• Title/Summary/Keyword: 흉강경

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Traumatic Extrapleural Hematoma Mimicking a Hemothorax (혈흉으로 오인된 흉막외혈종)

  • Park, Young-Woo;Lee, Jae-Wook;Lee, Dong-Gi
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.328-331
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    • 2010
  • Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.

Left Upper Mediastinal Lymph Nodes Dissection during Minimally Invasive Esophagectomy (식도암 최소 침습 수술 시 좌측 종격동 림프절 절제술)

  • Lee, Kyo-Seon;Jeong, In-Seok;Ryu, Sang-Woo;Song, Sang-Yun;Na, Kook-Joo
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.244-246
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    • 2007
  • Mediastinal lymph node dissection is a method that increases the long term survival of patients with an esophageal carcinoma. However, dissection of the left mediastinal lymph node is almost impossible, as it is not easy to see. Herein, a left mediastinal lymph node dissection, with thoracoscopy through a cervical incision wound during minimal invasive esophageal surgery, is reported.

Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report- (흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.585-588
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    • 1996
  • We experienced a case of upper esophageal leiomyoma successfully excised by thoracoscopic surgery. A 29-year-old male was presented with retrosternal discomfort and mild dysphagia and an esophagogram revealed smooth fElling defect In the upper third of the intrathor cic esophagus, and esophagoscopy showed a submucosal tumor without mucosal infiltration. Chest CT and MRI were performed to confirm size, character and location of the esophageal mass, the absence of infiltration of surrounding structures, and to define mediastinal Iymphadenopathy. The tumor was excised by thoracoscopic surgery and it was diagnosed as leiomyoma (4$\times$2xlcm in size). The postoperative course was uneventful.

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Pericardial Cyst in the Rt. Subpulmonary Region - A case report - (우폐하에 위치한 심막낭종 - 1예 보고 -)

  • Jeon, Hyun-Woo;Sa, Young-Jo;Park, Jae-Kil;Lee, Sun-Hee;Sim, Sung-Bo
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.459-462
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    • 2007
  • Pericardial cysts are uncommon benign congenital mediastinal lesions and they are most often found in either cardiophrenic angle. We present here one case of atypically located pericardial cyst that was located in the sub-pulmonary region. The clinicians should take into consideration this entity in the differential diagnosis of cystic lesion of the mediastinum. The diagnostic difficulties that are encountered and the utility of video-assisted thoracoscopy are described.

Video-assisted First Rib Resection (흉강경을 이용한 1번 늑골 절제술)

  • Kim, Dong-Jin;Kim, Young-Tae;Kim, Joo-Hyun;Kang, Chang-Hyun
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.463-466
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    • 2007
  • A 21 year old male patient was admitted for pain, edema and a tingling sensation in his right arm. He underwent venography and an MRI scan, and he was diagnosed with Paget-Schroetter syndrome. Thoracoscopic first rib re-section was performed after failure of thrombolytic therapy, The symptoms were relieved after the operation and he was discharged with warfarin medication. First rib resection is generally performed through the standard transaxillary or supraclavicular route. We report here on a successful thoracoscopic first rib resection.

Recurrence Analysis after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothorax (자연기흉의 비디오흉강경수술 후 재발에 대한 분석)

  • Kim, Sung-Wan;Kim, Duk-Sil;Lim, Chang-Young;Lee, Hyeon-Jae;Lee, Gun;Kong, Joon-Hyuk
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.710-715
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    • 2010
  • Background: Video-assisted thoracic surgery (VATS) became common in the treatment of spontaneous pneumothorax (SP). Therefor we've reviewed the recurrence rate after VATS and analysed the factors affecting recurrent pneumothorax after VATS on this study. Material and Method: This retrospective analysis was performed on 321 patients of SP who had undergone VATS from Jan. 2001 to Dec. 2008. The two groups were divided as follow: group A, non-recurrent group (298 patients: 93%); and group B, recurrent group (26 patients: 7%); the two groups were analysed retrospectively. Result: The average age of the study groups were $20.9{\pm}4.3$ years old in recurrent group vs. $25.9{\pm}11.7$ years old in non-recurrent group with statistical significance (p < 0.05). There were no statistical significance in male to female ratio, height/weight ratio, location of pneumothorax, smoking history, operative time, duration of drain, hospital stay, indication of opertion and incidence rate. Average length of duration in recurrence was 12.9 months. There was 22 (95.7%) recurrent patients after VATS within 4 year period among recurrent group. Treatment methods in 23 of recurrent patients were, 8 (VATS), 2 (Axillary thoracotomy) with 15% or more in amount of pneumothorax and 7 (7 Fr. chest tube), 6 (nasal 02) with 15% or less in amount of pneumothorax. Among 10 cases of reoperation, there were 3 cases of over looking type and 7 cases of new growing type. There was no additional recurrence after these procedures were given. Conclusion: There was higher recurrence rate in younger age after VATS thus for those under 20 yrs old, detailed and possible preoperative warning for recurrence is warranted. Most recurrence occured within 4 year period, thus for this reason, regular interval based follow up with chest x-ray study is suggested during this period.

