• Journal of Chest Surgery
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• 제33권2호
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• pp.183-185
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• 2000

With the marked decrease in operative mortality in simple heart diseases there have been several reports on the minimally invasive and cosmetic techniques including submammary incision right parasternal approach right anterolateral thoracotomy partial sternotomy and subxiphoid approach. We report here subxiphoid approach without sternotomy for the repair of atrial septal defect as the procedure that has less invasive technique and more cosmetic effect.

• Journal of Chest Surgery
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• 제52권5호
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• pp.335-341
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• 2019

Background: The endovascular approach to aortic disease treatment has been increasingly utilized in the past 2 decades. This study aimed to determine the long-term results of using the Seal thoracic stent graft. Methods: We retrospectively reviewed the outcomes of patients who underwent thoracic endovascular aortic repair or a hybrid procedure using the Seal thoracic stent graft (S&G Biotech, Seongnam, Korea) from January 2008 to July 2018 at a single institution. We investigated in-hospital mortality and the incidence of postoperative complications. We also investigated the mid-term survival rate and incidence of aorta-related complications. Results: Among 72 patients with stent grafts, 15 patients underwent the hybrid procedure and 21 underwent emergency surgery. The mean follow-up period was $37.86{\pm}30.73$ months (range, 0-124 months). Five patients (6.9%) died within 30 days. Two patients developed cerebrovascular accidents. Spinal cord injury occurred in 2 patients. Postoperative renal failure, postoperative extracorporeal membrane oxygenation support, and pneumonia were reported in 3, 1, and 6 patients, respectively. Stent-related aortic complications were observed in 5 patients (6.8%). The 1- and 5-year survival and freedom from stent-induced aortic event rates were 81.5% and 58.7%, and 97.0% and 89.1%, respectively. Conclusion: The use of the Seal thoracic stent graft yielded good mid-term results. Further studies are needed to examine the long-term outcomes of this device.

• The Korean Journal of Pain
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• 제9권2호
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• pp.349-353
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• 1996

Background: Although the paramedian approach for epidural blockade is useful in some clinical situation, the parameters which are correlated with the distance from skin to the epidural space has not been established. Methods: We studied in 143 patients having elective continuous epidural blocks for relief of postoperative pain. All blocks were performed using paramedian approach with Tuohy needle in the lumbar (group 1, n=100) and thoracic (group 2, n=45) area. We measured the distance from skin to the epidural space, body weight, height, and the angle between the shaft of the needle and the skin. Data were analyzed by linear regression. The relationships between parameters identified by the F-test with a P value of less than 0.05 were considered statistically significant. Results: The mean distance from skin to the lumbar epidural space was $4.4{\pm}0.7$ cm. significant correlation between the body weight and the depth of lumbar epidural space ($\gamma$ value : 0.492) was noted with regression equation of depth(cm)=2.293+0.034${\times}$body weight (kg). Also the significant correlation between the ponderal index (PI) and the depth of lumbar epidural space ($\gamma$ value : 0.539) was noted with regression equation of depth(cm)=1.703+0.07${\times}$PI, The mean distance from skin to the thoracic epidural space was $5.2{\pm}0.7cm$ which did not correlated with other anatomic measurements. Conclusion: We found that PI and body weight are the suitable predictors of the depth of the lumbar epidural space, but not the thoracic epidural space.

• Journal of Chest Surgery
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• 제47권4호
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• pp.327-332
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• 2014

Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique's popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures.

• Journal of Chest Surgery
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• 제48권2호
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• pp.129-133
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• 2015

Severe and permanent tricuspid regurgitation induced by pacemaker leads is rarely reported in the literature. The mechanism of pacemaker-induced tricuspid regurgitation has been identified, but its management has not been well established. Furthermore, debate still exists regarding the proper surgical approach. We present the case of a patient with severe tricuspid regurgitation induced by a pacemaker lead, accompanied by triple valve disease. The patient underwent double valve replacement and tricuspid valve repair without removal of the pre-existing pacemaker lead. The operation was successful and the surgical procedure is discussed in detail.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.291-295
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• 2000

A 22-year-old man is presented with 3 months' history of dull pain on the lower thoracic area. Imaging studies suggested osteoid osteoma of 11th thoracic spine, which was verified pathologically after en bloc resection through transfacetal approach. The patient's preoperative pain was resolved immediately. We emphasize the importance of early diagnosis and complete surgical excision of tumor nidus.

• Journal of Chest Surgery
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• 제44권6호
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• pp.440-443
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• 2011

A glomus tumor is an uncommon soft tissue tumor that is most commonly found in the subungual area and a glomus originating in the trachea is extremely rare. Histologically and ultrastructurally, these tumors have been divided into three subtypes: classic glomus tumors, glomangiomas, and glomangiomyomas. Glomangiomyomas account for less than 10% of all glomus tumors and are the least common type. We report a case of a 54-year-old man with glomangiomyoma of the trachea who presented with stridor. We treated the tumor by segmental resection and primary repair via a transcervical approach.

• Journal of Chest Surgery
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• 제49권6호
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• pp.489-492
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• 2016

The original valve-sparing procedures for aortic root aneurysms were remodeling and reimplantation of the aortic root. The remodeling technique provides more physiologic movement of the cusps within 3 reconstructed neo-sinuses, thus preserving root expansibility through the interleaflet triangles. However, the durability of remodeling has been a matter of concern due to the high rate of aortic insufficiency when annular dilation is not addressed. Therefore, a modified approach was developed, combining a physiologic remodeling of the root with a subvalvular annuloplasty. This case report highlights the first case of successful aortic root remodeling with external subvalvular ring annuloplasty in Korea.

• Journal of Chest Surgery
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• 제51권1호
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• pp.61-63
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• 2018

We report the case of a patient with mitral regurgitation complicated by type B dissection and Marfan syndrome (MFS) who was managed successfully with minimally invasive mitral valve repair. Without type A aortic dissection or aortic root dilation, MFS patients may develop mitral valve regurgitation, as in this case, and need valve surgery to improve their symptoms and long-term survival. However, it is not clear that a full sternotomy and prophylactic aortic surgery are necessary. Although retrograde perfusion to the dissected aorta is controversial, our approach minimizes the risk of future anticipated aortic surgery in MFS patients.

• Journal of Korean Neurosurgical Society
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• 제60권3호
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• pp.371-374
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• 2017

Ganglioneuroma (GN) is a rare benign tumor of neural crest origin usually found in the abdomen, but may occasionally present at uncommon sites including the cervical, lumbar, or sacral spine. However, GNs of thoracic spine are extremely rare. In this report, we describe a 12-year-old girl with giant GN in the thoracic spine, who underwent successful resection (T1-4 level) of the tumor. Histopathological examination confirmed the diagnosis. GN should be considered in the differential diagnosis of any paraspinal mass. A high index of suspicion and correlation of clinico-radiological findings is necessary in differentiating a large benign tumor from a malignant growth. Complete surgical excision is the treatment of choice; however tumor size and location need to be considered for the surgical approach (one-step or multiple surgeries). Close follow-up after surgery is mandatory.