• Title/Summary/Keyword: 흉부 외과적 시술

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The First Written Medical Record on Thoracic Surgery in Korean History (한국사 최초의 흉부외과 관련 의학기록)

  • Kim, Won-Gon
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.813-820
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    • 2009
  • On Dec 22, 1909, a young patriot called Lee Jae-Myung (1986~1910) attempted to assassinate Lee Wan-Yong, the prime minister of the last Yi Choseon cabinet and he later signed the annexation treaty with imperial Japan. Despite that Lee Jae-Myung failed in this assassination attempt, his heroic deed motivated national pride thereafter. After this attempted assassination, a medical record was prepared about stab wound that was inflicted upon Lee Wan-Yong during the trial of Lee Jae-Myung, and this record included many significant specific descriptions that were concerned with thoracic surgery. They included an intercostal stab wound and intercostal arterial hemorrhage, lung injury, chest contusion, traumatic pleuritis and supposedly pneumo-and hemothorax. Thoracentesis for drainage of the serosanguinous pleural effusion was also mentioned. This medical record is judged to be the first written medical record on thoracic surgery in Korean history. The aim of this study is to analyze the content of the record as it is related with a well known episode in modern Korean history.

Intervention for Chest Trauma and Large Vessel Injury (흉부 및 대혈관 외상의 인터벤션)

  • Hojun Lee;Hoon Kwon;Chang Won Kim;Lee Hwangbo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.809-823
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    • 2023
  • Trauma is an injury to the body that involves multiple anatomical and pathophysiological changes caused by forces acting from outside the body. The number of patients with trauma is increasing as our society becomes more sophisticated. The importance and demand of traumatology are growing due to the development and spread of treatment and diagnostic technologies. In particular, damage to the large blood vessels of the chest can be life-threatening, and the sequelae are often severe; therefore, diagnostic and therapeutic methods are becoming increasingly important. Trauma to nonaortic vessels of the thorax and aorta results in varying degrees of physical damage depending on the mechanism of the accident and anatomical damage involved. The main damage is hemorrhage from non-aortic vessels of the thorax and aorta, accompanied by hemodynamic instability and coagulation disorders, which can be life-threatening. Immediate diagnosis and rapid therapeutic access can often improve the prognosis. The treatment of trauma can be surgical or interventional, depending on the patient's condition. Among them, interventional procedures are increasingly gaining popularity owing to their convenience, rapidity, and high therapeutic effectiveness, with increasing use in more trauma centers worldwide. Typical interventional procedures for patients with thoracic trauma include embolization for non-aortic injuries and thoracic endovascular aortic repair for aortic injuries. These procedures have many advantages over surgical treatments, such as fewer internal or surgical side effects, and can be performed more quickly than surgical procedures, contributing to improved outcomes for patients with trauma.

The Covering of the Suture Area with an Absorbable Cellulose Mesh and Fibrin Glue in Bullectomy of Primary Spontaneous Pneumothorax (일차성 자연기흉의 수술시 흡수성 셀룰로스 망사 및 Fibrin glue의 도포와 재발에 대한 임상적 고찰)

  • 허동명;김병호
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.393-398
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    • 2001
  • 배경: 일차성 자연기흉의 재발방지를 위해서 폐기포절부위에 흡수성 셀룰로스망사와 Fibrin gluefm 도포하여 수술후 재발율을 줄일 수 있는 지 알아보았다. 대상 및 방법: 1996.4우러부터 2000.6월까지 2명의 술자가 222례의 일차성 자연기흉을 수술하였으며, 수술시기와 치료방법에 따라 4군으로 나누어 비교하였다. 제1군은 1996년부터 1997년가지 비디오흉강경수술 및 기계적 늑막유착술로 시술받은 군(25례), 제 2군은 같은 기간동안 액와개흉술 및 늑막유착술로 시술받은 군(53례), 제 3군은 1998년부터 2000.4월까지 흉강경수술 및 늑만유착술로시술받은 군(110례), 제 4군은 1999.7월부터 2000.6월까지 흉강경수술 및 봉합부위를 셀룰로스망사와 Fibrin glue로 보강한 군(34례)이었다. 각 군간, 엑스선상 기흉의 크기 및 폐기포의 수나 크기에 따라 재발율, 공기누출시간 및 흉관지속지간등을 일반선형모델을 사용하여 비교 분석하였다. 결과: 대상환자는 남자 203례, 여자 19례 이었고, 나이는 14게에서 68세이었고, 평균연령은 23.2$\pm$9.6세였다. 재발한 경우는제 1군이 5례(25%), 제 2군이 2례(3.8%), 제 3군이 5례(4.5%)이었고, 제 4군은 재발례가 없었다. 재발례는 모두 수술자의 수술경험이 2년이내일 때 발생하였다. 흉관지속기간은 제 4군이 제 3군(p<0.0006) 및 제1, 제2군(p<0.0001)에 비해서 더 짧았고, 술후 공기누출이 제 4군에서는 없었다. 술전흉부엑스선상 기흉의 크기에 따른 수술후 기흉의 재발울은 경도의 기흉에서 14.3%(2/14)이었고, 중등도 기흉에서 7.4%(10/134)이었으며, 심한 기흉에서는 재발례가 없었다. 재수술한 12례중 봉합부위근처에서 기포가 발행된 경우가 9례(75%)로 많았다. 결론: 재발방지를 위한 시술로 늑막유착술을 시행하지 않고 폐기포절제부위를 흡수성 셀룰로스망사와 Fibrin glue로 덮어주는 시술은 비교적 용이하며, 수술 후 공기 누출이 없었고, 수술 후 흉관지속기간이 더 짧았고, 단기간 추적에서 재발이 없었다. 재발에 영향을 미치는 것으로 흉부엑스선상 기흉의 크기가 작은 경우에는 재발율이 더 높았고, 수술자의 경험이 중요하였다.