Efficacy of mechanical pleurodesis for the treatment of spontaneous pneumothorax with VATS - A comparison of short-term recurrence according to the intensities of pleural abrasion - (비디오 흉강경을 이용한 자연기흉 수술에서 기계적 흉막유착술의 효과 -기계적 흉막유착술의 강도에 따른 단기 재발율의 비교-)

  • 허진필;이정철;정태은;이동협;한승세
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1070-1075
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    • 1998
  • Background: With the advent of thoracoscopy, there has been increasing interest in less invasive surgical bullectomy and pleurodesis. The recurrence rate, however, has been reported higher in surgery with thoracoscopy than with open thoracotomy and it is thought to be caused by inappropriate mechanical pleurodesis during thoracoscopic surgery. Materials and methods: We compared the short-term recurrence rates according to the intensities of pleural abrasion in 62 patients who underwent VATS for treatment of spontaneous pneumothorax from April 1996 to August 1997. The patients were divided into 2 groups: group A(n=32) included patients who received relatively weak pleural abrasion using Endo-forcep instrument for grasping the gauze, and group B(n=30) received strong pleural abrasion using conventional instrument wrapped tightly with gauze. Each intensity of pleural abrasion allowed petechia on the parietal pleura in group A, and some tearing and bleeding in group B. Results: Indications for operation, sex distribution, and age were comparable in both groups. There were no differences in chest tube indwelling time(3.78±3.35 vs 3.80±2.49 days), hospital stay(4.72±1.87 vs 4.67±2.20 days), and the amount and duration of analgesics required postoperatively. Persistent air-leak more than 7 days after surgery occurred in 4/32(12.5%) and 2/30(6.7%) in group A and B, respectively. No bleeding-related complication occured. Pneumothorax recurred 12.5%(4/32) and 0%(0/30) of patients at a mean follow-up of 9.7 and 9.6 months in group A and B, respectively, and it was statistically significant(p<0.05). Conclusions: Proper intensity of pleural abrasion is very important factor to reduce recurrence after VATS for spontaneous pneumothorax. During short-term follow-upafter surgery, we could achieve excellent result in reducing recurrence rate with VATS and strong pleural abrasion which is comparable to thoracotomy.

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Needle Thoracoscopic Sympathectomy for Essential Hyperhidrosis (2 mm 흉강내시경을 이용한 흉부교감신경 절제술)

  • 이두연;윤용한;홍윤주;문동석
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.598-603
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    • 1998
  • Excessive sweating of the palms, axillae, and face has a strong negative impact on the quality of life for many people. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. But a definitive cure can be obtained by upper thoracic sympathectomy. From June 1997 to October 1997, 117 cases of the needle (2 mm) thoracoscopic thoracic sympathectomies were performed in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center Yong-dong Severance Hospital in Seoul, Korea. We have followed up on 94 cases which include palmar hyperhidrosis (n=85), facial hyperhidrosis(n=5) and axillary hyperhidrosis(n=4). There were 42 males and 52 females whose ages ranged from 14 to 63 years(median:23 years). The T2 ganglia and T3-4 ganglia were excised by electrocuting with a hook and endoscissors and were removed for histologic examination. There have been no mortalities or life-threatening complications. The surgical results were classified as excellent(much improvement,very dry) in 93.6%, good(some improvement, minimally wet) in 2.1%, and fair(slight improvement, still wet) in 4.2%. Five patients(5.3%) required closed thoracostomy drainage because of pneumothorax in the immediate postoperative day. Horner's syndrome occurred in one case. The compensatory sweating occurred in 67 cases(71.2%) and was embarrassing in 21 cases(22.3%) and disabling in 9 cases(9.6%) of these cases. Primary failure occurred in one case. The patient with primary failure underwent successful operation. Fifty-one patients had concomitant hyperhidrosis. Our experiences indicate needle thoracoscopic sympathectomy is a very effective, safe, and time- saving procedure for essential hyperhidrosis.

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