE: To evaluate the safety and efficacy of the laparoscopic incidental appendectomy during gynecologic laparoscopic operation. Methods: This study was evaluated for the clinical analysis of 118 patients who underwent laparoscopic assisted vaginal hysterectomy(LAVH group, 65 cases) and LAVH with laparoscopic incidental appendectomy(LAVH + IA group, 53 cases) at the Wallace Memorial Baptist Hospital from Oct. 1996 to Nov. 1998. RESULTS: The following results were obtained: 1) There was no significant difference between two groups in regard to age. The mean age was 45.7 years in LAVH group and 43.8 years in LAVH + IA group. 2) There was no significant difference between two groups in mean operative time. The mean operative time was 90.4 minutes in LAVH group and 97.5 minutes in LAVH + IA group. 3) The mean appendectomy time was 7.1 minutes. 4) The mean time recovering normal bowel activity was 46.2 hours in LAVH group and 45.8 hours in LAVH + IA group. There was no significant difference between two groups. 5) The mean hospital stay was 6.4 days in LAVH group and 5.7 days in LAVH + IA group. There was no significant difference between two groups. 6) The postoperative complications occurred in 11 cases(9.3 %). The serious complications of appendectomy was not found. 7) Of the 53 appendices removed, 5(9.4 %) were abnormal pathologic findings. CONCLUSION: Laparoscopic incidental appendectomy during laparoscopic operation was not found to influence the operation time, hospital stay, gas passing time, but there is one case of wound infection due to incidental appendectomy. Therefore, a large number of study should be performed to evaluate the safety and efficacy of laparoscopic incidental appendectomy during laparoscopic operation.
Appendectomy* ; Humans ; Length of Stay ; Operative Time ; Postoperative Complications ; Protestantism ; Wound Infection

PURPOSE: To evaluate the functional results after internal fixation with two low profile plates in fractures of the distal tibia. MATERIALS AND METHODS: From March 1998 to October 2002, twelve patients with fractures of the distal tibia were treated with internal fixation using two low profile plates and followed for at least one year. Fractures according to AO/OTA classification were one Type A1, four Type A2, two Type C1, two Type C2 and three Type C3. We analyzed the functional results by the Olerud and Molander ankle scoring system and the postoperative complications. RESULTS: The average functional score was 81.2 points and the results were three excellent, six good, one fair and two poor. Bony union was achieved in all cases. There was 1 case of superficial wound infection as a complication. CONCLUSION: Internal fixation with two low profile plates in fractures of the distal tibia may minimize the incidence of soft tissue complications and provide good bony union and functional results. Therefore, we consider internal fixation with two low profile plates as a good alternative treatment of the distal tibial fracture.
Ankle ; Classification ; Humans ; Incidence ; Postoperative Complications ; Tibia* ; Tibial Fractures ; Wound Infection

BACKGROUND: According to the changes in the Environmental factors, traumatic diaphragmic rupture is seen in increasing frequency. Many reports described the early diagnostic methods and treatment modalities. In our institution, a study was retrospectively performed to obtain the early diagnostic and treatment methods of diaphragmic ruptures. MATERIAL AND METHOD: From January 1994 to April 1998, 20 patients with traumatic rupture of the diaphragm were treated in our institution and We analyzed the patients in preoperative clinical presentations, diagnostic accuracies, associated injuries and postoperative complications. RESULT: Socially active male patients were affected most. 75% of patients had blunt trauma and 25% had penetrating injury. There were 16 cases of ruptured right diaphragm, 3 cases of left diaphragm and 1 case on both. Preoperative diagnosis were possible in 10 patients (50%) and 6 patients(30%) were diagnosed intraoperatively, but 4 patients (20%) were diagnosed in the late stages. Most common postoperative complication was wound infection, and two died of associated injuries. CONCLUSION: We conclude that if there is suspicion of diaphragmic rupture after a trauma, careful study and examination is essential and interdepartmental collaboration is very important.
Cooperative Behavior ; Diagnosis ; Diaphragm* ; Humans ; Male ; Postoperative Complications ; Retrospective Studies ; Rupture* ; Wound Infection

PURPOSE: Laparoscopic surgery is widely applied for treating acute appendicitis, and even the complicated cases. Single port laparoscopic surgery has recently been introduced and it is being increasingly accepted for treating acute appendicitis. The aim of this study is to evaluate the effectiveness of single port laparoscopic appendectomy as compared with that of conventional laparoscopic surgery. METHODS: Eighty-seven patients who underwent laparoscopic appendectomy were enrolled. The clinicopathologic characteristics, the perioperative courses and postoperative pain using the VAS (visual analog scale) were compared between the conventional (n=61) and single port (n=26) groups. RESULTS: There were no significant differences in age (28.2 Vs. 32.4, respectively), gender (29:32 Vs. 13:13, respectively) and BMI (22.3 Vs. 22.0, respectively) between the two groups. An extraperitoneal location of the appendix was found in 10 cases (16.4%) of the conventional group and in 4 cases (15.4%) of the single port group. Statistically, no significant difference was shown in terms of the degree of inflammation of the appendicitis. The average length of the operation was significantly shorter in the single port group compared to that of the conventional group (52.4 Vs. 41.3 minutes, respectively, p<0.05). The VAS at 6 hours after surgery (5.2 Vs. 6.0, respectively) and at the time of discharge (1.9 Vs. 1.9, respectively) showed no differences between the two groups. There was no difference for the postoperative hospital stay (3.8 Vs. 3.1 days, respectively) and the rate of postoperative complications (16.4% Vs. 7.7%, respectively) between the two groups. Wound infection was the most common complication. CONCLUSION: When regarding the minimal scar and invasiveness, single port laparoscopic appendectomy is feasible option for treating acute appendicitis. With accumulation of experiences and the development of instruments, additional studies are needed for the indications and advantages of single port surgery.
Appendectomy ; Appendicitis ; Appendix ; Cicatrix ; Humans ; Inflammation ; Laparoscopy ; Length of Stay ; Pain, Postoperative ; Postoperative Complications ; 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

BACKGROUND/AIMS: Pyloric exclusion has been recommended in patients with severe injury to the pancreas and duodenum. METHODS: A retrospective case review of 8 patients treated with pyloric exclusion following pancreaticoduodenal injury from March 1994 to May 2002 in Department of Surgery, the Catholic University of Korea, Daejeon St. Mary's Hospital. RESULTS: The age range of the patients was from 8 to 31 years. Most of the etiolgy (n=7) was the blunt abdominal trauma and one case due to the iatrogenic injury from the therapeutic endoscopic retrograde cholangiopancretography. The time interval between the injury and the operation varied from 3 to 48 hours. The most common postoperative complication was wound infection (n=8). We found the other complications such as intraabdominal abscess (n=3), pneumonia (n=3), but the complications were treated successfully with conservative measures. There was no mortality cases in these patients. The duration of admission was delayed in the cases of concomitant injury (64 vs 46 days). All patients above 16 years old (n=7) were supported with parenteral nutritional fluid via central intravenous route (mean 32 days). We could not find the spontaneous opening of the pyloric closure at least 4 patients in postoperative 3 months but there was no major complication according to the sustained gastrojejunostomy. CONCLUSION: Pyloric exclusion appears to offer a satisfactory option for the treatment of the severe pancreaticoduodenal injury with minor complication. Do you have any comments about the spontaneous opening of the pyloric closure?
Abscess ; Adolescent ; Duodenum ; Gastric Bypass ; Humans ; Korea ; Mortality ; Pancreas ; Pneumonia ; Postoperative Complications ; Retrospective Studies ; Wound Infection