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Empyema Thoracis Resulting from Migrated Acupuncture Needle -Two Cases- (침(acupuncture needle)에 의한 농흉 -2례 보고-)

  • 황은구;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.101-103
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    • 2001
  • 한방용 침술은 비교적 광범위하게 이용되나 해부학적지식부족이나 소독이 불량할 때 여러 가지 합병증을 유발할 수 있다. 두 명의 환자에서 시술된 침이 피부와 근육을 관통하여 흉강내에 들어가 농흉을 발생시켜 늑막박피술과 침을 제거하였다.

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Surgical Treatment of Chest Tuberculosis (흉부결핵의 외과적 치료)

  • 이정상
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.158-163
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    • 1999
  • Background: The author studied to define the current indications for surgical management of chest tuberculosis and to analyze the results of the operative procedures. Material and Method: The records of 87 patients among 107 patients operated on between January 1992 and May 1995 were reviewed. These patients were divided into 4 groups. Group I patients (n=45) underwent decortication with or without wedge resection of the lesion. Group II patients(n=23) underwent radical curettages of chest wall involving rib caries with or without thoracotomy. Group III patients(n=12) underwent standard pneumonectomy or pleuropneumonectomy. Group IV patients(n=7) underwent exploratory thoracotomy or wedge resection of tuberculous lung lesion. Result: Statistical analysis revealed an inverse correlation between AIs and intratumoral microvessel densities in squamous cell lung carcinoma(Spearman rank correlation coefficient r=- 0.229, p=0.047). Conclusion: The author concludes that surgery for chest tuberculosis is the definite management for therapeutic indications and surgical radication of tuberculous carriers for management of chest tuberculosis is safe and has satisfactory results.

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Use of Percutaneous Endovascular Stent Graft in Patients with Thoracic Aortic Aneurysm (흉부대동맥류 환자에서 경피적 인조혈관 스텐트의 사용)

  • Geon Yong Sun;Baek Wan Ki;Yoon Yong Han;Kim Young Sam;Kim Kwang Ho;Kim Joung Taek
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.157-161
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    • 2006
  • Use of endovascular stent-graft in aortic aneurysm disease is now accepted as an alternative treatment to surgery. We successfully treated two patients with high risk of thoracic aortic aneurysm with percutaneous endovascular stent-graft. Three and ten months follow up chest CT showed obliteration of aneurysm and there was no complication after stent grafting.

Sclerotherapy of the varicose veins (정맥류 경화용법)

  • 김부연;김재영;이교준;함석진;김해균
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.231-234
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    • 2001
  • 배경: 하지 정맥률의 치료법중의 하나인 압박경화요법의 치료효과를 알아보고자 하였다. 대상 및 방법: 영동세브란스병원에서 1997년 8월부터 1999년 8월까지 복대-대퇴정맥판막 부전이 없는 하지정맥류 환자 중 압박경화용법을 시행 받은 94명을 대상으로 하였다. 병역 및 이화학적 검사결과, 압박경화용법의 치료효과와 합병증 등을 살펴보았다. 결과: 환자의 연령은 20대에서부터 70대까지 있었으며, 평균 43.4세였고 성별은 남자가 28명 여자가 66명 이었다, 정맥의 돌출 이외에 다른 증상은 없는 환자가 87명이었으며, 다리가 무거운 증사, 피로, 통증도 각각 1예, 2예, 2예가 있었다. 대상 환자 중에서는 소복재정맥에 이환된 사람이 83예이었다. 50명환자에서 1회의 시술만으로 만족할 만한 결과를 보였으며, 시술 후의 합병증으로 부분적인 열감, 정맥염, 괴사가 있었다. 결론: 복재-대퇴정맥판막 부전이 없는 하지정맥류의 치료에 있어 경화요법은 미용적으로 우수한 효과적인 치료법으로 생각된다.

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Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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Surgical Treatment for Rupture of the Right Common Iliac Artery Caused by Transcatheter Balloon Aortic Valvuloplasty in a Baby with Congenital Aortic Stenosis - A case report - (선천성 대동맥 판막 협착증에서 풍선 판막 성형술 중 발생한 총장골 동맥 파열의 외과적 치료 -1예 보고 -)

  • Han, Jong-Hee;Kim, Yong-Ho;Yu, Jeong-Hwan;Kim, Si-Wook;Kil, Hong-Ryang;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.116-119
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    • 2008
  • Transcatheter interventions are widely used for diagnosis and treatment of congenital heart disease. Complications associated with transcatheter interventions are uncommon. However, when they occur they are most often self-limited. Rarely, however, serious catheter related complications occur that may require emergent surgical intervention. In this case, the right common iliac artery was disrupted during transcatheter balloon valvuloplasty during the treatment of congenital aortic stenosis in a 2-week-old baby. After immediate surgical intervention with bleeding control using two balloon catheters the baby did well. Here we report this case and review the medical literature.