• Archives of Plastic Surgery
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• 제35권6호
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• pp.739-742
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• 2008

Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.

• Journal of Chest Surgery
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• 제35권7호
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• pp.556-559
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• 2002

Marfan 증후군에 심한 누두흉이 동반된 경우 정중흉골절개시 개흉기를 걸기도 힘들고 대혈관과 심장의 노출이 어려울 수 있다. 저자들은 대동맥근확장의 직경이 52 mm, 중등도의 대동맥판 폐쇄부전증,고도의 승모판 폐쇄증, 누두흉을 가진 33세의 남자환자에서 대동맥근부의 근치술과 승모판 치환술을 시행하면서 누두흉을 성공적으로 치유했기에 보고한다. 정중절개에 의해 심장 및 대동맥에 접근했고 개심술 후 프로타민 투여 직후 시행된 변형된 늑연골의 절제와 흉골거상으로 수술후 안정된 흉벽을 형성할 수 있었다.

• Journal of Chest Surgery
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• 제11권3호
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• pp.359-363
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• 1978

This is a case report of surgically treated esophageal traction diverticulum which was resulted from postpneumonectomy empyema. In March, 1976, left lower lobectomy and thoracoplasty were performed at a hospital to treat long standing lung abscess, after operation it developed into empyema. One year later [April, 1977], We did decortication and left upper lobectomy[ultimate pneumonectomy], which was followed by empyema again, 3 months later it developed esophagopleurocutaneous fistula. Esophagograms bowed an adult thumb tip sized traction diverticulum in the midportion of the esophagus. Finally in January, 1978, after 6 months of gastrostomy feeding, fistulectomy and diverticulectomy were performed The funnel shaped diverticulum was in midesophagus and retracted by surrounding inflammatory scar tissue. Now the postoperative course was uneventful.

• Journal of Chest Surgery
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• 제48권2호
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• pp.112-119
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• 2015

Background: Pectus excavatum (PE) is the most common chest wall deformity. The Nuss Questionnaire modified for Adults (NQmA) is a disease-specific health-related quality of life assessment tool for patients with pectus deformities. The aim of this study is to adapt the NQmA into Turkish. Methods: Two hundred and sixty-five patients with PE were participated, with an age range of 14 to 29 years. All patients underwent a physical examination and had not undergone corrective surgery. The Turkish version of the NQmA was completed by patients and their parents. Results: The content validity index based on expert opinions was 91% for the patient questionnaire and 96% for the parent questionnaire. The Cronbach's alpha value for the NQmA was found to be 0.805 for the patient questionnaire and 0.800 for the parent questionnaire. Exploratory factor analysis was used to assess construct validity. Two factors explained 51.1% of the total variance in the patient questionnaire (psychosocial: 31.145%, Cronbach's alpha=0.818; physical: 19.955%, Cronbach's alpha=0.862). In the parent questionnaire, two factors explained 51.422% of the total variance (psychosocial: 26.097%, Cronbach's alpha=0.743; physical: 25.325%, Cronbach's alpha=0.827). Construct validity was confirmed by confirmatory factor analysis. Conclusion: The Turkish version of the NQmA was found to be valid and reliable for the assessment of quality of life in patients with PE.

• Journal of Chest Surgery
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• 제41권6호
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• pp.803-806
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• 2008

너스 수술은 미용적으로 우수한 수술법이나 전종격동 박리 시 출혈과 장기 손상을 유발할 수 있다. 저자들은 기존의 전종격동 통과방법이 갖고 있는 단점을 극복하기 위해 노력해 왔고, 보다 안전하고 간편하게 양측에 1cm의 수술 창으로 수술을 진행 할 수 있는 광투시 진입기구를 개발하게 되었다. 총 67명의 환자가 광투시 진입기구를 이용한 너스 수술을 시행 받았다. 36명은 광투시 진입기구만을 사용하였고(나이 <14), 31명은 흉강경을 추가로 이용하였다(나이 ${\geq}14$). 너스 수술 중이나 후에 흉강내 대량 출혈이나 장기손상 같은 주요합병증은 얼었다. 너스 수술에서 광투시 진입기구를 사용함으로써 출혈과 장기 손상 등 치명적인 합병증 없이 안전하고 간단하게 전종격동 박리를 할 수 있었다.

