• Title/Summary/Keyword: Thoracostomy

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Clinical Experience of Atelectasis (무기폐의 임상적 고찰)

  • 류삼열
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1098-1106
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    • 1991
  • Atelectasis may be defined as collapse of the lung due to absence of air within the alveoli. It may involve anatomic segments, lobes, or whole lungs but also may be a diffuse miliary process, as in the adult respiratory distress syndrome. The key to treatment are the anticipation and prevention of atelectasis in various clinical situations, the recognition and treatment of underlying disease, and the prompt initiation of vigorous treatment once atelectasis is found. Repeated assessment by physical examination is necessary to determine the presence of atelectasis and its response to treatment. During the period of January, 1981 to October, 1990, 100 patients with atelectasis were treated in the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. There were 70 males and 30 females ranging from 3 days to 79 years of age. The occurrence ratio of right to left side was 2.1 : 1. The underlying pathologic lesions of atelectasis were pneumonia with effusion(28), lung ca.(24), pulmonary tuberculosis(24), and chronic empyema(9), The treatment procedure for atelectasis were closed thoracostomy in 26 cases, ressection in 21 cases, therapeutic bronchoscopy in 14 cases and etc.

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Surgical Treatment of Annuloaortic Ectasia - A Case Report - (Annuloaortic Ectasia 에 대한 Bentall 씨 수술치험)

  • 고정관
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.882-888
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    • 1988
  • A case of Annuloaortic Ectasia associated with Marfan syndrome and mitral regurgitation is treated surgically by Bentall`s method and mitral annuloplasty. The Annuloaortic Ectasia is frequently accompanied with Marfan syndrome, its definition is simply explained as the following; the marked dilatation of the sinuses of Valsalva and the aortic annulus as well as the huge aneurysm of the ascending aorta. As the operative finding, the intimal tearing was shown as circular and the both coronary ostia were changed the position into high up. The patient was taken a corrective operation replacing the ascending aorta and aortic valve with a composite graft[St. Jude medical valve 29mm, woven Dacron tubular graft 31mm]. The both coronary ostia were reimplanted on the graft with 4-0 prolene by continuous suture. Mitral annuloplasty was performed. After the operation, the patient developed both spontaneous pneumothorax, he improved state by the closed thoracostomy. He has been doing well, postoperatively.

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Surgical Treatment of Emphysematous Bullae (기낭성 폐기종의 외과적 치료)

  • 김형묵
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.165-170
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    • 1973
  • The selection and treatment with resection and drainage for patients with emphysematous bullae is discussed with reference to two patients recently. One case with bilateral multiple bullous emphysema resulting tension pneumothorax due to rupture of the bullae on right, 47 year old man with pulmonary tuberculosis history for 16 years, was treated with resection of the bullae on right including upper lobectomy and c!osed rhoracostomy drainage on left for another spontaneous pneumothorax, and result was excellent for 6 month after discharge. Another 53 year old man with giant tension air cysts occupying right whole lung field and shifting mediastinum to the left was treated with right under water sealed closed thoracostomy drainage for 7 days in vain, and resection was not performed for his poor respiratory function and general condition. The most useful preoperarive information was obtained from a study of the plain chest radiogram and the surgical procedure of choice was obliteration of the bullae at thoracotomy.

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Mediastinitis Caused by Prevotella Intermedia/Nigrescens Occurred after Acupuncture -A case report- (침술후 발생한 Prevotella intermedia/nigrescens에 의한 종격동염 -치험1례-)

  • 김수성;하경임
    • Journal of Chest Surgery
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    • v.33 no.5
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    • pp.440-444
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    • 2000
  • A 54-year-old male patient was admitted due to dyspnea with chest pain and reddish swelling in the right lteral neck and right upper which developed 2 or 3 days age. He was treated with acupuncture in the neck about one week ago prior to admission. CT scans of the chest showed density of air and abnormal soft tissue which suggested abscess of the anterior mediastinum and subcutaneous tissue. He underwent cervical and mediastinal drainage with closed thoracostomy and antibiotic therapy. Black-pigmente anaerobic nonspore-forming gram-negative bacilli were isolated from the mediastinal pus and were identified as Prevotella intermedia/nigrescens upon performing biochemical tests and API rapid ID 32A (bioMeriux, France) kit. He underwent decortication of the right side because of loculated empyema on 41st postoperative day. He was fully recovered and discharged on the 82nd hospital day. This was thought to be another case of descending necrotizing mediastinitis not caused by peritonsilar abscess but by cellulitis developed after acupuncture. Early deterction of mediastinits and aggressive drainage of mediastinal abscess are important.

