• Journal of Chest Surgery
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• v.35 no.3
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• pp.235-238
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• 2002

Among the causes of SVC syndrome, intraluminal tumor, especially the leiomyosarcoma is very rare. We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission. On physical examination, facial edema and venous engorgement on upper extermities and upper chast wall were showed. The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC Surgery was performed through median sternotomy. For complete resection of the tumor and thrombus, we used partial and total CPB. The follow up SVC cavogram revealed no abnormality 14 months after the operation.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1105-1110
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• 1997

Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any part of the body Excessive sweating has a strong negative impact on the qual ty of life for many persons. From June 1992 to May 1996, 211 cases of thoracoscopic thoracic sympathectomy were performed in the Department of Thoracic Surgery, Yongdong Severance Hospital, Seoul, Korea. Among the 211 cases, 192 patients had palmar hyperhidrosis, and 19 cases had facial hyperhidrosis. There were 121 males and 90 (tamales, and the ages ranged from 10 to 67 years(average: 24.82 years old). The average operation time and the average postoperative hospital stay were 91.94 minutes and 4.31 days, respectively. Perioperative courses were uneventful, and all the patients had immediate and complete relief of symptoms with mild compensatory sweating on the chest wall and the back. Even though a thoracoscopy has the possibility of emergency conversion to a thoracotomy and technical difficulties still exist, especially in patients with facial hyperhidrosis, our experience indicates that video-assisted thoracoscopic thoracic sympathectomy is a very safe and useful procedure for h perhidrosis.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.141-144
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• 2008

Low grade fibromyxoid sarcoma (LGFM) is a rare, deep soft-tissue malignant tumor. Although its histologic features are benign, the clinical course is malignant. The usual tumor locations are the lower extremity and chest wall. LGFM originating from the visceral pleura is extremely rare. We report here on a 37 year old man with a LGFM of the visceral pleura. Thirty three months after surgery, the patient is alive without any sign of local recurrence or distant metastasis.

• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.23-30
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• 2012

Purpose : This study was designed to compare the easiness and speed of insertion of three supraglottic airway devices(SADs) in a manikin setting. Methods : Three different SADs - Laryngeal Mask Classic(cLMA), I-gel and Streamlined Liner of the Pharynx Airway(SLIPA) were applied. One hundred and nineteen paramedical students with(group H) or without (group L) previous airway experience were taught brief manikin training about the use of the cLMA, I-gel and SLIPA. The students inserted each device in a randomized order. Time to effective ventilation was recorded in seconds from holding the device to the first chest inflation. Success was determined as adequate chest wall movement. Results : The insertion attempts were lesser in I-gel($1.00{\pm}0.00$) and SLIPA($1.05{\pm}0.27$) than cLMA($1.16{\pm}0.41$, p<.05). The shortest time to insertion was recorded for I-gel($10.5{\pm}3.0sec$), followed by the SLIPA($12.9{\pm}4.5sec$) and cLMA($19.6{\pm}4.1sec$, p<.05). There were no significant differences in the insertion attempts and insertion time of I-gel between group L and group H. But in cLMA, longer insertion time and more insertion attempts were recorded in group L than group H. Conclusion : Both I-gel and SLIPA were superior to cLMA in the easiness and speed of insertion. Even in novice students, I-gel showed an excellent result in a manikin.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.175-179
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• 2005

The operative case of transmanubrial osteomuscular sparing approach for the tumor involving thoracic inlet is reported. A 69-year-old man visited the hospital due to right upper extremity weakness. Chest roentgenogram showed bronchiectasis, chronic pulmonary tuberculosis, and fungal ball in right upper lobe. On computed tomogram, tumor was located in epidural space of the 6th, the 7th cervical, and the 1st thoracic spine and extended to the apex of the right thorax. A neurosurgeon performed laminectomy and removed the tumor located in the spinal canal. A thoracic surgeon performed a transmanubrial osteomuscular sparing approach and removed the tumor involving thoracic inlet. The tumor was diagnosed as hemangiopericytoma. The patient recovered without complication.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.915-918
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• 1998

The chest wall deformity associated with Poland's syndrome is a very rare anomaly which consists of congenital unilateral absence of the sternal head of the pectoralis major muscle and various abnormalities of the upper extremity. Other clinical features associated with Poland's syndrome include deficiency or absence of the breast and nipple, deficiency of subcutaneous fat and axillary hair, and abnormalities of costal cartilages and anterior ends of ribs. The origin remains uncertain, but is considered not to be hereditary. Poland's syndrome may pose a serious psychologic and cosmetic problem, early recognition and surgical correction may prove beneficial. A 37 year old patient with Poland's syndrome was encountered and underwent satisfactory surgical correction.

