• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3825-3830
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• 2013

More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma (ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC, evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affecting lymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwent transthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed. The ${\chi}^2$ test or Fisher's exact test were used to detect factors related to lymph node metastasis. Univariate and multivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females with a median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining 20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computed tomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients with carcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumours and 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph node metastases in the follow-up. The 5- and 10-year overall survival rates were 81.4% and 70.1%, respectively. Only histologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph node metastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independent prognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade and pT category affected the presence of lymph node metastases and were independent prognostic factors for early ESCC.

• Journal of Chest Surgery
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• 제8권1호
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• pp.37-44
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• 1975

Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

• Journal of Chest Surgery
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• 제31권1호
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• pp.40-45
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• 1998

종격동은 기관, 식도, 심장 및 주요혈관 등 주장기와 조직으로 이루어진 곳으로 다양한 병변이 발생하며, 종격동 질환의 진단과 치료에서 외과적 접근방법은 중요한 부분을 차지해왔다. 최근 흉강경수술 개발은 종격동질환 진단 및 치료에서 새로운 효과적인 수기로 평가받고있다. 고려대학교 안암병원 흉부외과에서는 1992년 3월부터 1997년 4월까지 종격동의 병변에 33명의 환자에서 비디오 흉강경술을 시행하였다. 환자는 남자가 16명 여자가 17명이었으며 연령은 14세부터 69세였고 평균 42세였다. 대상이된 종격동 질환의 해부학적 위치는 전종격동 14례, 중종격동 5례, 후종격동 11례, 상종격동 3례였다. 종격동 질환은 신경초종 9례, 낭성기형종이 5례, 심막 낭종 4례, 신경절신경종 2례,흉선 2례, 흉선낭종 2례, 흉선종 1례, 식도평활근종 2례, 유피종 1례, 지방종 1례, 악성 림프종 1례, 기관지 원성 낭종 1례, 심막 삼출 1례, Boerhaave's병 1례였다. 수술중 작업 창이 필요했던 경우가 6례였다. 개흉수술로 전환한 경우는 6례(24%)로 종양이 커서 개흉수술 전환이 필요했던 경우가 1례, 심한유착으로 인한 개흉수술 전환이 3례, 흉강경으로 접근이 어려웠던 경우가 2례있었다. 평균 수술 시간은 116분($\pm$56분)이었다. 수술후 흉강 드레인 거치기간은 평균 4.7일이었다. 수술후 평균 입원일수는 8.7일이었다. 종격동 각부위의 종양 및 염증성 질환의 진단과 치료에 비디오 흉강경의 적용이 가능하였으며, 비디오 흉강경을 이용한 종격동 종양 절제술은 안전성, 수술후 통증경감 및 빠른회복 등의 장점이 있는 것으로 나타났다.

• Journal of Chest Surgery
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• 제24권6호
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• pp.590-594
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• 1991

We experienced a case of leiomyoma on proximal thoracic esophagus. The patient, a 42-year-old female, noted the insidious onset of dysphagia and chest discomfort for 6 months. Esophagogram showed a smooth filling defect in upper third of thoracic esophagus, T1-T4 level and esophagoscopy revealed a firm mobile mass about 6cm in length with normal overlying mucosa. The lesion was approached the Rt. posterolateral thoracotomy through 4th ICS and enucleated of tumor without difficulty. The patient`s hospital course was uncomplicated.

• Journal of Chest Surgery
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• 제26권3호
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• pp.236-240
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• 1993

Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

• Journal of Chest Surgery
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• 제28권4호
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• pp.423-425
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• 1995

Endobronchial hamartoma is a extremely rare lesion. The patient was 47 years old female and complained of cough and dyspnea for several years. On bronchoscopy, a finger tip size mass, nearly occluding the left main bronchus and located 4cm from the carina, was found. Bronchoscopic biopsy showed the chronic inflammatory findings.We performed bronchotomy and removed the mass through left thoracotomy. The endobronchial tumor was confirmed hamartoma histopathologically.

