• Journal of Chest Surgery
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• v.29 no.7
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• pp.789-791
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• 1996

Medstinoscopy has been used in the diagnosis for detection of mediastinal Iymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A 19-year-old male complained of chest disconyortness and dysphagia. A chest roentgenogram showed. the right paratracheal mass. Computed topography findings were consistent with a diagnosis of bronchogenic cyst, and excision of cyst was accomplished via the mediastinoscopy thus avoiding thoracotomy.

• Journal of Chest Surgery
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• v.49 no.4
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• pp.313-316
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• 2016

Paratracheal air cysts are a rare entity in which cystic formation occurs adjacent to the trachea. Most patients with paratracheal air cysts are asymptomatic, and the cysts are detected incidentally on chest radiograph or computed tomography (CT) scan. Most symptomatic patients complain of pulmonary symptoms or repeated respiratory infection. Rarely, the air cysts can lead to paralysis of the recurrent laryngeal nerve as a result of direct compression. We report a case of a 59-year-old male patient who presented with voice change, and the cause was identified as paratracheal air cysts on a chest CT scan. Surgical resection via video-assisted mediastinoscopy was performed, and the voice recovered immediately after the operation.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.267-272
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• 2010

Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis. Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis. Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure. Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1110-1115
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• 1998

Esophagectomy has a high morbidity rate, mainly related to pulmonary complications. The respiratory morbidity of open esophagectomy is high, ranging from 6% to 10%. This high morbidity is partially responsible for the 6∼15% mortality rate of esophagectomy. Many techniques of esophagectomy without thoracotomy have been described since the initial report of Orringer and Sloan. Endoscopic microsurgical dissection of the esophagus was clinically introduced in 1989. Endoscopic microsurgical dissection of the esophagus was developed as a minimally invasive procedure that avoids thoracotomy and provides precise vision during the operation in order to reduce mediastinal trauma and to improve the peri- and post-operative situation. A 20 year-old women who accidentally swallowed about 150 cc of glacial acetic acid underwent an esophagectomy using the operating mediastinoscopy, cervical esophagogastric anastomosis, pyloromyotomy, and feeding jejunostomy tube placement for esophageal stricture. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day. Our clinical experience shows that endoscopic microsurgical dissection of esophagus is a safe and feasible method because it offers excellent optical control and enables the surgeon to operate in a minimally invasive manner.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.175-178
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• 2014

Background: Resection rates of lung cancer are low in general and especially in countries like Nepal. Advanced stage at presentation and poor general condition of the patient are the usual causes. Materials and Methods: In this prospective observational study, one hundred cases of lung cancer who presented at the Thoracic Surgery Unit between October 2011 and October 2012 were included. Results: Those aged in the $6^{th}$ and $7^{th}$ decades together accounted for 72/100 patients. The male to female ratio was 2:1. There was a mean-$29.2{\pm}14.2$ pack yrs smoking history with only five non-smokers. Seventy-six patients presented with locally advanced disease while 21 had metastases. Only three had local disease. The average time between onset of symptoms to first contact with a doctor was $2.3{\pm}5.3$ months (range: 0-35.6 months). Average time between first contact to referral was $50.4{\pm}65.7$ days (range-0-365). Only three patients were resected, one after neo-adjuvant chemotherapy. Advanced disease was the cause of unresectability in 95 cases. One of three patients with local disease had pulmonary functions allowing the warranted resection. $N_2$ disease with $T_{1-3}$ on CT scan was found in 47. Three of these patients underwent mediastinoscopy and all confirmed uninvolved $N_2$. Conclusions: Lung resection rates in our center remain low. Late presentation leading to advanced disease and poor pulmonary reserves preclude resection in most cases. More liberal use of mediastinal staging and better assessment of pulmonary functions may allow us to improve resection rates.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.522-530
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• 1984

During a 12-month period, 31 patients underwent diagnostic and therapeutic thoracoscopy for previously undiagnosed thoracic diseases. In all patient, the diagnosis had been unobtainable by the usual diagnostic modalities of thoracentesis, closed pleural biopsy, bronchoscopy, or mediastinoscopy. The patients ranged from 4 years to 84 years old. One procedure was performed for mediastinal mass, 8 for parenchymal lesions, 21 for pleural diseases, and 1 for diaphragmatic disease. A correct diagnosis was obtained by thoracoscopy in 31 procedures for a 90% overall accuracy rate. There was no clinically significant morbidity in this series and no procedure-related mortality. Thoracoscopy, performed under intercostal nerve block and regional anesthesia, has proved to be a very attractive method of the diagnosis of thoracic disease.

• Journal of Chest Surgery
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• v.44 no.3
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• pp.257-259
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• 2011

The extent of resection and release of the trachea is important for successful anastomosis. Bilateral bronchial dissection is one of the release techniques for resection of the lower trachea. We present the experience of cervical video-assisted mediastinoscopic bilateral bronchial release for long segmental resection and anastomosis of the lower trachea.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.481-485
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• 2004

Lung cancer has become a leading cause of cancer death in Korea. Accurate staging of non-small cell lung cancer (NSCLC) is essential to the ability to offer a patient the most effective available treatment and the best estimate of prognosis. PET with F-18 fluorodeoxyglucose (FDG) is indicated for the nodal staging of NSCLC and detection of distant metastases. Use of PET for mediastinal staging should not be relied on as a sole staging modality, and positive findings should be confirmed by mediastinoscopy. FDG PET avoids futile surgery by a more accurate selection of patients, especially by the detection of unexpected distant metastases.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.424-428
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• 1979

Clinical observation were performed on 25 cases of Mediastinal tumors or Cyst, those were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Korea University Hospital, during the 6 years period from March 1973 to March 1979. The following results are obtained. Of 25 cases, 19 patients were males and 6 patients were females. Range of age varied widely from 2 years to 72 years. Approximately 28% were younger than 15 years of age at the time of diagnosis. The common subjective symptoms of the patients were anterior chest pain [36%], coughing [27%], dyspnea and a few incidence of hemoptysis. Diagnostic procedures were posteroanterior and lateral chest roentgenorgrams, Chest tomograms, Brochograms, Esophagograms, Mediastinoscopy, Scalene and Axillary Lymph node biopsy, and Needle aspiration biopsy. In the histological distribution on Mediastinal tumors in order of frequency, Neurogenic tumor 6 cases [25%], Lymphoma 5 cases [21%], Bronchogenic cyst 4 cases [17%], Pericardial cyst 2 cases [8.3%], Teratodermoid tumor 2 cases [8.3%], and each one case of Rhabdomyosarcoma, Seminoma, Cavernous hemangioma, Anthracosis, Tuberculoma were noted respectively. Of 24 cases of the histologically confirmed Mediastinal tumors, 6 cases [24%] were malignant. Thoracotomy for removal of tumor or cyst was performed on 17 cases and offered cure of all benign tumors. In 6 cases of malignant tumors, Chemotherapy with Vincristine, Cyclophosphamide and Prednisolone was given to 1 case Lymphoma. There was no case of postoperative mortality.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.208-211
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• 2010

An occurrence of hemangioma in the mediastinum is a very rare, accounting for less than 0.5% of mediastinal tumors. Capillary hemangiomas and cavernous hemangiomas consists of over 90% of mediastinal hemangiomas. However, venous hemangioma has never been reported in South Korea and has also very rarely been reported worldwide. We found mediastinal solid mass, as an incidental finding during a follow-up chest CT scan of a 44-year-old female patient who had undergone colon cancer surgery. We performed a mediastinoscopic biopsy. We did a thoracotomy to remove this mass because hemorrhage and found a totally resected venous hemangioma.