• Journal of Chest Surgery
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• 제41권4호
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• pp.523-526
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• 2008

최근 금속막대를 이용한 누두흉의 최소 침습 수술법이 미용 성형적인 측면에서 널리 시행되고 있다. 누두흉은 형태가 매우 다양하고, 연령에 따라 치료 방법에 차이가 있다. 드물지만 다른 선천적인 기형을 동반할 수 있고 이에 대해 여러 가지 변형된 술식이 개발되어 시행되고 있다. 저자들은 성인 여자에서 아직까지 보고된 바 없는 유방 저형성증을 동반한 누두흉에 대한 너스 술식과 유방 확대술을 동시에 시행한 경험 예를 보고한다.

• Journal of Chest Surgery
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• 제39권11호
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• pp.868-871
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• 2006

흉벽 기형의 일종인 누두흉의 수술방법인 Nuss 술식은 비교적 안전하고 교정 만족도가 높아 최근 많이 이용되는 방법이며 합병증으로는 기흉, 막대 편위, 창상 감염, 심낭염, 흉막 삼출, 혈흉, 심장 천공 등이 있다. 본원에서는 30세 남자 환자에서 Nuss 수술 3년 후 막대 편위로 인한 제거 수술 중 발생한 급성 흉부대동맥 손상을 경험하여 보고하는 바이다. 편위된 막대는 별 저항 없이 뽑혔으나 양측 수술 창을 통해 동맥혈이 뿜어져 나와 양손으로 출혈을 막고 신속하게 대퇴동-정맥 환류로 체외 순환을 시행하면서 정중 흉골절개를 가하고 초저온 순환 정지 하에 대동맥궁 기시부의 열상 부위를 봉합하였다. 환자는 수술 후 13일째 별다른 문제 없이 퇴원하였다.

• Journal of Chest Surgery
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• 제39권2호
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• pp.171-175
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• 2006

최소 침습성 흉부수술은 최근에 가장 발전되어온 중요한 수술의 한 분야이다. 선천성 낭종성 선종양 기형은 비교적 드물게 발생하는 폐질환으로 누두흉, 선천성 심장 및 폐혈관 질환 같은 여러 가지 선천성 기형 등이 동반될 수 있다. 저자들은 우하엽 폐에 선천성 낭종성 선종양 기형이 있으며 누두흉이 동반된 5세 된 남아 환자를 최소 침습적인 방법으로 치료 경험하였다. 저자들은 흉강경을 이용하여 우하엽 폐절제술을 실시하였고, 동시에 누두흉에 대해서는 흉골 하 금속막대를 이용한 너스 술식으로 교정하였다. 이와 같이 이러한 질환에 대한 최소 침습적인 수술방법은 유용하고 미용적으로 우수하다.

• Journal of Chest Surgery
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• 제45권5호
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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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• 제8권1호
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• pp.51-56
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• 1975

The typical traction diverticulum of the mid-thoracic esophagus is conical or funnel shaped with a wide orifice, is small (rarely exceeding 2cm in length), and is situated horizontally or extends superiorly. It is a true diverticulum, having a complete investment by the esophageal muscle coats. Each of these characteristics promotes easy emptying of the diverticulum. Since food accumulation is presented, there is no tendency to progressive enlargement of the sac, and no associated dysphagia. The diverticula of mid-esophagus rarely develop and rarely produce symptoms. When symptoms develop, they are usually caused by granulomatous infections of the mediastinal lymph nodes. And also such diverticula only rarely give rise to significant complications, the most serious of which is a tracheobronchial fistula. Generally when such complications develop or a diverticulum itself produces symptoms, moderate or severe, surgery intervenes. A case of mid-esophageal diverticulum, traction type, which surgically treated with good results, was experienced at the Department of Thoracic Surgery of Kyung-Pook University. School of Medicine. In this case, there were substernal discomfort, acid regurgitation, and back pain for about 6 months. On the operative findings, it was noticed that the diverticulum was developed by traction and adhesion of perihilar nodes to the esophageal wall. The diverticulum was a small finger tip size and the neck of it was obscure. The surrounding inflammatory change was minimal.