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Review article
Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review
Massimiliano Polastri, Esra Pehlivan, Robert M. Reed, Allaina Eden
J Yeungnam Med Sci. 2024;41(4):235-251.   Published online August 22, 2024
DOI: https://doi.org/10.12701/jyms.2024.00521
  • 52,406 View
  • 121 Download
AbstractAbstract PDF
Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.
Case report
Atypical presentation of DeBakey type I aortic dissection mimicking pulmonary embolism in a pregnant patient: a case report
Sou Hyun Lee, Ji Hee Hong, Chaeeun Kim
J Yeungnam Med Sci. 2024;41(2):128-133.   Published online February 5, 2024
DOI: https://doi.org/10.12701/jyms.2023.01319
  • 1,409 View
  • 43 Download
AbstractAbstract PDF
Aortic dissection in pregnant patients results in an inpatient mortality rate of 8.6%. Owing to the pronounced mortality rate and speed at which aortic dissections progress, efficient early detection methods are crucial. Here, we highlight the importance of early chest computed tomography (CT) for differentiating aortic dissection from pulmonary embolism in pregnant patients with dyspnea. We present the unique case of a 38-year-old pregnant woman with elevated D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, initially suspected of having a pulmonary embolism. Initial transthoracic echocardiography did not indicate aortic dissection. Surprisingly, after an emergency cesarean section, a chest CT scan revealed a DeBakey type I aortic dissection, indicating a diagnostic error. Our findings emphasize the need for early chest CT in pregnant patients with dyspnea and elevated D-dimer and NT-proBNP levels. This case report highlights the critical importance of considering both aortic dissection and pulmonary embolism in the differential diagnosis of such cases, which will inform future clinical practice.
Original article
Impact of Controlling Nutritional Status score on short-term outcomes after carotid endarterectomy: a retrospective cohort study
Hee Won Son, Gyeongseok Yu, Seung Jun Lee, Jimi Oh
J Yeungnam Med Sci. 2023;40(3):259-267.   Published online October 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00507
  • 2,011 View
  • 70 Download
  • 1 Web of Science
AbstractAbstract PDF
Background
Malnutrition and impaired immune responses significantly affect the clinical outcomes of patients with atherosclerotic stenosis. The Controlling Nutritional Status (CONUT) score has recently been utilized to evaluate perioperative immunonutritional status. This study aimed to evaluate the relationship between immunonutritional status, indexed by CONUT score, and postoperative complications in patients undergoing carotid endarterectomy (CEA).
Methods
We retrospectively evaluated 188 patients who underwent elective CEA between January 2010 and December 2019. The preoperative CONUT score was calculated as the sum of the serum albumin concentration, total cholesterol level, and total lymphocyte count. The primary outcome was postoperative complications within 30 days after CEA, including major adverse cardiovascular events, pulmonary complications, stroke, renal failure, sepsis, wounds, and gastrointestinal complications. Cox proportional hazards regression analysis was used to estimate the factors associated with postoperative complications during the 30-day follow-up period.
Results
Twenty-five patients (13.3%) had at least one major complication. The incidence of postoperative complications was identified more frequently in the high CONUT group (12 of 27, 44.4% vs. 13 of 161, 8.1%; p<0.001). Multivariate analyses showed that a high preoperative CONUT score was independently associated with 30-day postoperative complications (hazard ratio, 5.98; 95% confidence interval, 2.56–13.97; p<0.001).
Conclusion
Our results showed that the CONUT score, a simple and readily available parameter using only objective laboratory values, is independently associated with early postoperative complications.
Case reports
Transient osteoporosis of the hip with a femoral neck fracture during follow-up: a case report
Yusuke Tabata, Shuhei Matsui, Masabumi Miyamoto, Koichiro Omori, Yoichiro Tabata, Tokifumi Majima
J Yeungnam Med Sci. 2023;40(2):212-217.   Published online September 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00479
  • 5,018 View
  • 72 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
We report a case of transient osteoporosis of the hip with a femoral neck fracture found during follow-up. A 53-year-old man presented with left hip pain without trauma. The pain did not improve after 2 weeks and he was brought to our hospital by ambulance. Magnetic resonance imaging (MRI) of the left hip joint showed diffuse edema in the bone marrow, which was identified by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and increased signal intensity on short tau inversion recovery. This edema extended from the femoral head and neck to the intertrochanteric area. He was diagnosed with transient osteoporosis of the left hip. Rest gradually improved his pain; however, 3 weeks later, his left hip pain worsened without trauma. X-ray, computed tomography, and MRI results of the hip joint demonstrated a left femoral neck fracture, and osteosynthesis was performed. Differential diagnoses included avascular necrosis of the femoral head, infection, complex regional pain syndrome, rheumatoid arthritis, leukemia, and other cancers. Transient osteoporosis of the hip generally has a good prognosis with spontaneous remission within a few months to 1 year. However, a sufficient length of follow-up from condition onset to full recovery is necessary to avoid all probable complications such as fractures.