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Cardiac Rupture Clinical Analysis of 10 -Operative Cases- (심장 파열 수술치험 10례에 대한 분석)

  • Son, Yeong-Sang;Choe, Yeong-Ho;Kim, Hak-Je
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1001-1006
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    • 1995
  • From January, 1990 to December, 1994, we have operated 10 patients with cardiac rupture. The patients are divided into two groups according to their clinical manifestation ; five patients in each hemorrhage and tamponade group. The patients in both groups could maintain their vital signs with closed thoracostomy and fluid resuscitation. The effect of pericardiocentesis was especially dramatic in three patients of tamponade group. The average time from injury to admission was 101 minutes and that of the patients who came our hospital via one or two other hospitals was 170 minutes comparing 31 minutes of those who came directly. The average time from admission to operation was 211 minutes. Considering 98 minutes for the diagnosis and preoperative management and another 30 minutes for the preparation for operation, operations were delayed by 83 minutes to get permission. We conclude that this delaying time for transport and operation of heart-ruptured patients should be shortened in order to manage them more effectively.

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Surgical Treatment of Thoracic Injuries Combined with Abdominal Injuries (복부 손상을 동반한 흉부손상 환자의 외과적 치료)

  • Jeong, Seong-Un;Kim, Byeong-Jun;Lee, Seong-Gwang
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.842-846
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    • 1995
  • Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

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A Clinical Review of Lung Abscess - 27 cases - (폐농양의 임상적 고찰)

  • 김민호
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.552-556
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    • 1987
  • During the preantibiotic era, lung abscess carried a high mortality, however, with the introduction of penicillin and subsequently other antibiotics, significant improvement was resulted. Clinical review was performed on 27 cases of lung abscess, those were admitted and treated at the Department. of Thoracic and Cardiovascular Surgery, Chonbuk University Hospital, from 1979 to August, 1986. The following results were obtained. The most common age of occurrence was between the age of 40 and 60 [14 cases] and 22 cases were male patients. The common symptoms were cough, putrid sputum production, fever and chilliness. Numerous etiological factors may play a role in the formation of lung abscess; pneumonia [7 cases], aspiration [5 cases], bronchiectasis [2 cases], liver abscess [1 case] and broncholith [1 case]. The bacteriologic study revealed increased incidence of Enterobacteriaceae [15 cases]. The treatment methods were postural drainage [12 cases]. pneumonostomy [5 cases], lobectomy [8 cases], thoracostomy [2 cases].

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Video-Assisted Thoracoscopic Ligation of the Thoracic Duct in a Patient with Traumatic Chylothorax

  • Lee, Deok Heon;Cho, Joon Yong;Oh, Tak-Hyuk
    • Journal of Trauma and Injury
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    • v.29 no.3
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    • pp.89-92
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    • 2016
  • Non-surgical traumatic chylothorax following blunt chest trauma is rare, with only a few cases having been reported. In general, conservative treatment measures are recommended as initial management of traumatic chylothorax; these include closed thoracostomy, dietary restriction, and parenteral nutrition. There are few reports of surgery for traumatic chylothorax. We report our experience with thoracic duct ligation using video-assisted thoracoscopic surgery in a patient with chylothorax following blunt chest injury with associated fractures of the thoracic spine.

Clinical Observation of Penterating Thoracic Injury (흉부 관통상에 대한 임상적 고찰)

  • Kim, Seong-Jun;Lee, Hong-Sik;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.283-288
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    • 1992
  • From january 1970 through december 1990, 130 cases of patients with chest penetrating injury were admitted to department of thoracic and cardiovascular surgery in Chosun University Hospital. We analyzed above patients and obtained results were as follows: 1. The ratio of male to female was 7.1:1 in male predominance, and the majority[69.6%] was distributed from 2nd to 3rd decade. 2. The most common cause of chest penetrating injuries was stab wound. 3. 110 cases[84.5%] were arrived to our emergency room within six hours after trauma. 4. The most common injuring mode was hemo, pneumothorax. 5. The frequently injured site of the penetrating chest trauma was left side of the chest [64.65%]. 6. The common associated injuries of penetrating chest injuries were extremities injuries, abdominal injuries, head & facial injuries. 7. The common method of surgical treatment were closed thoracostomy[78 cases], open thoracotomy[20 cases], laparatomy[12 cases]. 8. The overall motality was 3.07%[4/130], and the causes were hypovolemic shock, sepsis and asphyxia.

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Clinical evaluation of thoracic empyema: review of 59 cases (농흉의 임상적 고찰: 59례 보)

  • 김현순
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.274-277
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    • 1982
  • A Clinical analysis of 59 patients of thoracic empyema was done who were received surgical intervention at dept. of thoracic surgery of the C.A.F.G.H. in the period of 2.5 years from January 1979 to June 1982. Occurrence ratio of Left and Right side pleural cavity of empyema was 1: 1.4. The predisposing factors of empyema were pulmonary Tbc. [49%], Chest pain [25%], Cough [8%], in order. B.P.F. was associated with empyema in 5 cases. The pleural cavity empyema was treated with several surgical procedures and conservative measures. Among of the 59 cases, the 30 cases [50%] were treated with decortication, 12 cases [20%] with closed thoractomy drainage, 9 cases with frequent thoracenteses, 5 cases with partial decortication and thoracoplasty and 3 cases with open thoracostomy tube drainage. Among of the 59 cases thoracic empyema, the full recovery were in 32 cases [54%], partial recovery in 20 cases [34%], not improved in 3 cases [5%] and 3 cases were died. The mortality rate was 5% and the recovery rate was 89%.

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