ABSTRACT
BACKGROUN/AIMS: We performed this study to review and compare the clinical characteristics of choledochal cyst between children and adults. METHODS: We reviewed medical records of patients with choldochal cyst who underwent surgical treatment between January 1984 and December 1996. We analyzed clinical symptoms, laboratory data and procedures. To compare clinical characteristics, patients under age 15 were grouped as children and the others were as adults. RESULTS: Sixty-eight patients, 21 children and 47 adults, underwent surgical treatment, Female predominance is common in both group. Abdominal pain was the most frequent symptom in both groups. Abdominal mass and jaundice were observed more frquently in children. Fever and chilling is more common in adults. The combined disease were more common in adults. Two adult patients had combined malignant diseases, cholangiocarcinoma and pancreas adenocarcinoma respectively. According to Todani's classsification, the most common type was type I in both group. The most common surgical procedure is cyst excision and hepaticojejunostomy in both groups. CONCLUSION: There was no significant difference in choledochal cysts between child and adults clinically. But combined diseases were common in adults, early detection and early surgry will be needed in this disease.
Subject(s)
Adult , Child , Female , Humans , Abdominal Pain , Adenocarcinoma , Cholangiocarcinoma , Choledochal Cyst , Fever , Jaundice , Medical Records , PancreasABSTRACT
BACKGROUND: To secure a rapid and safe approach which is at the same time cosmetically appealing, we employed the right anterolateral thoracotomy incision for repair of atrial septal defects and valvular heart diseases in the adult. MATERIAL AND METHOD: Between October 1989 and June 1998, 44 adult patients underwent open heart surgery through right anterolateral thoracotomy at our institution. Operative time, cardiopulmonary bypass time, aortic cross clamp time, blood loss until chest tube removal, length of ICU stay, days to discharge, and survival were compared with those that received cardiac surgery via conventional sternotomy. RESULT: No significant differences were observed between the two groups. There was no death and no additional morbidity directly related to this approach. Cosmetically satisfying results were obtained with safety using the right anterolateral thoracotomy approach. CONCLUSION: Our data show that the right anterolateral thoracotomy approach is a safe alternative to conventional median sternotomy as it offers excellent exposure and aesthetically more acceptable wounds while not adding on to the operative risks.
Subject(s)
Adult , Humans , Cardiopulmonary Bypass , Chest Tubes , Heart Septal Defects, Atrial , Heart Valve Diseases , Operative Time , Sternotomy , Thoracic Surgery , Thoracotomy , Wounds and InjuriesABSTRACT
BACKGROUND: The current study was undertaken to investigate the results of a modification in the conventional Maze III Procedure devised by the authors. The aim of the technical modification was in improving the left atrial contractility. MATERIAL AND METHOD: Between July 1997 and December 1998, 34 patients with chronic atrial fibrillation for more than 1 year duration underwent a modified Maze III procedure. The assessment of the left atrial function was made by various echocardiographic measurements and SA nodal recovery was evaluated by HRV Holter monitoring. RESULT: All 34 patients were in sinus rhythm. On echocardiography, right atrial contraction was detected in 32 patients(94.1%) and left atrial contraction in 33 patients(97.1%). The echocardiographic A wave at 1, 6, and 12 months or more were 50.5+/-31.5, 62.1+/-25.1, 66+/-20.6 cm/sec, respectively, and the E wave measurements at the same time points were 152+/-31.1, 134.4+/-35.2, 133+/-27.5 cm/sec. The corresponding A/E ratios were 0.32+/-0.13, 0.48+/-0.18, 0.5+/-0.15, showing a rising trend. Treadmill evaluation at 6 months showed a mean 82% increase in heart rate after excising, and the SDNN and SDANN upon HRV Holter at 1 and 3 months postoperatively were 65.3+/-28.1/87.8+/-27.2 ms, and 60.0+/-24.1/83.4+/-25.7 ms, respectively, showing a predoinant autonomic recovery in the parasympathetic system(PSDNN = 0.01, PSDANN =0.015). CONCLUSION: The results of our data suggest that the current modification in the conventional Maze III Procedure was efective in enhancing the postoperative left atrial contractility.