• 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.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.482-485
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• 2006

Video-assisted thoracoscopic surgery has gained a broad acceptance for various thoracic lesions because it is the minimally invasive surgery with little tissue trauma, less pain, improved cosmetic results and short recovery time. However, there are some limitations for this method, such as restricted visual sensory information to a two-dimensional image and limited maneuverability of the tips of the instruments. To overcome these limitations, advanced technology has been introduced and the da $Vinci^{TM}$ Surgical System (Intuitive Surgical Inc, Mountain View, CA, USA) became available in 2001. In Korea, the da $Vinci^{TM}$ Surgical System was introduced in Severance hospital (Yonsei University College of Medicine) in May 2005, and approved by KFDA in July 2005. Herein, we report the first experience of robot-assisted thoracic surgery with the da $Vinci^{TM}$ Surgical System in extirpation of a large teratoma in anterior mediastinum.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.388-392
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• 1998

Hyperhidrosis is one of abnormalities in autonomic nervous system, it has been treated with dermatologic principles or thoracic sympathectomy via thoracotomy. But these techniques were rather ineffective or invasive. Recently, Video Assisted Thoracoscopic Surgery(VATS) is widely applided in thoracic surgical area, and palmar & axillary hyperhidrosis is not the exception. From August 1995 to February 1997, 52 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic sympathectomy with VATS in the department of thoracic & cardiovascular surgery, Inje university, Pusan Paik Hospital. There were 27 men and 25 women and the mean age was 22 years. Mean operating time was 172 min and unilateral sympathectomy via minithoracotomy was applied in one patient due to severe pleural adhesion. Mean postoperative hospital stay was 2.6 days. During mean 12.5 months follow-up, there was no recurrence of sweating in the both hands. Thirty patients(57.7%) complained moderate degree of compensatory sweating, but the discomfort was decreased in severity. 83.8% of all patients were satisfied with the result of operation.

• Journal of Chest Surgery
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• v.55 no.1
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• pp.49-54
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• 2022

Background: We compared the safety and effectiveness of robotic anatomical resection and video-assisted thoracoscopic surgery (VATS). Methods: A retrospective analysis was conducted of the records of 4,283 patients, in whom an attempt was made to perform minimally invasive anatomical resection for lung cancer at Seoul National University Hospital from January 2011 to July 2020. Of these patients, 138 underwent robotic surgery and 4,145 underwent VATS. Perioperative outcomes were compared after propensity score matching including age, sex, height, weight, pulmonary function, smoking status, performance status, comorbidities, type of resection, combined bronchoplasty/angioplasty, tumor size, clinical T/N category, histology, and neoadjuvant treatment. Results: In total, 137 well-balanced pairs were obtained. There were no cases of 30-day mortality in the entire cohort. Conversion to thoracotomy was required more frequently in the VATS group (VATS 6.6% vs. robotic 0.7%, p=0.008). The complete resection rate (VATS 97.8% vs. robotic 98.5%, p=1.000) and postoperative complication rate (VATS 17.5% vs. robotic 19.0%, p=0.874) were not significantly different between the 2 groups. The robotic group showed a slightly shorter hospital stay (VATS 5.8±3.9 days vs. robotic 5.0±3.6 days, p=0.052). N2 nodal upstaging (cN0/pN2) was more common in the robotic group than the VATS group, but without statistical significance (VATS 4% vs. robotic 12%, p=0.077). Conclusion: Robotic anatomical resection in lung cancer showed comparable early outcomes when compared to VATS. In particular, robotic resection presented a lower conversion-to-thoracotomy rate. Furthermore, a robotic approach might improve lymph node harvesting in the N2 station.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.260-265
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• 2018

Background: A method of wound closure using knotless suture material in the chest tube site has been introduced at our center, and is now widely used as the primary method of closing chest tube wounds in video-assisted thoracic surgery (VATS) because it provides cosmetic benefits and causes less pain. Methods: We included 109 patients who underwent VATS pulmonary resection at Samsung Medical Center from October 1 to October 31, 2016. Eighty-five patients underwent VATS pulmonary resection with chest drain wound closure utilizing knotless suture material, and 24 patients underwent VATS pulmonary resection with chest drain wound closure by the conventional method. Complications related to the chest drain wound were compared between the 2 groups. Results: There were 2 cases of pneumothorax after chest tube removal in both groups (8.3% in the conventional group, 2.3% in the knotless suture group; p=0.172) and there was 1 case of wound discharge due to wound dehiscence in the knotless suture group (0% in the conventional group, 1.2% in the knotless suture group; p=0.453). There was no reported case of chest tube dislodgement in either group. The complication rates were non-significantly different between the 2 groups. Conclusion: The results for the complication rates of this new chest drain wound closure method suggest that this method is not inferior to the conventional method. Chest drain wound closure using knotless suture material is feasible based on the short-term results of the complication rate.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.630-633
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• 2002

Although the incidence of descending necrotizing mediastinitis(DNM) is low, this is a serious disease because it"s mortality have been reported to be as high as 40∼50%. Currently, many authors have emphasized aggressive surgical approaches rather than medical treatment alone. We report good results in 2 DNM patients treated by less invasive approach with video-assisted thoracoscopic surgery, Less invasive methods with video-assisted thoracoscopic surgery can reduce hospital stay and morbidity if effective drainage can be achieved in selected DNM patients.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.798-801
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• 2007

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.140-142
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• 2023

The azygos vein sometimes merges abnormally across the right upper lobe of the lung and it hangs at the lower edge of a membranous septum, called the meso-azygos. The septum invaginates the lobe and makes a fissure. The smaller medial part of the right upper lobe is called an azygos lobe. A 16-year-old male patient was diagnosed with right-sided pneumothorax, and a closed thoracostomy was done in the emergency room. During elective wedge resection including the bulla, the meso-azygos, abnormal azygos vein, and azygos lobe were detected. We reviewed the computed tomography images and found that the azygos lobe had re-expanded laterally, not medially, to the meso-azygos after the closed thoracostomy in the emergency room. The patient had been diagnosed with left-sided pneumothorax a year ago, and no one noticed the azygos lobe at that time. We report the intraoperative findings and comparative images of a migratory azygos lobe.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.130-133
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• 2016

The rupture of an internal mammary artery (IMA) aneurysm in a patient with type 1 neurofibromatosis (NF-1) is a rare but life-threatening complication requiring emergency management. A 50-year-old man with NF-1 was transferred to the emergency department of Kyungpook National University Hospital, where an IMA aneurysmal rupture and hemothorax were diagnosed and drained. The IMA aneurysmal rupture and hemothorax were successfully repaired by staged management combining endovascular treatment and subsequent video-assisted thoracoscopic surgery (VATS). The patient required cardiopulmonary cerebral resuscitation, the staged management of coil embolization, and a subsequent VATS procedure. This staged approach may be an effective therapeutic strategy in cases of IMA aneurysmal rupture.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.478-480
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• 2016

Spontaneous perforation of the esophagus after forceful vomiting is known as Boerhaave syndrome, a rare and life-threatening condition associated with a high rate of mortality. The management of Boerhaave syndrome is challenging, especially when diagnosed late. Herein, we report the successful management of late-diagnosed Boerhaave syndrome with T-tube drainage in a 55-year-old man. The patient was transferred to our institution 8 days after the onset of symptoms, successfully managed by placing a T-tube, and was discharged on postoperative day 46 without complications.