Citations

Citations to this article as recorded by  
  • Hip effusion/synovitis influences results after multiple drilling core decompression for bone marrow edema syndrome of hip
    Hua-zhang Xiong, Yan-li Peng, Yu-hong Deng, Ying Jin, Ming-hong Tu, Shu-hong Wu
    BMC Surgery.2023;[Epub]     CrossRef
The endoscopic transnasal approach to the lesions of the craniocervical junction: two case reports
Baraa Dabboucy, Wissem Lahiani, Damien Bresson, Nouman Aldahak
J Yeungnam Med Sci. 2023;40(1):96-101.   Published online July 20, 2022
DOI: https://doi.org/10.12701/jyms.2022.00234
  • 2,480 View
  • 68 Download
AbstractAbstract PDF
The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.
Original articles
Patient outcomes and prognostic factors associated with colonic perforation surgery: a retrospective study
Do-bin Lee, Seonhui Shin, Chun-Seok Yang
J Yeungnam Med Sci. 2022;39(2):133-140.   Published online October 29, 2021
DOI: https://doi.org/10.12701/yujm.2021.01445
  • 4,919 View
  • 124 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Despite advances in surgery and intensive perioperative care, fecal peritonitis secondary to colonic perforation is associated with high rates of morbidity and mortality. This study was performed to review the outcomes of patients who underwent colonic perforation surgery and to evaluate the prognostic factors associated with mortality.
Methods
A retrospective analysis was performed on 224 consecutive patients who underwent emergency colonic perforation surgery between January 2008 and May 2019. We divided the patients into survivor and non-survivor groups and compared their surgical outcomes.
Results
The most common cause of colon perforation was malignancy in 54 patients (24.1%), followed by iatrogenic perforation in 41 (18.3%), stercoral perforation in 39 (17.4%), and diverticulitis in 37 (16.5%). The sigmoid colon (n=124, 55.4%) was the most common location of perforation, followed by the ascending colon, rectum, and cecum. Forty-five patients (20.1%) died within 1 month after surgery. Comparing the 179 survivors with the 45 non-survivors, the patient characteristics associated with mortality were advanced age, low systolic blood pressure, tachycardia, organ failure, high C-reactive protein, high creatinine, prolonged prothrombin time, and high lactate level. The presence of free or feculent fluid, diffuse peritonitis, and right-sided perforation were associated with mortality. In multivariate analysis, advanced age, organ failure, right-sided perforation, and diffuse peritonitis independently predicted mortality within 1 month after surgery.
Conclusion
Age and organ failure were prognostic factors for mortality associated with colon perforation. Furthermore, right-sided perforation and diffuse peritonitis demonstrated a significant association with patient mortality.

