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난치성 복통에 대한 흉강경적 내장신경절제술

Other Titles
 Thoracoscopic Splanchnicectomy for Intractable Abdominal Pain 
Authors
 장한정  ;  이재길  ;  강창무  ;  양희준  ;  김경식  ;  최진섭  ;  김병로  ;  이혜연  ;  이우정 
Citation
 JOURNAL OF THE KOREAN SURGICAL SOCIETY , Vol.69(3) : 231-235, 2005 
Journal Title
JOURNAL OF THE KOREAN SURGICAL SOCIETY (대한외과학회지)
ISSN
 1226-0053 
Issue Date
2005
MeSH
Thoracoscopic splanchnicectomy ; Intractable abdominal pain
Keywords
Thoracoscopic splanchnicectomy ; Intractable abdominal pain
Abstract
Purpose: In patient with intractable abdominal pain due to cancer, with respect to the quality of life, it is often insufficient to relieve pain with the use of analgesics. The development of laparoscopic surgery has made a thoracoscopic splanchnicectomy possible, but the results by using several different methods have varied between different authors. Herein, we introduce a modified method of thoracoscopic splanchnicectomy on the basis of anatomical background from cadaver dissection.
Methods: Sixteen thoracoscopic splanchnicectomies were performed, with the Numerical rating scale (NRS) used for the assessment of pain. The procedure was performed, under general anesthesia, using a double lumen catheter to deflate the lung on the operation side with the patient in the lateral decubitus position. Openings were made in the 7th intercostal space at the postaxillary line for a 12 mm trocar and in the 4th and 5th intercostals spaces for 5 and 2 mm trocars, respectively. The terminal branch of the greater splanchnic nerve ends In 5th intercostal space. Six or seven branches of the splanchnic nerve were cut, dissected downward to just above the diaphragm and then cut. The sympathetic trunk was also cut in this level if the patient suffered from constipation.
Results: A splanchicectomy appeared to result in significant reduction of abdominal pain in all cases. The average reduction in the pain score was 78%. There were no postoperative complications.
Conclusion: A thoracoscopic splanchnicectomy is the treat-ment of choice for intractable intraabdominal cancer pain, helping with drug cessation or the reduction and recovery of daily activity in most patients.
Files in This Item:
T200501332.pdf Download
DOI
OAK-2005-05995
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anatomy (해부학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Byong Ro(김병로)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lee, Jae Gil(이재길) ORCID logo https://orcid.org/0000-0002-1148-8035
Lee, Hye Yeon(이혜연) ORCID logo https://orcid.org/0000-0001-6945-1967
Chang, Han Jeong(장한정)
Choi, Jin Sub(최진섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151443
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