A Comparison on the Operative Results of Benign Esophageal Disease by Video-Assisted Thoracic Surgery and Thoracotomy

양성 식도질환에서 개흉술과 비디오 흉강경을 이용한 수술 성적의 비교

  • 정성호 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 박승일 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 오정훈 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 송태승 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 김현조 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 김동관 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 손광현 (서울 중앙 병원 흉부외과, 울산대학교 의과대학) ;
  • 최인철 (서울 중앙 병원 마취과, 울산대하교 의과대학)
  • Published : 2000.09.01

Abstract

Background: Video-assisted thoracic surgery(VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. Material and Method: Group I (n=18) underwent video-assisted thoracic surgery, and group II(n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. Result: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I(155.6$\pm$77.8cc) than in group II(572.8$\pm$280.1cc)(p<0.05). Conclusion: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.

Keywords

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