Citations

Citations to this article as recorded by  
  • Colorectal Oncologic Emergencies
    Joshua Sullivan, Alec Donohue, Shaun Brown
    Surgical Clinics of North America.2024; 104(3): 631.     CrossRef
  • Risk Factors for Postoperative Major Morbidity, Anastomotic Leakage, Re-Surgery and Mortality in Patients with Colonic Perforation
    Maximilian Brunner, Lara Gärtner, Andreas Weiß, Klaus Weber, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann
    Journal of Clinical Medicine.2024; 13(17): 5220.     CrossRef
  • Evaluation of Morbidity and Mortality in Iatrogenic Colonic Perforation During Colonoscopy: A Comprehensive Systematic Review and Meta-Analysis
    Ajibola A Adebisi, Daniel E Onobun, Adeola Adediran, Reginald N Ononye, Ethel O Ojo, Adedayo Oluyi, Ayotunde Ojo, Stephen Oputa
    Cureus.2024;[Epub]     CrossRef
  • One Year of Experience Managing Peritonitis Secondary to Gastrointestinal Perforation at a Tertiary Care Hospital: A Retrospective Analysis
    Muhammad Hasaan Shahid, Faisal I Khan, Zain Askri, Arslan Asad, M. Azhar Alam, Danish Ali, Rabia Saeed, Aun Jamal, Tauseef Fatima, M. Farooq Afzal
    Cureus.2022;[Epub]     CrossRef
  • Risk factors for urgent complications of colorectal cancer
    S. N. Shchaeva
    Pelvic Surgery and Oncology.2022; 12(2): 28.     CrossRef
Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery
Yoo Jin Lee, Bong Soo Park, Sihyung Park, Jin Han Park, Il Hwan Kim, Junghae Ko, Yang Wook Kim
Yeungnam Univ J Med. 2021;38(2):136-141.   Published online October 27, 2020
DOI: https://doi.org/10.12701/yujm.2020.00542
  • 6,636 View
  • 104 Download
  • 2 Crossref
AbstractAbstract PDF
Background
Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery.
Methods
This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016.
Results
AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02–0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61–0.89; p=0.002).
Conclusion
Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

Citations

Citations to this article as recorded by  
  • Supplemental oxygen is associated with increased complications and readmission following total shoulder arthroplasty
    Nikhil Vallabhaneni, Alexander S. Guareschi, Josef K. Eichinger, Richard J. Friedman
    Seminars in Arthroplasty: JSES.2023; 33(3): 512.     CrossRef
  • Acute kidney injury after primary total hip replacement
    M. L. Lebed, M. G. Kirpichenko, E. V. Novikova, T. G. Lebed, A. V. Mankov
    Acta Biomedica Scientifica.2023; 8(5): 125.     CrossRef
Review article
Frailty and elderly in urology: implications for postoperative complications
Phil Hyun Song
Yeungnam Univ J Med. 2020;37(4):296-301.   Published online October 8, 2020
DOI: https://doi.org/10.12701/yujm.2020.00752
  • 5,607 View
  • 63 Download
AbstractAbstract PDF
The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of preoperative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.
Case reports
Cushing syndrome in pregnancy, diagnosed after delivery
Han Byul Kim, Mi Kyung Kim, El Kim, Keun Soo Ahn, Hye Soon Kim, Nam Kyung Kim
Yeungnam Univ J Med. 2021;38(1):60-64.   Published online May 22, 2020
DOI: https://doi.org/10.12701/yujm.2020.00290
  • 6,219 View
  • 120 Download
  • 3 Crossref
AbstractAbstract PDF
Cushing syndrome (CS) is rare in pregnancy, and few cases have been reported to date. Women with untreated CS rarely become pregnant because of the ovulatory dysfunction induced by hypercortisolism. It is difficult to diagnose CS in pregnancy because of its very low incidence, the overlap between the clinical signs of hypercortisolism and the physiological changes that occur during pregnancy and the changes in hypothalamus-pituitary-adrenal axis activity that occur during pregnancy and limit the value of standard diagnostic testing. However, CS in pregnancy is associated with poor maternal and fetal outcomes; therefore, its early diagnosis and treatment are important. Here, we report two patients with CS that was not diagnosed during pregnancy, in whom maternal and fetal morbidity developed because of hypercortisolism.

