Journal of the Korean Surgical Society最新文献_第8页

Afferent loop obstruction following laparoscopic distal gastrectomy with Billroth-II gastrojejunostomy. 腹腔镜远端胃切除术合并Billroth-II型胃空肠吻合术后传入袢阻塞。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.281

Dong Jin Kim, Jun Hyun Lee, Wook Kim

{"title":"Afferent loop obstruction following laparoscopic distal gastrectomy with Billroth-II gastrojejunostomy.","authors":"Dong Jin Kim, Jun Hyun Lee, Wook Kim","doi":"10.4174/jkss.2013.84.5.281","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.281","url":null,"abstract":"Purpose: Afferent loop (A-loop) obstruction is an uncommon postgastrectomy complication following Billroth-II (B-II) or Roux-en-Y reconstruction. Moreover, its development after laparoscopic gastrectomy has not been reported. Here we report 4 cases of A-loop obstructions after laparoscopic distal gastrectomy (LDG) with B-II reconstruction.Methods: Among the 396 patients who underwent LDG with a B-II anastomosis between April 2004 and December 2011, 4 patients had A-loop obstruction. Their data were obtained from a prospectively maintained institutional database and analyzed for outcomes.Results: Four patients (1.01%) developed A-loop obstruction. All were male, and their median age was 52 years (range, 30 to 73 years). The interval between the initial gastrectomies and the operation for A-loop obstruction ranged from 4 to 540 days (median, 33 days). All 4 patients had symptoms of vomiting and abdominal pain and were diagnosed by abdominal computed tomographic (CT) scan. The causes of the A-loop obstructions were adhesions (2 cases) and internal herniations (2 cases) that were treated with Braun anastomoses and reduction of the herniated small bowels, respectively. All patients recovered following the emergency operations.Conclusion: A-loop obstruction is a rare but serious complication following laparoscopic and open gastrectomy. It should be considered when a patient complains of continuous abdominal pain and/or vomiting after LDG with B-II reconstruction. Prompt CT scan may play an important role in diagnosis and treatment.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"281-6"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31409421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 19

Neoadjuvant human epidermal growth factor receptor-2 targeted therapy in patients with locally advanced breast cancer. 局部晚期乳腺癌患者的新辅助人表皮生长因子受体-2靶向治疗

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.273

Dong Hui Cho, Se Kyung Lee, Sangmin Kim, Min-Young Choi, Seung Pil Jung, Jeonghui Lee, Jiyoung Kim, Min Young Koo, Soo Youn Bae, Jung-Han Kim, Jee Soo Kim, Kil Won Ho, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang

{"title":"Neoadjuvant human epidermal growth factor receptor-2 targeted therapy in patients with locally advanced breast cancer.","authors":"Dong Hui Cho, Se Kyung Lee, Sangmin Kim, Min-Young Choi, Seung Pil Jung, Jeonghui Lee, Jiyoung Kim, Min Young Koo, Soo Youn Bae, Jung-Han Kim, Jee Soo Kim, Kil Won Ho, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang","doi":"10.4174/jkss.2013.84.5.273","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.273","url":null,"abstract":"Purpose: We analyzed the responses of patients with locally advanced breast cancer to neoadjuvant chemotherapy (NAC) and NAC combined with neoadjuvant human epidermal growth factor receptor-2 (HER2) targeted therapy (NCHTT).Methods: We retrospectively reviewed 59 patients with HER2 amplified locally advanced breast cancer among patients who were treated surgically after neoadjuvant therapy at Samsung Medical Center between 2005 and 2009. Thirty-one patients received conventional NAC and 28 patients received NCHTT. Pathologic responses were assessed according to response evaluation criteria in solid tumors (RECIST) guidelines.Results: Pathologic complete response (pCR) was achieved in 13 out of 28 patients treated with NCHTT and in 6 out of 31 patients treated with NAC alone (46.4% vs. 19.4%, respectively, P = 0.049). Breast conserving surgery (BCS) was more frequently performed in the NCHTT group than in the NAC only group (71.4% vs. 19.4%, P < 0.001). The 3-year recurrence-free survival (RFS) rate was 100% in the NCHTT group and 76.4% in the NAC group (P = 0.014). Together, NCHTT, type of operation (BCS vs. mastectomy) and pathologic nodal status were significant prognostic factors for RFS in univariate analysis.Conclusion: We found that NCHTT produced higher pCR rates than NAC alone in locally advanced breast cancer.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"273-80"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31409420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for advanced gastric cancer with isolated para-aortic lymph node metastasis. 姑息性化疗后腹腔镜辅助胃切除术联合腹主动脉旁淋巴结切除术治疗晚期胃癌伴孤立腹主动脉旁淋巴结转移。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.304