• Journal of Chest Surgery
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• v.45 no.5
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• pp.308-315
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• 2012

Background: Long-term surveillance comparing satisfaction between the early experience of Nuss procedure vs. Ravitch procedure. Materials and Methods: A total of 100 patients that underwent surgical correction of a pectus excavatum between 2001 and 2004 and were followed for ${\geq}2$ years were included. Surveillance on the degree of satisfaction was performed using five-levels of the Likert scale and self-assessment scoring. Results: Nuss or Ravitch surgery was performed in 63 and 37 patients, respectively. The Nuss procedure required a shorter operation time and shorter hospital stay than the Ravitch procedure (p<0.001). The surveillance demonstrated that 17.6% of the Nuss group and 35.7% of the Ravitch group were not satisfied with the outcome of the surgery (p=0.072). The most common causes of dissatisfaction were redepression in the Nuss group (n=5) and incomplete correction in the Ravitch group (n=7). The multivariate analysis showed that reoperation and a high postoperative pectus index were significant risk factors for a low satisfaction score. Conclusion: The Nuss procedure had several advantages over the Ravitch procedure in the immediate postoperative period. However, the long-term satisfaction was determined by a complete correction without recurrence or need for re-intervention rather than by the operation type.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.356-360
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• 2021

Background: Primary pulmonary malignant mesenchymal tumors are rare, constituting only 0.4% of all lung cancers. Since sarcomas are chemo/radio-resistant, surgical resection is the optimal treatment choice for patients with suitable medical conditions and tumor stage. In the present study, we analyzed the surgical outcomes and survival of primary pulmonary malignant mesenchymal tumors treated surgically. Methods: We retrospectively examined the records of patients with primary pulmonary malignant mesenchymal tumors who underwent surgical resection at our department between January 2010 and December 2020. Patient data were analyzed according to age, sex, tumor grade and stage, resection completeness, surgical type, and tumor histopathology. Results: Twenty patients were included in the study. There were 13 men (65%) and 7 women (35%). The median survival rate was 36 months (range, 19-53 months), and the 5-year overall survival rate was 37%. Unfavorable prognostic factors for overall survival included parietal pleural invasion (p=0.02), high tumor grade (p=0.02), advanced tumor stage (p=0.02), and extensive parenchymal resection (pneumonectomy and bilobectomy, p=0.01). The median length of disease-free survival was 31 months (interquartile range, 21-41 months), and the 5-year disease-free survival rate was 32%. The most unfavorable prognostic factors for recurrence were parietal pleural invasion (p=0.02), high tumor grade (p=0.01), and tumors requiring lung resection with chest wall resection (p=0.02). Conclusion: Primary malignant mesenchymal lung tumors are aggressive and have a high mortality rate. However, acceptable overall and disease-free survival rates can be obtained with surgical therapy.

• Journal of Chest Surgery
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• v.54 no.3
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• pp.186-190
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• 2021

Background: Pre-lifting of the sternum marked a major turning point in pectus excavatum repair. The author developed the crane technique in 2002 and successfully applied it to more than 2,000 cases using sternal wire stitching. However, blind sternal suturing limited the use of the wire-stitch crane. We propose a novel screw for sternal lifting as a new tool for the crane technique. Methods: We developed a screw system strong enough to withstand the pressure needed for sternum lifting. The screw was designed to have a broader thread to hold the bony tissue securely. The screw's sustaining power was tested using the torsion, driving torque, and axial pull-out tests in a polyurethane block and ex-vivo porcine sternum. Results: The screws were easily driven into the sternum, and the head of the screw was connectable to the table-mounted retractor. In the torsion test, the 2° offset torsional yield was 4.53 N·m (reference value, 1 N·m). In the polyurethane block driving torque test, the maximum torque was 0.98 N·m (reference value, 0.70 N·m). The axial pull-out test was 446 N (reference value, 100 N). The maximum pull-out resistance in the ex-vivo porcine sternum model was 1,516 N. Conclusion: The screw crane was strong enough to sustain the chest wall weight to be lifted. Thus, the screws could effectively replace the sternal wire stitching in crane pre-lifting of the sternum. We expect that application of the screw-crane will be easy and that it will improve the safety and success rate of pectus repair surgery.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.291-299
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• 2024

Background: Postoperative pain management following minimally invasive repair of pectus excavatum (MIRPE) remains a critical concern due to severe post-procedural pain. Promising results have been reported for cryoanalgesia following MIRPE; however, its invasiveness, single-lung ventilation, and additional instrumentation requirements remain obstacles. Serratus anterior plane block (SAPB) is a regional block technique capable of covering the anterior chest wall at the T2-9 levels, which are affected by MIRPE. We hypothesized that SAPB would be a superior alternative pain control modality that reduces postoperative pain more effectively than conventional methods. Methods: We conducted a retrospective study of patients who underwent MIRPE between March 2022 and August 2023. The efficacy of pain control was compared between group N (conventional pain management, n=24) and group S (SAPB, n=26). Group N received intravenous patient-controlled analgesia (IV-PCA) and subcutaneous local anesthetic infusion. Group S received bilateral continuous SAPB with 0.3% ropivacaine after a bilateral bolus injection of 30 mL of 0.25% ropivacaine with baseline IV-PCA. Pain levels were evaluated using a Visual Analog Scale (VAS) at 1, 3, 6, 12, 24, 48, and 72 hours postoperatively and total intravenous rescue analgesic consumption by morphine milligram equivalents (MME). Results: Mean VAS scores were significantly lower in group S than in group N throughout the 72-hour postoperative period (p<0.01). Group S showed significantly lower MME at postoperative 72 hours (group N: 108.53, group S: 16.61; p<0.01). Conclusion: SAPB improved immediate postoperative pain control in both the resting and dynamic states and reduced opioid consumption compared to conventional management.