• Journal of Chest Surgery
• /
• v.43 no.4
• /
• pp.454-457
• /
• 2010

A 42 year old male was admitted for a bony mass on the posterior arc of the left $6^{th}$ rib, which was detected in a multiphasic health screening test. According to the chest computed tomography scan and bone scan, osteochondroma was suspected. He underwent VATS rib resection. There was no vessel or nerve injury. The patient was discharged without any complication on the $4^{th}$ post operative day. The pathological diagnosis was benign fibrous histiocytoma. Generally, posterolateral thoracotomy is needed for rib resection, but we found that there was no difficulty in doing this kind of surgery under a thoracoscopic approach, which has the advantage of better cosmesis.

• Journal of Chest Surgery
• /
• v.47 no.5
• /
• pp.483-486
• /
• 2014

A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

• Journal of the Korean Society of Clothing and Textiles
• /
• v.34 no.12
• /
• pp.1933-1946
• /
• 2010

This paper is a comparative analysis of the $19^{th}$ century practice of indigo dyes and dyeing in Korea and England. From over hundreds species of indigo plants in the world, it was dyer's knotweed and woad that were cultivated in Korea; however, the only indigo plant grown in England was woad. Indigo dye was produced in the form of damp indigo sediment (jeon) in Korea; however, imported indigo (as a main dye) and couched woad (as an additional dye) were indigo dyes used in England. There existed three kinds of indigo vats, the ice vat, ash-water vat, and indigo sediment (jeon) vat, in Korea. The fresh leaves of indigo were used for both the ice vat and ash-water vat. The ice vat was very convenient for preparation, but had a weakness in the inability to produce a very deep shade of blue. The ash-water vat and indigo sediment (jeon) vat were in use for producing a very deep shade of blue. The indigo sediment Goon) vat was employed presumably only by professional dyers. The indigo vat practiced in England was categorized into two types; one was woad-indigo vat, and the other was an indigo powder vat prepared by using imported indigo rock. There was a tendency to adopt different kinds of indigo vats according to the material to be dyed. The woad-indigo vat was employed for the dyeing of wool. A few of chemical vats with imported indigo were adopted, especially for the dyeing of cotton. Indigo dyers in 19th century Korea were differentiated from the rest of the dyers. They managed the growing of indigo plants as well as the production of indigo sediment (jeon). Woad dyers in 19th century England handled woolen cloth as well as worsted and woolen yarn in general. However, they sometimes dyed silk skein as well. They produced several colors such as black, blue, slates, grays, by using both woad and imported indigo.

• Journal of Chest Surgery
• /
• v.39 no.9 s.266
• /
• pp.725-728
• /
• 2006

A six-month old boy and a thirty-month old girl who suffered from dyspnea were admitted to our hospital. Their primary disease was congenital myopathy, and both of them had a history of recurrent pneumonia. Chest X-ray scan showed unilateral diaphragmatic eventration. To minimize the injury of weakened respiratory muscle in children with myopathy, VATS plication was performed under double lung ventilation. Each of the two patients were discharged on the 17th and 24th postoperative day. We report two cases of successful VATS plication in children with diaphragmatic eventration associated with congenital myopathy.

• Journal of Chest Surgery
• /
• v.33 no.9
• /
• pp.738-743
• /
• 2000

Background: Video-assisted thoracic surgery(VATS) is being used as a therapeutic modality in many diseases in which thoracotomy has been used. We studied that the VATS can substitute the thoracotomy in benign esophageal disease. Material and Method: Group I (n=18) underwent video-assisted thoracic surgery, and group II(n=19) thoracotomy. Group I includes 14 leiomyomas and 4 achalasias. Group II includes 16 leiomyomas and 3 achalasias. Operative technique is enucleation in the leiomyoma and modified Heller's myotomy in the achalasia. Analyzing factors of operation-efficacy are anesthetic time, operation time, hospital stay, chest tube drainage amount and chest tube removal day. The degree of the postoperative pain is assessed by the frequency of opioid analgesics injection. Result: There was no death in both groups. There were 5 complications in the group I and 2 in the group II. Prolonged pleural effusion and restenosis of achalasia occurred to 1 patient in each group. In the group I, there were 1 temporaty vocal cord palsy and 2 mucosal tear leading to thoracotomy. There were no differences in anesthesia time, operation time, hospital stay, total chest tube drainage amount, chest tube removal day and frequency of opioid analgesics injection. The amount of the chest tube drainage at POD 1 day was significantly lower in group I(155.6$\pm$77.8cc) than in group II(572.8$\pm$280.1cc)(p<0.05). Conclusion: The results of our data showed that video-assisted thoracic surgery for benign esophageal disease is as effective as thoracotomy and in addition, cosmetic effect is much better. We concluded VATS may be a substitute for thoracotomy in benign esophageal disease.

