• Journal of Chest Surgery
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• 제26권3호
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• pp.236-240
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• 1993

Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

• Journal of Chest Surgery
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• 제27권2호
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• pp.128-131
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• 1994

Recently we performed video-assisted thoracoscopic[VAT] examination and bullectomy under local anesthesia. Of the 10 patients undergoing VAT examination under local anesthesia with primary spontaneous pneumothorax, 8 patients underwent VAT bullectomy under local anesthesia using endo-GIA; 7 patients discharged within 24 hours after operation; 1 patient had an air leak after operation, so chemical pleurodesis with doxycycline was performed and discharged postoperative day 3. There have been no recurrence to date[60-120 days after operation]. We think spontaneous pneumothorax can be treated on an out-patient basis.

• Journal of Chest Surgery
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• 제27권3호
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• pp.226-229
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• 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
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• 제29권5호
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• pp.589-592
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• 1996

기관 절개술을 시행받은 중증 근무력증 환자(Osserman's Group-ll-C-1) 2례에서 흥강내시경을 이용 하여 흉선 절제술을 시행하였다. 첫 환자는47세 남자로서 기관지 절개 부위로 기계적 보조호흡을받고 있는 상태였으며, 두번째 환자는 60세 남자로서 기계적 보조호흡치료에서 일단 회복되 였으나 다시 호흡 부전이 악화되는 상태였다. 두 예 모두 기관 절개술이 되어 있었으므로,정중흥골절골술등의 기존 방 식에 의한 수술의 경우 수술후 종격동염의 발생 가능성이 높을 것으로 예상되어 흥강내시경을 이용하 여 흉선 절제술을 시행하였다. 수술후 각각 16일째와 3일째에 기계적 보조호흡을 중단할수 있었고,종격동염의 발생없이 회복되었 다. 따라서 기관지 절개술을 시행받고 있는 중증 근무력증 환자에게 흥강내시경을 이용한 흉선 절제술 이 기존의 수술 방식을 대체할 수 있는 중요한 술식이라고 보고한다.

• Journal of Chest Surgery
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• 제31권5호
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• pp.513-517
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• 1998

비디오 흉강경의 이용은 여러 흉부질환에서 개흉술을 대치해 나가는 경향이며, 오늘날 광범위한 적응증은 개흉술의 대치가 보다 안전하고 유용함을 보여준다. 본원에서는 1993년 6월부터 1995년 6월까지 비디오 흉강경을 이용해 치료한 33명의 환자를 대상으로 하였다. 이들의 진단명을 보면 재발성 기흉이 16례, 엑스레이상 기포가 보이는 경우가 6례, 7일 이상 공기유출이 지속되는 경우가 4례, 양측성 기흉이 3례, 다한증 2례, 반대측 기흉의 과거력이 1례, 원발성 혈기흉 1례 순이었다. 이들의 평균 흉관 삽관 기간은 2.1$\pm$0.4일 이었으며, 재원 기간은 3.4$\pm$0.6일 이었으며 합병증은 48시간이상 자속된 공기유출이 3례에서 있었다. 이상과 같이 비디오 흉강경을 이용한 흉부 수술은 안전하고, 통증이 적으며, 짧은 재원 기간을 보여준다.

• Journal of Chest Surgery
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• 제27권9호
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• pp.808-811
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• 1994

We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

• Journal of Chest Surgery
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• 제36권9호
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• pp.678-682
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• 2003

이차성 자연 기흉은 흉강경 수술의 좋은 적응증이다. 이 방법은 흔히 전신마취와 일측폐환기를 필요로 한다. 그러나 전신마취와 일측폐환기가 위험성이 큰 환자도 있다. 대상 및 방법: 1999년 9월부터 2001년 8월까지 15명의 고위험군 환자를 대상으로 경막외 마취하에 흉강경수술을 시행하였다. 결과: 15명이 성공적으로 흉강경 수술을 마쳤다. 술 후 누출 기간은 평균 4.3일이었고, 의미 있는 합병증은 없었으며 재발도 없었다. 결론: 흉강경 수술은 고위험인자를 가진 이차성 자연 기흉환자의 치료로 경막외 마취하에 안전하게 시행할 수 있다.

• 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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• 제33권4호
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• pp.306-309
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• 2000

Background: The purpose of this study was to evalute the diagnostic value of 2mm video thoracoscopy for primary spontaneous penumothorax. Material and Method: During the period of March to June 1999, we prospectively analyzed 33 consecutive patients suffering from primary spontaneous pneumothorax. 2mm video-assisted thoracoscopy was compared with the operative finding. We observed recurrence during the mean follow-up of 3months. Result: Blebs were present in 24 patient(73%: 24/33). These were treated by 10mm video-assised thoracoscopic stapling. Nine pateints with no bleb were treated with pleural drainage. There were no significant differences in the bleb finding. No recurrence occurred during the follow-up period. Conclusion: A 2mm video thoracoscopic examination for primary spontaneous pnumothorax is a useful alternative in deciding the operative indication.

• Journal of Chest Surgery
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• 제37권2호
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• pp.160-165
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• 2004

다방성 흉막수 또는 농흉 환자의 성공적인 치료를 위해서는 효과적인 배액술과 원인적 질환의 확진이 필요하다. 본 연구의 목적은 폐쇄성 흉강 삽관술 등의 치료에도 배액되지 않은 농흉이나 다방성 흉막수 환자에서 비디오 흉강경을 이용한 배액술 및 데브리망, 세척술의 효과와 실효성의 평가를 목적으로 한다. 대상 및 방법: 2000년 4월부터 2002년 7월까지 본원 흉부외과에 흉막수 및 농흉으로 입원한 환자 중 폐쇄성 흉강 삽관술 등으로 적절히 배액되지 않았던 환자 중 발병한지 2주일이 안된 20명을 대상으로 수술 전 흉부 전산화 단층 촬영을 실시하여 환자의 상태를 평가한 후 전신 마취하에서 비디오 흉강경을 이용한 배액술 및 데브리망, 조직검사, 세척술을 실시하였다. 결과: 20예의 환자 중 18예에서 성공적인 비디오 흉강경 배액 및 세척술이 실시되었고 2예에서 개흉술을 시행하였다. 남녀 비는 4 : 1이었으며 평균 연령은 48.9세(17∼72세), 수술 후 평균 흉관 거치 기간은 8.2일(4∼22일), 수술 후 평균 재원 기간은 15.2일(7∼33일)이었다. 원인 질환으로 결핵, 폐렴에 의한 합병증, 외상에 의한 혈흉, 전이성 유방암 등이었다. 수술 후 중대한 합병증은 없었으며 환자들은 증상이 호전되어 외래 통원 치료 및 추적 관찰 중이다. 결론: 기질화 되지 않은 초기의 농흉이나 다방성 흉막수 환자에서 비디오 흉강경을 이용한 배액술, 데브리망은 비교적 안전하고 유용한 시술이라 하겠다.