• Title/Summary/Keyword: 개흉술

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Clinical Evaluation of Open Thoracotomy in Spontaneous Pneumothorax (자연기흉의 개흉술에 관한 임상적 고찰)

  • Go, Yeong-Ho;Son, Dong-Seop
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.470-474
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    • 1993
  • A clinical evaluation was performed on 56 patients[ 60 cases ] of open thoracotomy in spontaneous pneumothorax who were admitted and treated at department of Thoracic and Cardiovascular Surgery, Chung Ang University, Yong San Hospital during the past 3 years from March 1990 to February 1993. The results were as follows. 1. The sex ratio was male predominence [ M:F = 7:1 ]. 2. The most common age group were 2nd, 3rd decades. 3. The most common chief complaints were dyspnea and chest pain [46.3% ]. 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax [ 78.3%], secondary tuberculosis [ 18.3%], and others [ 3.4% ]. 5. The site of spontaneous pneumothorax was 50% in right, 40% in left, and 10% in both. 6. The state of activity on attack was almost in the usual life [ 98.3% ]. 7. Average height was 172.5 $\pm$ 5.39 cm in male and 164.0 $\pm$ 3.51 cm in female, average weight was 59.1 $\pm$ 7.06 kg in male and 52.0 $\pm$ 4.97 kg in female. 8. The common indications of open thoracotomy were recurrence [ 34.4% ] and persistent air leakage [ 17.8% ]. 9. The operative procedures were bullectomy [ 73.3% ], partial resection [ 11.7% ], lobectomy [ 11.7% ], and others [ 3.3% ]. 10. The most frequent location of bulla or bleb were apical segment of RUL [ 43.3 % ] and apicoposterior segment of LUL [ 40.0% ]. 11. The number of visible bulla or bleb were mainly 1 to 5, and size was about 1 to 3 cm.

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Spontaneous Pneumothorax associated with Thoracic Endometriosis - Report of a case- (흉부 자궁내막증에 의한 자연 기흉 - 1예 보고 -)

  • Cho Jung Soo;Kim Young Sam;Kim Joung Taek;Baek Wan Ki;Lee Kyung Hi;Kim Lucia;Kim Kwang Ho
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.518-521
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    • 2005
  • Pneumothorax associated with thoracic endometriosis is a rare clinical entity and it is called catamenial pneumothorax if the recurrence of pneumothorax is related to the period of menstruation. Several hypotheses about its pathogenesis are suggested including spontaneous rupture of the bulla, endometrial implants of the visceral pleura, and passage of air from the genital tract through endometrial fenestration of the diaphragm. Pneumothorax is associated with chest pain and dyspnea within 72 hours of the onset of menses in young women and developed usually at right side. We report a case of 32-year-old woman who had bilateral pneumothorax and thoracic endometriosis confirmed histopathologically in the visceral pleura by thoracotomy.

Iatrogenic Large Esophageal Perforation Caused by Sengstaken-Blackmore Tube (식도 정맥류 출현 환자에서 Sengataken-Blackmore관에 의한 의인성 거대 흉부식도 파열)

  • 윤영철;조광현;권영민;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.51-54
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    • 2003
  • This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

Primary Malignant Fibrous Histiocytoma of the Diaphragm -One Case Report- (횡격막의 원발성 악성 섬유성 조직구종 -1례 보고-)

  • 김대현;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.118-121
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    • 2003
  • A 25-year-old female patient was adimitted due to discomfort in the right chest and left epigastric area. Chest X-ray and chest CT showed a round 4$\times$4$\times$4cm sized mass located in the right lower lobe and abutted on the right diaphragm and metastatic lesions in the right lower lobe and right middle lobe. In exploratory thoracotomy, we discovered a mass originating from the right diaphragm which directly invaded the right lower lobe and metastatic subpleural lesions in the right lower lobe and right middle lobe. The mass was diagnosed as sarcoma by frozen section biopsy and we removed the mass by on bloc resection of the right diaphragm and right lower lobe. Metastatic subpleural lesions in the right lower lobe and right middle lobe were removed by wedge resection. The mass was malignant fibrous histiocytoma of the diaphragm in permanent pathologic examination and chemotherapy was done as adjuvant measure. We report one extremely rare case of malignant fibrous histiocytoma of the diaphragm with literature.