• Journal of Chest Surgery
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• 제26권10호
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• pp.812-814
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• 1993

Six patients with flail chest were performed operative stabilization with Judet`s Struts.The indications of opertive stabilization were exploratory thoracotomy or laparotomy in 4 patients, and severe chest pain due to displaced ribs which deteriorated respiratory pattern and gas exchange in 2 patients. After operation, all patients became comfortable and complained less pain.Two patients restored spontaneous breathing without ventilator therapy and 2 patients were ventilated during 4 days and 5 days, respectively.There were no morbidity and mortality related to operative stabilization.

• Journal of Chest Surgery
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• 제5권2호
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• pp.147-152
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• 1972

This is a report on the 4 cases of benign mediastinal teratoid tumor in the Department of Thoracic Surgery Chonnam University Hospital during the period from August, 1961 to August ,1972. All the tumors were teratomas which had three germinal layers and located in the anterior mediastinum. All the cases had symptoms such as Pancoast syndrome. exertional dyspnea, middle lobe syndrome with fistulous Connection to the cyst and retrosternal discomfort. X-ray studies are essential to recognize the tumor and its location. It`s believed that a exploratory thoracotomy is recommended because of the complications of the tumors and a possibility of malignancy.

• Journal of Chest Surgery
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• 제31권5호
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• pp.513-517
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• 1998

비디오 흉강경의 이용은 여러 흉부질환에서 개흉술을 대치해 나가는 경향이며, 오늘날 광범위한 적응증은 개흉술의 대치가 보다 안전하고 유용함을 보여준다. 본원에서는 1993년 6월부터 1995년 6월까지 비디오 흉강경을 이용해 치료한 33명의 환자를 대상으로 하였다. 이들의 진단명을 보면 재발성 기흉이 16례, 엑스레이상 기포가 보이는 경우가 6례, 7일 이상 공기유출이 지속되는 경우가 4례, 양측성 기흉이 3례, 다한증 2례, 반대측 기흉의 과거력이 1례, 원발성 혈기흉 1례 순이었다. 이들의 평균 흉관 삽관 기간은 2.1$\pm$0.4일 이었으며, 재원 기간은 3.4$\pm$0.6일 이었으며 합병증은 48시간이상 자속된 공기유출이 3례에서 있었다. 이상과 같이 비디오 흉강경을 이용한 흉부 수술은 안전하고, 통증이 적으며, 짧은 재원 기간을 보여준다.

• Journal of Chest Surgery
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• 제24권9호
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• pp.903-906
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• 1991

Retrospective review of 26 patients undergoing open lung biopsy at the Yonsei University during 10 years period was conducted to evaluate open lung biopsy for DILD. From January 1980 to August 1990, open lung biopsy was performed in 26 patients through a limited thoracotomy incision[a limited anterior or a posterolateral thoracotomy]. Open lung biopsy was indicated for diffuse interstitial pulmonary diseases undiagnosed by indirect clinical and radiological diagnostic methods. The types of incision were limited anterior[11] and limited posterolateral[15]. Preoperative evaluation of the lung disease included sputum culture[26], sputum cytology [19], bronchoscopy[9] and TBLB[7]. In 23 patients the histologic appearances after open lung biopsy were sufficiently specific histologic pictures to confirm diagnosis. The results of the biopsies changed usual therapeutic plan in 17 patients among them. The complications were resp. insufficiency[3], pulmonary ed6ma[3], sepsis[2], and others[3] in 6 patients. Diagnosis from the open lung biopsy was included respiratory pneumonia[7], fibrosis[7], infection[5], malignancy[2], others[5]. 4 patients died of respiratory insufficiency. The causes of the other three death were not due to direct result of the biopsy itself. Open lung biopsy in the patient with a diffuse infiltrative lung disease is an one of the accurate diagnostic method and frequently leads to change of the therapeutic plans. So we conclude that open lung biopsy remains our diagnostic method of choice in diffuse infiltrative lung disease undetermined etiology.