• Advances in pediatric surgery
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• 제16권2호
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• pp.154-161
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• 2010

Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

• Journal of Chest Surgery
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• 제28권3호
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• pp.297-302
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• 1995

Video-assisted thoracic surgery [VATS is emerging as a viable alternatives to thoracotomy when surgical treatment of spontaneous pneumothorax is required.Apical blebs and bullaes of the lung can be resected,and pleural abrasion can be accomplished with minimal postoperative pain and a shorter postoperative stay in hospital. We compared our results with thoracoscopic management of spontaneous pneumothorax in 20 patients [group I with a group of 32 patients previously subjected to lateral limited thoracotomy [group II . Indications for operation, sex distribution, and average age [groupI, 24.7 years ; group II, 34.4 years were comparable. Operation time [112.42 54.7 min versus 124.8 35.3 min ; P 0.03 and chest tube duration [64.4 52.3 hours versus 97.7 45.4 hours ; P 0.01 were less in group I. Postoperative hospital stay was less in group I[3.84 0.99 days;P 0.01 , as was the use of parenteral narcotics after 48 hours. [5/20=25% versus25/32=78% . Pain was quantitated by verbal rating scale in postoperative 1 to 3 days. Patients undergoing VATS experienced significantly less postoperative pain. Postoperative complication was less in group I[1/20=5% versus 3/32=8.3% . In conclusion, Video-assisted thoracoscopic management of spontaneous pneumothrax allows performance of the standard surgical procedure while avoiding the thoracotomy incision.Video-assisted thoracic surgery [VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.

• Journal of Chest Surgery
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• 제51권5호
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• pp.363-366
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• 2018

One of the complications of permanent pacemaker implantation is unintended phrenic nerve stimulation. A 15-year-old boy with a permanent pacemaker presented with chest discomfort due to synchronous chest wall contraction with pacing beats. Even after reprogramming of the pacemaker, diaphragmatic stimulation persisted. Therefore, we performed thoracoscopic phrenic nerve insulation using a Gore-Tex patch to insulate the phrenic nerve from the wire. A minimally invasive approach using a thoracoscope is a feasible option for retractable phrenic nerve stimulation after pacemaker implantation.

• Journal of Chest Surgery
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• 제29권6호
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• pp.660-663
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• 1996

Pulmonary arteriovenous fistula is relatively rare disease, and the most common types are congenital in origin. The clinical presentation of pulmonary arteriovenous fistula ranges from incidental finding on a chest roentgenogram to polycythemia, cyanosis, congestive heart failure, and major neurologic deficits caused by paradoxical embolism. Recently we have experienced a case of asymptomatic, well-localized pulmonary arteriovenous fistula In a 13 years-old female patient, which was successfully treated by thoracoscopic lobectomy.

• Journal of Chest Surgery
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• 제39권3호
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• pp.251-254
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• 2006

견관절의 골절 고정에 주로 이용되는 K-강선(Kirschner wire)은 드물게 흉곽 내, 또는 다른 장기로 원격 이동되는 것이 보고되었다. 흉곽 내로 이동된 K-강선은 대부분 개흉술을 통하여 제거되어 왔으나, 최근에는 종격동의 중요 장기를 침범하지 않은 K-강선에 한하여 흉강경을 이용한 제거가 가능한 것으로 보고되었다. 본원에서는 쇄골 고정에 이용되었던 K-강선이 흉곽 내 폐의 우상엽을 침범한 환자에게서 흉강경 수술로 성공적으로 제거하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제47권3호
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• pp.280-282
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• 2014

Atrial septal defect (ASD) is one of the most common congenital heart defects in adults. Surgical repair is the most common treatment approach, but device closure has recently become widely performed in accordance with the trend toward less invasive surgical approaches. Although surgery is recommended when ASD is accompanied by atrial fibrillation, this study reports a case in which a complete cure was achieved by closure of a device and totally thoracoscopic ablation.

• Journal of Chest Surgery
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• 제54권4호
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• pp.246-252
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• 2021

Although lobectomy remains the gold-standard surgical treatment for non-small-cell lung cancer, the frequency of thoracoscopic segmentectomy is increasing. Multiple factors must be considered in the choice of the procedure, ranging from adequate surgical planning or simulation, tumor localization, and identification of the intersegmental plane to severing the intersegmental plane to achieve an oncologically safe surgical margin with no or minimal manual palpation and different landmarks. In this article, we present an overview of methods for each procedural step of thoracoscopic segmentectomy, from preoperative planning to division of the intersegmental plane.

• Journal of Chest Surgery
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• 제39권1호
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• pp.80-84
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• 2006

흉추에 발생하는 종양에 대한 수술 치료법은 동시에 전측방 및 후방 개흉 도달법을 통해 척추 수술을 실시하는 것이 기존에 권장되는 방법이다. 그러나 최근 개흉술에 따른 여러 가지 유병 요인으로 인해 흉강경을 이용한 수술 기법이 척추 수술에 성공적으로 도입되어 왔다. 저자들은 10번 흉추에 발생한 거대 세포종에 대하여 양측 흉강 접근을 통해 흉강경 보조 하에 흉추의 전방을 박리하고, 후방 도달법을 통해 정형외과 의사에 의하여 전 척추 일괄 절제술 및 척추 재건술을 성공적으로 시행한 예를 보고한다. 이러한 흉강경을 이용한 척추 수술법은 개흉으로 유발되는 단점을 피하면서 흉추 전방 도달을 위한 개흉 수술을 대체하는 효과적이고 안전한 방법이라고 여겨진다.

• Journal of Chest Surgery
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• 제24권3호
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• pp.261-264
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• 1991

The result of thoracotomy for recurrent and persistent pneumothorax is usually excellent. However the patients undergone thoracotomy suffer from postoperative chest pain and require long postoperative recovery period. Also the operative incision scar gives the patients cosmetic problems. Subpleural blebs are usually causes of pneumothorax. They can be reached through the thoracoscope without thoracotomy and can be ablated by electrical cautery through it. Six patients with recurrent and persistent pneumothorax were managed thoracoscopic-ally. Five patients were successful and one case was failed. The failed case was explored 21 days after thoracoscopy. Follow-up period was from one to eight months. Although the follow-up period was short, thoracoscopic management of recurrent and persistent pneumothorax is thought to be good for preventing thoracotomy.

• Journal of Chest Surgery
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• 제28권1호
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• pp.78-80
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• 1995

We report the thoracoscopic resection of thymus and pericardial fat tissue in a patient who was in the setting of late severe myasthenia gravis[Osserman`s Group II-C-2 and previous tracheostomy state. The patient was 33-year-old female. She had been supported with mechanical ventilator for 88 days and suffered from recurrent pneumonia. Our first aim was to weaning her from mechanical ventilator. Traditional methods such as median sternotomy or transcervial thymectomy or transsternal sternotomy were difficult because of the anticipating complications of mediastinitis or morbidity, especially chest pain, following thoracotomy. We could wean her from the mechanical ventilator at postoperative 9 days. So, we concluded that video-assisted thoracoscopic thymectomy is a useful alternative tool in this case.