• Journal of Chest Surgery
• /
• v.27 no.3
• /
• pp.226-229
• /
• 1994

VATS is now used by many thoracic surgeons and in various anatomic locations such as lung parenchyme, pleura and mediastinum, etc. VATS of mediastinal masses has special characteristics compared to that of other diseases. Those are no positional changes of the mass during collapse of the lung and close proximity of the mass to major vascular structures, nerves and other vital organs. From 1992. July to 1993. August, 10 mediastinal masses were treated with video assisted thoracoscopy. There were five males and five females, ages ranged from 11 years to 65 years with average 37.7 17.7 years old. Of the 10 patients, 4 were bronchogenic cysts, 2 were teratoma, and the others were thymoma, neurilemmoma, pericardial cyst, and thymic cyst. Needle aspiration was done in large cysts and the working thoracotomy[or utility thoracotomy] was done in large solid masses for the purpose of easy dissection, easy handling and easy delivery of the mass. The average operation time were 155.6 6.8 minutes and the duration of air leakage were 1 2.2 days. The duration of the chest tube drainage were 3.3 2.6 days. The lengths of the postoperative hospitalization were 5.1 2.7 days which were shorter than those of 12 mediastinal masses treated with conventional thoracotomy during the same periods [p<0.05]. There was 1 patient converted to thoracotomy because of a bleeding at innominate vein. 3 postoperative complications were occured. Those were persistent air leakage for 7 days, diaphragmatic palsy and hoarseness which were recovered within 1 month. We conclude that mediastinal mass can be excised with video assisted thoracoscopy and the posthospitalization is reduced. But careful attention is required for avoiding injury to major vascular structures, nerves, and other vital organs.

• Journal of Chest Surgery
• /
• v.44 no.3
• /
• pp.225-228
• /
• 2011

Background: Conventional treatment (i.e. chest tube insertion and chemical pleurodesis) still remains standard for patients with secondary spontaneous pneumothorax because the risk of surgical bullectomy is deemed high in this subset. However, it has been suggested that surgical treatment using thoracoscopy may expedite postoperative recovery and, thus, may reduce hospital stay. Materials and Methods: Retrospective review of 61 patients with secondary spontaneous pneumothorax, who underwent conventional treatment (n=39) or video-assisted thoracoscopic surgery (VATS) (n=22) between January 2007 and December 2009, was performed. Talc was used for chemical pleurodesis in both groups. Results: Hospital stay of conventional treatment group and VATS group was $14.2{\pm}14.2$ days (4~58 days) and $10.6{\pm}5.8$ days (5~32 days), respectively, with statistically significant difference (p=0.033). Recurrence rate of conventional treatment group was also significantly higher (12/39, 30%) compared to VATS group (1/22, 4.5%) (p=0.016). Conclusion: In selected patients with secondary spontaneous pneumothorax with continuous air leak or inadequate lung expansion, thoracoscopic surgery with chemical pleurodesis using talc results in shorter hospital stay and lower recurrence rate compared to conventional approach.

• Journal of Chest Surgery
• /
• v.54 no.3
• /
• pp.200-205
• /
• 2021

Background: Various methods have been used to reduce postoperative pain after thoracic surgery. However, these methods may affect the patient's respiratory response and delay recovery from anesthesia. We aimed to evaluate the effects of fentanyl and remifentanil during extubation after video-assisted thoracic surgery (VATS). Methods: This study included 45 randomly-selected male patients who underwent VATS for pneumothorax between July 2011 and August 2012. We divided the participants into 3 groups: the F group, which received a bolus injection of 1.0 ㎍/kg of fentanyl; the R1 group, which received a 0.04 ㎍/kg/min remifentanil infusion; and the R2 group, which received a 0.08 ㎍/kg/min remifentanil infusion. Hemodynamics, pain, cough, consciousness level, and nausea were assessed for each group. Results: The number and severity of coughs were lower in the R1 and R2 groups than in the F group, and there were no differences between the R1 and R2 groups. Respiratory depression and loss of consciousness were not observed in any of the patients, and there were no differences in hemodynamics. Conclusion: In comparison with fentanyl, remifentanil did not result in a wide fluctuation of blood pressure and heart rate upon emergence from general anesthesia. Moreover, remifentanil contributed to cough suppression and postoperative pain control. Remifentanil seems to be a safe and effective analgesic after VATS.

• The Korean Journal of Pain
• /
• v.34 no.2
• /
• pp.234-240
• /
• 2021

Background: Various truncal block techniques with ultrasonography (USG) are becoming widespread to reduce postoperative pain and opioid requirements in video-assisted thoracoscopic surgery (VATS). The primary aim of our study was to determine whether the USG-guided serratus anterior plane block (SAPB) is as effective as the thoracic paravertebral block (TPVB) in VATS. Our secondary aim was to evaluate patient and surgeon satisfaction, block application time, first analgesic time, and length of hospital stay. Methods: Patients in Group SAPB received 0.4 mL/kg bupivacaine with a USG-guided SAPB, and patients in Group TPVB received 0.4 mL/kg bupivacaine with a USG-guided TPVB. We recorded the pain scores, the timing of the first analgesic requirement, the amount of tramadol consumption, and postoperative complications for 24 hours. We also recorded the block application time and length of hospital stay. Results: A total of 62 patients, with 31 in each group (Group SAPB and Group TPVB) completed the study. Between the two groups, there were no significant differences in rest and dynamic pain visual analog scale scores at 0, 1, 6, 12, and 24 hours after surgery. The total consumption of tramadol was significantly lower in the TPVB group (P = 0.026). The block application time was significantly shorter in Group SAPB (P < 0.001). Conclusions: An SAPB that is applied safely and rapidly as a part of multimodal analgesia in patients who undergo VATS is not inferior to the TPVB and can be an alternative to it.

• Journal of Chest Surgery
• /
• v.56 no.4
• /
• pp.240-243
• /
• 2023

Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.