• Journal of Chest Surgery
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• v.43 no.4
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• pp.441-446
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• 2010

The ideal graft requires acceptable size, less tissue toxicity, resistance to infection, and long-term durability. Great saphenous veins are gaining popularity as acceptable graft conduits, but they require time to grow in caliber. We report 2 cases of graft bypass and reconstruction using superficial femoral veins to acheive immediate high-flow patency.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.877-883
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• 1998

Background: Cardiopulmonary bypass(CPB), a standard adjunct for open heart surgery, can also play an important role in treating patients with noncardiac diseases. Material and Method: We report a collective analysis of noncardiac applications of cardiopulmonary bypass experienced at Seoul National University Hospital from 1969 to 1996. Out of a total of 20 patients, 8 were treated for membranous obstruction of inferior vena cava(MOVC), 5 for malignant melanoma, 3 for pulmonary embolism, 1 for double lung transplantation, 1 for intracranial giant aneurysm(GA), 1 for renal cell carcinoma(RC), and 1 for liposarcoma. CPB was used to induce profound hypothermia with circulatory arrest in 6 patients(MOVC 4, GA 1, RC 1). Result: CPB time was 113 mins on average for MOVC, 161 mins for GA, and 156 mins for RC, while the lowest rectal temperature was 26$^{\circ}C$ on average in MOVC, and 19$^{\circ}C$ in GA and RC. Postoperative recovery was good in all MOVC patients. The patient with GA, who underwent reoperation for the removal of hematoma, died 14 days postoperatively. The patient with RC recovered from the operation in a good condition but died from metastatic spread 6 months later. CPB was instituted for pulmonary embolectomy in 3 patients, in whom postoperative courses were uneventful, except in 1 patient who showed transient neurologic symptoms. CPB was used in a patient with double-lung transplantation for hemodynamic and ventilatory support. The patient was weaned successfully from CPB but died from low output and septicemia 19 days postoperatively. CPB without circulatory arrest was used to treat in 4 patients with MOVC. These patients showed good postoperative courses. CPB was used to administer high concentrations of chemotherapeutic agents to the extremities in 6 patients(malignant melanoma 5, recurrent liposarcoma 1). CPB time was 153 mins on average. No complications such as edema and neurologic disability were found. Conclusion: Although CPB has a limited indication in noncardiac diseases, if properly applied, it can be a very useful adjunct in a variety of surgical cases.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.391-396
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• 2003

Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.387-393
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• 2010

Background: The aims of the present study were to assess and compare mid-term clinical outcomes including recurrences between endovenous laser therapy (EVLT) and stripping. Material and Method: Between January 2007 and February 2010, 318 limbs in 237 patients with saphenous truncal varicosities were treated by laser energy using a 980 nm diode or were treated with conventional stripping. At the initial visit and at 1, 2, 6, 12, 18, 24, and 36 months postoperatively, clinical examination and questioning for Venous Clinical Severity Score (VCSS) as well as duplex ultrasonography were done. In order to compare clinical outcomes between the two treatment groups, EVLT versus stripping, all data were processed and analyzed. Result: There were no significant differences between the two treatment groups in the extent of the reflux and the number of insufficient perforating veins. The in EVLT and the stripping group at 12 months were $90.3{\pm}4.5%$ and $93.9{\pm}4.2%$, respectively (p>0.05). Total recurrence rates were 4.4% in the EVLT group and 1.5% in the stripping group (p>0.05). In both groups, the VCSS scores were significantly reduced at week 1, 1 month, and 2 months after EVLT or stripping (p<0.001). Conclusion: Efficiency in eliminating truncal saphenous vein incompetence and reducing venous clinical severity were equal in the two treatment groups.

• Journal of Chest Surgery
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• v.35 no.2
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• pp.144-148
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• 2002

The present study was done to determine the efficacy and safety of varicose vein removal using a minimally invasive, powered vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compared this to a retrospective group of conventional phlebectomy operations. There were 133 limbs in 104 patients(72 women, 32 men) treated with the use of the vein extractor aided by transcutaneous illumination. The hydrodissection was performed with Trivex™ Irrigated illuminator(Smith & Nephe $w^{ R}$) system using normal saline after the 2~3mm sized skin incision. Varicose clusters were extracted by the use of TriveTM esector(Smith & Nephe $w^{ R}$) system under transillumination. After the varisoce vein extraction, the operation area was compressed with surgical pad for bleeding control. The complication rate was 3.84% The mean number of incisions was 3.24 and mean operative time per limb was 65.9 minutes. The mean hospitalization was 1.86 days. The varicose vein extraction using transilluminated powered phlebectomy(TIPP) is a safe, efficacious and cosmetically satisfactory method. The procedure decreases the operating time and the number of incisions required to remove varicose clusters. Further evaluation and long term follow up will be necessary to determine the recurrence rate and long termcomplications.to determine the recurrence rate and long termcomplications.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.415-420
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• 2005

Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). Material and Method: From March 200f to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. Result: Operative time was significantly shorter in the TIPP group than CP group (for one leg $108.4\pm27.6\;min\;vs\;83_4\pm24.4\;min,\;for\;both\;legs\;184.7\pm28.4\;min\;vs\; 137.8\pm24.4\;min)$. There was signifcant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group $(5.9\pm2.2\;vs\;4.2\pm1.6)$. Mean duration of hospitalization was Significantly shorter in the TIPP group than CP group $(4.4\pm1.0\;days\;vs\;5.8\pm1.9\;days)$. Complications were pain $(15.9\%)$, remnant lesion $(9.5\%)$, and ecchymosis $(4.8\%)$ in the CP group and ecchymosis $(19.6\%),\;pain\;(7.8\%),\;and\;remnant\;lesion\;(7.8\%)$ in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. Conclusion: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.408-410
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• 2018

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1097-1101
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• 1998

Renal cell carcinoma involves the inferior vena cava(IVC) in approximately 5-10% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Circulatory arrest with cardiopulmonary bypass is an operative technique that recently has been used to assist in resection of tumors that extend into the vena cava above the level of hepatic veins. We performed removal of tumor thrombi of IVC in 4 patients. All of them who had the renal cell carcinormas with infrahepatic vena caval extension were performed by standard surgical technique without cardiopulmonary bypass. But in one patient, inferior vena caval thrombectomy was done using circulatory arrest because of the recurred extension of the tumor thrombi within the vena cava above the insertion of the hepatic vein. All patients were recovered without any significant problems.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.764-767
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• 2008

The use of extracorporeal membrane oxygenation in cardiopulmonary resuscitation has remarkably increased in recent times. We report here on a case of successful resuscitation with using ECMO for a patient who suffered from repeated life threatening hemoptysis. We applied both veno-venous and veno-arterial ECMO to treat this pa tient's respiratory failure and cardiac arrest, respectively. By clinically judging the different cardiopulmonary conditions of this patient, we were able to apply the appropriate types of ECMO.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.316-319
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• 2010

An aneurysm is a focal, localized dilatation of a blood vessel. This term is most commonly applied to dilatation of arteries. However, dilatation can occur in any part of the vascular system. Primary true aneurysm of the superficial venous system that contains all the vascular layers is known to be very rare. We report here on surgically treating a case of primary true aneurysm on the dorsalis pedis vein and we briefly review the related literature.