Sang-Yong Son, Chang Min Lee, Ju-Hee Lee, Sang-Hoon Ahn, Jin Won Kim, Kuhn-Uk Lee, Do Joong Park, Hyung-Ho Kim

{"title":"Laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for advanced gastric cancer with isolated para-aortic lymph node metastasis.","authors":"Sang-Yong Son, Chang Min Lee, Ju-Hee Lee, Sang-Hoon Ahn, Jin Won Kim, Kuhn-Uk Lee, Do Joong Park, Hyung-Ho Kim","doi":"10.4174/jkss.2013.84.5.304","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.304","url":null,"abstract":"Prophylactic para-aortic lymphadenectomy is not recommended in curable advanced gastric cancer. However, there are few reports on therapeutic para-aortic lymphadenectomy after palliative chemotherapy in far advanced gastric cancer. We report three cases of laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy after palliative chemotherapy for the first time in Korea. Three gastric cancer patients with isolated para-aortic lymph node (PAN) metastasis showed partial response to capecitabine-based chemotherapy, and laparoscopy-assisted gastrectomy with para-aortic lymphadenectomy was performed with curative intent. The mean total operation time was 365 minutes (range, 310 to 415 minutes), and the mean estimated blood loss was 158 mL (range, 125 to 200 mL). The mean number of retrieved PAN was 9 (range, 8 to 11), and all pathologic results showed no metastasis of para-aortic region. All patients recovered and were discharged without any significant complications.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"304-8"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31500800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

The results of aspiration thrombecomy in the endovascular treatment for iliofemoral deep vein thrombosis. 吸血栓形成在髂股深静脉血栓血管内治疗中的效果。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.292

Jae Hoon Lee, Woo Hyung Kwun, Bo Yang Suh

{"title":"The results of aspiration thrombecomy in the endovascular treatment for iliofemoral deep vein thrombosis.","authors":"Jae Hoon Lee, Woo Hyung Kwun, Bo Yang Suh","doi":"10.4174/jkss.2013.84.5.292","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.292","url":null,"abstract":"Purpose: The aim of this study is to evaluate the results of aspiration thrombectomy (AT) in the endovascular treatment for iliofemoral deep vein thrombosis (DVT) through the comparison of catheter directed thrombolysis (CDT) alone group and CDT with AT group.Methods: From November 2001 to April 2011, 100 patients received endovascular treatment with CDT alone or CDT with AT for iliofemoral DVT at Yeungnam University Medical Center. We compared procedure, clinical outcomes and complications between the two groups.Results: The mean age of patients was 60.48 ± 14.57 years. The patients consisted of 41 men and 59 women. CDT alone and CDT with AT were performed in 29 and 71 patients, respectively. The mean procedural time of the CDT-alone group was longer than the CDT with AT group (P < 0.001) and dose of urokinase used during the procedure significantly decreased in the CDT with AT group (P < 0.001). There were no statistically significant differences in clinical outcomes between the two groups. Cases of pulmonary embolism was not noted in each group in our series, but entrapped thrombus during procedure was noted in 6 of 37 in the CDT with AT group and 0 of 9 in the CDT-alone group among 46 patients with prophylactic inferior vena cava (IVC) filter insertion.Conclusion: In conclusion, CDT with AT is safe and effective for the treatment of an acute iliofemoral DVT. In AT treatment, prophylactic IVC filter insertion should be considered for the prevention of pulmonary embolism by floating thrombi.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"292-7"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31409423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Outcome of the patients with chronic mesh infection following open inguinal hernia repair. 腹股沟疝切开修补术后慢性补片感染的疗效分析。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.287

Cihangir Akyol, Firat Kocaay, Erkinbek Orozakunov, Volkan Genc, Ilknur Kepenekci Bayram, Atil Cakmak, Semih Baskan, Ercument Kuterdem

{"title":"Outcome of the patients with chronic mesh infection following open inguinal hernia repair.","authors":"Cihangir Akyol, Firat Kocaay, Erkinbek Orozakunov, Volkan Genc, Ilknur Kepenekci Bayram, Atil Cakmak, Semih Baskan, Ercument Kuterdem","doi":"10.4174/jkss.2013.84.5.287","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.287","url":null,"abstract":"Purpose: Hernia repairs are the most common elective abdominal wall procedures performed by general surgeons. The use of a mesh has become the standard for hernia repair surgery. Herein, we discuss a management strategy for chronic mesh infections following open inguinal hernia repair with onlay prosthetic mesh.Methods: In this study, 15 patients with chronic mesh infections following open inguinal hernia repairs were included. The medical records of these patients were retrospectively reviewed and information regarding presentation, type of previous hernia repair, type of mesh, operative findings and bacteriological examination results were obtained. In all cases, the infected mesh was removed completely and the patients were treated with antibiotic regimens and local wound care.Results: Fifteen mesh removals due to chronic infection were performed between January 2000 and March 2012. The mean interval of hernia repair to mesh removal was 49 months. All patients were followed up for a median period of 62 months (range, 16 to 115 months). In all patients, the infections were resolved successfully and none were persistent or recurrent. However, one patient developed recurrent hernia and one developed nerve injury.Conclusion: Chronic mesh infection following hernia repair mandates removal of the infected mesh, which rarely results in hernia recurrence.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"287-91"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31409422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 37