Subphrenic Abscess Due to Retained Gauze (체내에 남은 거즈가 원인인 횡경막 하 농양)

  • Hwang, Eui-Doo;Won, Tae-Hee;Kim, Si-Wook;Na, Myung-Hoon;Yu, jae-Hyun;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.105-107
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    • 2004
  • Eighty-four-year old man who had lapalotomy for stomach ulcer perforation 35 years ago was admitted for left lower chest discomfort. Chest X-ray and CT showed a large mass with air fluid level in left lower lung field. The tentative diagnosis was infected bronchogenic cyst. After a thoracotomy, the mass was confirmed as elevated diaphragm and subphrenic abscess with a foreign body, retained surgical gauze. The pus and gauze were located between stomach and diaphragm. His hospital course was smooth and uneventful, he was discharged with good outcome on postoperative day 9.

Thoracoscopic Anterior Release of the Spine in Total en Bloc Spondylectomy for Primary Thoracic Spinal Tumor -A case report- (원발성 흉추종양에 대한 전 척추 일괄 절제술 시 흉강경을 이용한 척추 전방 박리술 -1예 보고-)

  • Cho Deog Gon;Rhyu Kee Won;Kang Yong Koo;Cho Kyu Do;Jo Min Seop;Wang Young Pil
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.80-84
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    • 2006
  • A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior on bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.

Thoracic Trauma in Children (소아에서의 흉부외상)

  • 구본원;김성완
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.77-82
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    • 1997
  • Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

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Thoracoscopic Aortic Valve Replacement assisted with AESOP (Automated Endoscope System for Optimal Positioning) 3000 (AESOP 3000을 이용한 흉강경적 대동맥 판막 치환술)

  • Shin Hong Ju;Kim Hee Jung;Choo Suk Jung;Song Hyun;Chung Cheol Hyun;Song Meong Gun;Lee Jae Won
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.507-509
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    • 2005
  • Open heart surgery via right thoracotomy can be accomplished in atrial septal defects, and mitral valve diseases. Recently, thoracoscopic atrial septal defect closure, mitral valve repair, Maze operation, and minimal invasive direct coronary artery bypass (MIDCAB) are accomplished with AESOP 3000. However, there is no report of thoracoscopic aortic valve replacement in Korea. We report a successful thoracospic aortic valve replacement assisted with AESOP 3000 in a 31-year-old female patient.

A Case Report of Endobronchial Lipoma (기관지내 지방종 -체험 1례-)

  • Lee, Jong-Mok;Park, Jong-Ho;Baek, Hui-Jong;Jo, Jae-Il
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.116-118
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    • 1997
  • Endobronchial lipomas Are rare lesions that usually obstruct a major bronchus and cause irreversible pulmonAry damage distally. They are histologically benign tumors. But they can produce pulmonary damage or irreversible bronchiectasis if dignoses or tr atments are delayed. Whenever possible, the treatment of choice is resection by means of bronchoscopy. If endoscopic removal is not possible or lf the nature of the tumor is unclear, surgery is necessary. with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma . We present a case of endobronchial lipoma causing bronchial obstruction and peripheral organizing pneumonia with its clinical features. diagnosis find treatment methods.

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Occult Papillary Thyroid Carcinoma Presenting as a Huge Mediastinal Cystic Metastasis (종격동에 거대 낭성 전이를 일으킨 갑상선의 잠재성 유두상 암종)

  • Chekar, Jay Key;Song, Sang-Yun;Na, Kook-Ju;Ahn, Byoung-Hee;Oh, Sang-Gi;Jeong, In-Seok;Park, Min-Ho
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.113-116
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    • 2010
  • The initial presentation of distant metastases in patients with papillary thyroid carcinoma is quite rare. Most distant metastases are solid nodular lesions. A 67-year-old man who complained of severe dyspnea underwent surgery due to a large mediastinal cystic mass compressing the trachea and great vessels. Pathologically, the cystic mass was a metastatic thyroid papillary carcinoma. The thyroid evaluations were compatible with a well differentiated thyroid carcinoma. An occult thyroid carcinoma presenting as a large mediastinal cystic lesion is extremely rare.