Citations

Citations to this article as recorded by  
  • Cushing’s disease with twin pregnancy and diabetes mellitus: a case report and literature review
    Hideyasu Asai, Ikuo Yamamori, Shigeru Hagimoto, Kyoichi Okumura, Koki Sakakibara
    Endocrine Journal.2024; 71(10): 1003.     CrossRef
  • Endogenous Cushing’s syndrome during pregnancy
    Nada Younes, Matthieu St-Jean, Isabelle Bourdeau, André Lacroix
    Reviews in Endocrine and Metabolic Disorders.2023; 24(1): 23.     CrossRef
  • Cushing Syndrome in Pregnancy: A Case Presentation and Review of Literature
    HamidReza Samimagham, Ava Ziaei, Mohammad Tamaddondar, Mitra Kazemi Jahromi
    Journal of Kermanshah University of Medical Sciences.2023;[Epub]     CrossRef
Late complication of the Nuss procedure: recurrent cardiac tamponade
Won Jong Park, Jang Won Son, Kyu Hwan Park, You Min Kim, Jong Ho Nam, Kang Un Choi, Jung Ho Kim
Yeungnam Univ J Med. 2019;36(3):260-264.   Published online June 13, 2019
DOI: https://doi.org/10.12701/yujm.2019.00241
  • 6,928 View
  • 70 Download
AbstractAbstract PDF
Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.
Original articles
Factors affecting complications after treatment of epidermal cyst
Man Ki Choi, Kyu Jin Chung
Yeungnam Univ J Med. 2019;36(2):136-140.   Published online April 1, 2019
DOI: https://doi.org/10.12701/yujm.2019.00164
  • 9,227 View
  • 121 Download
  • 5 Crossref
AbstractAbstract PDF
Background
Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment.
Methods
Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively.
Results
Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications.
Conclusion
Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

Citations

Citations to this article as recorded by  
  • Epidermoid cyst in lower lip mimicking Keratoacanthoma: A rare case report
    V. Tharani, Nandhini Gunasekaran, K.K. Raja, Ramesh Kumar A
    Oral Oncology Reports.2024; 9: 100178.     CrossRef
  • Intradural intramedullary epidermoid cyst in a 17-year-old male: An exceptionally rare case report and review of the literature
    Babak Alijani, Sahand Karimzadhagh, Elahe Abbaspour, Zoheir Reihanian, Mohammad Haghani Dogahe, Nooshin Zaresharifi
    International Journal of Surgery Case Reports.2024; 116: 109331.     CrossRef
  • Enhancing Outcomes and Efficiency in Large Epidermal Cyst Management: Quality Improvement Approach in Primary Care
    Waseem Jerjes, Pratik Ramkumar, Yousuf Yaqub
    Clinics and Practice.2024; 14(6): 2433.     CrossRef
  • Intradiploic Epidermoid Cyst of the Posterior Fossa – Case Report and Review of the Literature
    Gonçalo Januário, Bruno Cunha, Ludovica Cellini, Gonçalo Novais
    Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery.2023; 42(01): e73.     CrossRef
  • Development of Multiple Epidermal Inclusion Cysts After Radiofrequency Microtenotomy for Plantar Fasciitis: A Case Report
    Jennifer Skolnik, Jane Pontious, Todd Hasenstein
    The Journal of Foot and Ankle Surgery.2021; 60(5): 1088.     CrossRef
Digital subtraction angiography vs. real-time fluoroscopy for detection of intravascular injection during transforaminal epidural block
Kibeom Park, Saeyoung Kim
Yeungnam Univ J Med. 2019;36(2):109-114.   Published online January 24, 2019
DOI: https://doi.org/10.12701/yujm.2019.00122
  • 5,892 View
  • 96 Download
  • 5 Crossref
AbstractAbstract PDF
Background
Transforaminal epidural block (TFEB) is an effective treatment option for radicular pain. To reduce complications from intravascular injection during TFEB, use of imaging modalities such as real-time fluoroscopy (RTF) or digital subtraction angiography (DSA) has been recommended. In this study, we investigated whether DSA improved the detection of intravascular injection during TFEB at the whole spine level compared to RTF.
Methods
We prospectively examined 316 patients who underwent TFEB. After confirmation of final needle position using biplanar fluoroscopy, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under RTF; 30 s later, 2 mL of nonionic contrast medium was injected at a rate of 0.5 mL/s under DSA.
Results
Thirty-six intravascular injections were detected for an overall rate of 11.4% using RTF, with 45 detected for a rate of 14.2% using DSA. The detection rate using DSA was statistically different from that using RTF (p=0.004). DSA detected a significantly higher proportion of intravascular injections at the cervical level than at the thoracic (p=0.009) and lumbar (p=0.011) levels.
Conclusion
During TFEB at the whole spine level, DSA was better than RTF for the detection of intravascular injection. Special attention is advised for cervical TFEB, because of a significantly higher intravascular injection rate at this level than at other levels.