Heterotopic pancreas of the gallbladder associated with segmental adenomyomatosis of the gallbladder. 胆囊异位胰腺与胆囊节段性腺肌瘤病有关。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.309

Seok Won Lee, Sung Pil Yun, Hyung-Il Seo

引用次数: 19

Analysis of the occupational stress of Korean surgeons: a pilot study. 韩国外科医生职业压力分析:一项初步研究。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.261

Sang-Hee Kang, Yoon-Jung Boo, Ji-Sung Lee, Woong-Bae Ji, Byoung-Eun Yoo, Ji-Young You

{"title":"Analysis of the occupational stress of Korean surgeons: a pilot study.","authors":"Sang-Hee Kang, Yoon-Jung Boo, Ji-Sung Lee, Woong-Bae Ji, Byoung-Eun Yoo, Ji-Young You","doi":"10.4174/jkss.2013.84.5.261","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.261","url":null,"abstract":"Purpose: Surgeons serve one of the most challenging and stressful professions. Ineffective control of occupational stress leads to burnout of the surgeon. The aim of this study was to obtain preliminary data on the sources and the degree of stress of surgeons and to determine the feasibility of the survey.Methods: A total of 63 surgeons in our three affiliated hospitals were enrolled in this study. Fifty-five questions were used to assess the demographics, characteristics and Korean occupational stress scale (KOSS), which were prepared and validated by the National Study for Development and Standardization of Occupational Stress.Results: Forty-seven of the 63 surgeons participated in this study (74.6%). The mean KOSS score of the survey was 50.9 ± 8.55, which was significantly higher than that of other professions (P < 0.01). Drinking and smoking habits were not related to the KOSS score. Doing exercise was related to a low KOSS score in terms of low KOSS total score (P < 0.01). Average duty hours (P < 0.01) and night duty days per week (P = 0.01) were strongly related to higher KOSS in the linear regression analysis.Conclusion: This is the first study to evaluate job stress of surgeons in Korea. This study showed that Korean Surgeons had higher occupational stress than other Korean professions. A larger study based on this pilot study will help generate objective data for occupational stress of Korean Surgeons by performing a survey of the members of the Korean Surgical Society.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"261-6"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31409418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Prevention of venous thromboembolism with enoxaparin in bariatirc surgery. 依诺肝素预防减肥手术中静脉血栓栓塞。

Journal of the Korean Surgical Society Pub Date : 2013-05-01 Epub Date: 2013-04-24 DOI: 10.4174/jkss.2013.84.5.298

Hee Doo Woo, Yong Jin Kim

{"title":"Prevention of venous thromboembolism with enoxaparin in bariatirc surgery.","authors":"Hee Doo Woo, Yong Jin Kim","doi":"10.4174/jkss.2013.84.5.298","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.5.298","url":null,"abstract":"Purpose: Venous thromboembolism (VTE) after bariatric surgery is a significant cause of morbidity and mortality. Current modalities of thromboprophylaxis include subcutaneous injection of unfractionated or low-molecular-weight heparin (LMWH), pneumatic compression, elastic stockings, and inferior vena cava filters. Despite universal agreement on the need for thromboprophylaxis, no clear consensus has been reached regarding the best regimen and treatment duration of bariatric surgery.Methods: From April, 2009 to December, 2011, we performed 200 bariatric surgery (191 with primary intent, 9 with revisional intent). There was no history of VTE prior to surgery. Clexane therapy was done with 4000 U SQ once daily for 2 weeks to the day before surgery. Development of VTE was assessed by direct interview, physical examination in out-patient clinic, and phone calls to patients for history taking if needed. The history taking was presented in questionnaire format. The patients were asked to state their symptoms of VTE by answering the questionnaire. The patients were followed up for a minimum of 6 months after surgery to determine the incidence of clinical VTE.Results: Two-week Clexane therapy was completed in 193 patients. Clexane was stopped in 5 due to surgical related complications (4 bleeding, 1 reoperation due to leak), in 2 due to Clexane related complications (1 epistaxis, 1 metrorrhagia). Follow-up of out-patient clinic were 68%, those who could follow up by telephone were 89%. There was no evidence of VTE.Conclusion: A 2-week VTE prophylaxis regimen using LMWH is simple, effective and associated with a low incidence of complications.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 5","pages":"298-303"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.5.298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31500799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

