• Journal of Chest Surgery
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• v.49 no.5
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• pp.356-360
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• 2016

Background: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results: No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion: The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1020-1024
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• 1992

Thirty-four patients underwent 39 subaxillary minithoracotomies for the treatment of primary spontaneous pneumothorax from June 1987 to April 1992. The age of patients ranged from 17 to 32 years. The ratio of male to female was 8.8: 1 with male predominance. The associated pulmonary lesions and pleural adhesion were not seen on the chest X-rays in all cases. Average operative time was 83 minutes[30~130 min]. Postoperative average duration of air leakage was 2.4 days, the chest tube indwelling was 5.1 days, and postoperative hospital stay was 8 days, Analgegics were not given for pain control postoperatively In conclusion, the subaxillary minithoracotomy has the following advantages: reducing the operative time, postoperative pain, morbidity, hospital stay, shoulder problems, and excellent cosmetic result.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1101-1105
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• 1989

Fifty one patients with empyema thoracic were managed at the Kyung Hee University Medical Center during 5 years between December, 1982, and December, 1987. The patients were classified into two groups; group A [early minithoracotomy-9 patients] and group B[conventional chest tube insertion-42 patients]. Each group was retrospectively analyzed to compare the results in terms of leukocyte count change, body temperature change, duration of hospitalization, elapsed time to chest tube removal and the need for subsequent decortication and tube change. There was no statistical difference between two groups in terms of etiology, age and sex. l. In the group A, mean preoperative leukocyte count [19,300/mme] decreased to 8,688/mme postoperatively. In the group B, leukocyte count changed from 16,985/mme to 14,433/mme. Their differences were significant [P< 0.05]. 2. In the group A, mean preoperative body temperature [38.5] decreased to 36.7. In the group B, body temperature changed from 38.1oC to 37.5 oC. Their differences were significant [P < 0.05]. 3. Mean duration of Hospitalization; 18.2 days [group A], 30.2 days [group B]. Their differences were significant [P < 0.01]. 4. Mean elapsing time for chest tube removal; 15.2 days [group A], 28.5 days [group B]. Their differences were significant [P < 0.01]. 5. There was no need for subsequent decortication and chest tube change in the group A. There were 22 cases [52.3 %] for subsequent decortication and 12 cases [28.6 %] for chest tube change in the group B. Early minithoracotomy in treating empyema thoracis resulted in a shorter hospital stay and a shorter period of tube drainage than conventional method.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.648-652
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• 1999

Background: Bullectomy through a transaxillary minithoracotomy have been widely used in the treatment of primary spontaneous pneumothorax. Material and Method: From September 1997 to September 1998, 22 consecutive cases of those who underwent transaxillary mini thoracotomy with Finochieto rib spreader(group F) and 24 consecutive cases with Naruke thoraco-opener(group N) at Taegu Fatima Hospital were reviewed retrospectively to compare the clinical results of transaxillary minithoracotomy with different rib spreaders in the opera tive treatments of primary spontaneous pneumothorax. Result: There were no significant differences in operative time, hospital stay, postoperative hospital stay, the duration of the indwelling chest tube, and the number of postoperative recurrences and complications in the two group. CONCLUSION This technique may be useful in the operative treatments of primary spontaneous pneumothorax.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.910-915
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• 1996

The bullectomy through transaxillary minithoracotomy and video assisted thoracic surgery(VATS) have been widely used in treatment of spontaneous pneumothorax. The study comprised a retrospective review of 1 13 consecutive cases of whom underwent bullectomy through transaxillary minithoracotomy at Shinchon Severance Hospital(group T) and 129 consecutive cases of whom underwent thoracoscopical bullectomy at Youngdong Severance(group V) between January 1992 to Jun 1994. This study compare the clinical and economic resuts of group T and group V There were no significant differences for operation time, indwelling periods of chest tube, hospital stay, complication rate and rate of recurrence in the two groups. The times of parenteral analgesics use and treatment cost were significant less in group T.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.937-942
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• 2003

Morbidity, the use of analgesics, the amount of postoperative drainage and the postoperative hospital stay were reduced in VATS for pneumothorax. However, some authors preferred minithoracotomy to VATS because the rate of recurrence after VATS were between 5% and 10%. Therefore, we present a modified thoracoscopic bullectomy (MTB) which we believe has the advantages of conventional VATS and minithoracotomy. Material and Method: Sixty-six patients who received the operation from January 2002 to December 2002 were divided into 3 groups. Twenty-six patients were treated by axillary minithoracotomy and thirteen by conventional VATS and 18 by modified thoracoscopic bullectomy, The mean age was 21.9 years (range, 16∼35 years) for minithoracotomy group, 20.6 years (range, 17∼28 years) for conventional VATS group and 22.6 years (range, 16∼39 years) for MTB group. The mean follow-ups were 11.4 months for minithoracotomy group, 9.5 months for conventional VATS group and 4.7 months for MTB group. Result: The mean duration of operation was 55.79$\pm$23.35 minutes in MTB and 44.23$\pm$19.24 minutes in conventional VATS (p=0.333). The number of staplers being used was 1.63 $\pm$0.76 in MTB, 1.41$\pm$0.64 in minithoracotomy (p=0.663), and 2.92$\pm$1.19 in conventional VATS (p<0.001). The duration of indwelling chest tube was 1.63$\pm$0.76 day in MTB, 4.07$\pm$ 1.41 day in minithoracotomy (p<0.001) and 4.46$\pm$2.33day in conventional VATS (p<0.001). Hospital length of stay was 3.26$\pm$0.81 day in MTB, 6.04$\pm$2.21 day in minithoracotomy (p<0.001) and 6.69$\pm$3.33 day in conventional VATS (p<0.001). The number of postoperative complication and recurrence were 2 in minithoracotomy (7.4%), 5 in conventional VATS (38.5%) and 1 in MTB (5.6%). Conclusion: Modified thoracoscopic bullectomy is an effective procedure in the treatment of spontaneous pneumothorax.

• Proceedings of the KTCVS Conference
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• 1997.04a
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• pp.32-34
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• 1997

• Journal of Chest Surgery
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• v.55 no.3
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• pp.239-242
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• 2022

Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.340-345
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• 2013

Background: This study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results. Methods: Thirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of $16.5{\pm}9.7$. Group II comprised 14 female and 3 male patients with an average age of $18.5{\pm}9.8$ showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was $1.8{\pm}0.2$. The average pulmonary artery pressure was $35{\pm}10$ mmHg. Following the diagnosis, performing elective surgery was planned. Results: No significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM. Conclusion: To conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.