Citations

Citations to this article as recorded by  
  • 1. Lumbosacral radicular pain
    Laurens Peene, Steven P. Cohen, Jan Willem Kallewaard, Andre Wolff, Frank Huygen, Antal van de Gaag, Steegers Monique, Kris Vissers, Chris Gilligan, Jan Van Zundert, Koen Van Boxem
    Pain Practice.2024; 24(3): 525.     CrossRef
  • Safety of local anesthetics in cervical nerve root injections: a narrative review
    Zachary E. Stewart
    Skeletal Radiology.2023; 52(10): 1893.     CrossRef
  • An update on technical and safety practice patterns in transforaminal epidural steroid injections
    Ashley E. Gureck, Berkenesh Gebrekristos, Razvan Turcu, Dana Kotler, Alec L. Meleger
    Interventional Pain Medicine.2023; 2(4): 100286.     CrossRef
  • Thoracic transforaminal epidural steroid injection for management of thoracic spine pain: A multicenter cross-sectional study of short-term outcomes
    Josh Levin, John Chan, Lisa Huynh, Matt Smuck, Jayme Koltsov, Bilge Kesikburun, Graham E. Wagner, Marc Caragea, Keith Kuo, Zachary L. McCormick, Byron Schneider, Evan Berlin, D.J. Kennedy, Serdar Kesikburun
    Interventional Pain Medicine.2022; 1(1): 100004.     CrossRef
  • The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
    Mansoor M Aman, Ammar Mahmoud, Timothy Deer, Dawood Sayed, Jonathan M Hagedorn, Shane E Brogan, Vinita Singh, Amitabh Gulati, Natalie Strand, Jacqueline Weisbein, Johnathan H Goree, Fangfang Xing, Ali Valimahomed, Daniel J Pak, Antonios El Helou, Priyanka
    Journal of Pain Research.2021; Volume 14: 2139.     CrossRef
Original Article
Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length
Geon Woo Lim, Young Dong Yu, Kyung Hwa Choi, Seung Ryeol Rhee, Dong Soo Park, Young Kwon Hong
Yeungnam Univ J Med. 2018;35(2):179-186.   Published online December 31, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.2.179
  • 6,060 View
  • 75 Download
  • 3 Crossref
AbstractAbstract PDF
Background
To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.
Methods
A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.
Results
The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.
Conclusion
Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

Citations

Citations to this article as recorded by  
  • Mechanical characteristics of the ureter and clinical implications
    Sorcha O’Meara, Eoghan M. Cunnane, Stefanie M. Croghan, Connor V. Cunnane, Michael T. Walsh, Fergal J. O’Brien, Niall F. Davis
    Nature Reviews Urology.2024; 21(4): 197.     CrossRef
  • Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture
    Bing Wang, Wenzhi Gao, Kunlin Yang, Honglei Liu, Yangjun Han, Mingxin Diao, Chao Zuo, Minghua Zhang, Yingzhi Diao, Zhihua Li, Xinfei Li, Gang Wang, Peng Zhang, Chunji Wang, Chunjuan Xiao, Chen Huang, Yaming Gu, Xuesong Li
    Journal of Clinical Medicine.2023; 12(4): 1655.     CrossRef
  • Left-sided flap transposition of the appendix for urethroplasty in oncourology
    A. K. Nosov, D. I. Rumyantseva, E. M. Mamizhev, P. A. Lushina, N. A. Shchekuteev, M. V. Berkut
    Cancer Urology.2022; 18(1): 127.     CrossRef
Case Reports
A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy
Moni Ra, Myungkyu Kim, Mincheol Kim, Sangwoo Shim, Seong Yeon Hong
Yeungnam Univ J Med. 2018;35(1):84-88.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.84
  • 6,088 View
  • 48 Download
AbstractAbstract PDF
A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature 38.7℃, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.
Guide wire fracture during percutaneous coronary intervention.
Hak Ro Kim, Tae Hoon Yim, Byung Chul Kim, Ho Jun Lee, Hong Geun Oh, Hyun Sik Ju, Tae Jin Kim, Young Bok Kim
Yeungnam Univ J Med. 2016;33(1):52-55.   Published online June 30, 2016
DOI: https://doi.org/10.12701/yujm.2016.33.1.52
  • 1,921 View
  • 6 Download
AbstractAbstract PDF
Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.

JYMS : Journal of Yeungnam Medical Science
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