The effect of a positive T-lymphocytotoxic crossmatch on clinical outcomes in adult-to-adult living donor liver transplantation. 阳性t淋巴细胞毒性交叉配型对成人活体肝移植临床结果的影响。

Journal of the Korean Surgical Society Pub Date : 2013-04-01 Epub Date: 2013-03-26 DOI: 10.4174/jkss.2013.84.4.245

Young-Kyu Kim, Seong Hoon Kim, In Sung Moon, Sung-Sik Han, Seong Yeon Cho, Tae You, Sang-Jae Park

{"title":"The effect of a positive T-lymphocytotoxic crossmatch on clinical outcomes in adult-to-adult living donor liver transplantation.","authors":"Young-Kyu Kim, Seong Hoon Kim, In Sung Moon, Sung-Sik Han, Seong Yeon Cho, Tae You, Sang-Jae Park","doi":"10.4174/jkss.2013.84.4.245","DOIUrl":"https://doi.org/10.4174/jkss.2013.84.4.245","url":null,"abstract":"Purpose: There is controversy concerning the effect of a positive T-lymphocytotoxic crossmatch (TLC) on clinical outcomes in adult living donor liver transplantation (LDLT). The aim of this study was to investigate the effect of TLC on clinical outcomes in LDLT and to determine how long a pretransplant positive TLC continues after liver transplantation (LT).Methods: Between January 2005 and June 2010, 219 patients underwent adult LDLT at National Cancer Center. The TLC test was routinely performed before LDLT. TLC test results were positive in 8 patients (3.7%). Patients were divided into 2 groups according to the result of TLC: positive TLC (n = 8) and negative TLC (n = 211) groups. All patients with a pretransplant positive TLC (n = 6) underwent a TLC test every week until negative conversion of TLC, except 2 patients who refused to receive the TLC test.Results: Acute cellular rejection, surgical complications and patient or graft survival were not significantly different between both groups. All patients with a positive TLC (n = 6) had a posttransplant negative TLC. The median time to negative conversion of TLC was 1.5 weeks (range, 1 to 3 weeks).Conclusion: A pretransplant positive TLC does not affect clinical outcomes in adult LDLT. Moreover, T-lymphocytotoxic cross-reactivity disappeared within 3 weeks (range, 1 to 3 weeks) after LT.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 4","pages":"245-51"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4174/jkss.2013.84.4.245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31349805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Selective shunt during carotid endarterectomy using routine awake test with respect to a lower shunt rate. 在颈动脉内膜剥脱术中使用常规清醒测试进行选择性分流，以降低分流率。

Journal of the Korean Surgical Society Pub Date : 2013-04-01 Epub Date: 2013-03-26 DOI: 10.4174/jkss.2013.84.4.238

Jayun Cho, Kyung Keun Lee, Woo-Sung Yun, Hyung-Kee Kim, Yang-Ha Hwang, Seung Huh

{"title":"Selective shunt during carotid endarterectomy using routine awake test with respect to a lower shunt rate.","authors":"Jayun Cho, Kyung Keun Lee, Woo-Sung Yun, Hyung-Kee Kim, Yang-Ha Hwang, Seung Huh","doi":"10.4174/jkss.2013.84.4.238","DOIUrl":"10.4174/jkss.2013.84.4.238","url":null,"abstract":"Purpose: To evaluate shunt rate and discuss the resultsrelated to selective shunt placement during carotid endarterectomy (CEA) using routine awake test.Methods: Patients with CEA from 2007 to 2011 were retrospectively reviewed from prospectively collected data. The need for shunt placement was determined by the awake test, based on the alteration in the neurologic examination. We collected data by using the clinical records and imaging studies, and investigated factors related to selective shunt such as collateral circulation and contralateral internal carotid artery (ICA) stenosis.Results: There were 45 CEAs under regional anesthesia with the awake test in 44 patients. The mean age was 61.8 ± 7.1 years old. There were 82.2% (37/45) of males, and 68.9% (31/45) of symptomatic patients. Selective shunt placement had been performed in only two (4.4%) patients. Among them fewer cases (4%) had severe (stenosis >70%) contralateral ICA lesions, and more cases (91%) of complete morphology of the anterior or posterior circulation in the circle of Willis. There was no perioperative stroke, myocardial infarctionor death, and asymptomatic new brain lesions were detected in 4 patients (9%), including 2 cases of selective shunt placement.Conclusion: CEA under routine awake test could besafe and feasible method with low shunt placement rate in selected patients.","PeriodicalId":49991,"journal":{"name":"Journal of the Korean Surgical Society","volume":"84 4","pages":"238-44"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/65/jkss-84-238.PMC3616278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31349806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0