• Title/Summary/Keyword: Video-assisted thoracoscopy

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Video-Assisted Thoracoscopic Diagnosis and Treatment of Mediastinal Mass (비디오 흉강경을 이용한 종격동 종양의 진단과 치료)

  • 백희종
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.779-784
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    • 1994
  • Vidio-assisted thoracic surgery[VATS] has recently evolved as an alternative to thoracotomy for several thoracic disorders,and the role of thoracoscopy has expanded with advances in surgical techniques and instruments. From May 1993 to May 1994, 13 patients with mediastinal mass underwent VATS for diagnosis and treatment at Gil General Hospital. There were four males and nine females, and their ages raged from 5 years to 66 years with average 38.8 years. Among 13 patients, 3 were operated for tissue diagnosis,9 for treatment,and 1 for diagnosis and treatment. Pathologic diagnoses were as follows; 5 benign neurogenic tumors, 2 thymoma, 2 sarcoidosis, 1 teratoma, 1 peripheral neuroepithelioma, 1 tbc lymphadenitis, and 1 pericardial cyst. The mean time of operation was 111.7 $\pm$ 30.7 minutes[60-160], mean duration of chest tube drainage was 2.9 $\pm$1.9days[1-9], mean hospital stay was 6.2 $\pm$2.6 days[4-13]. There was no patient needed blood transfusion or conversion to open thoracotomy. Accurate diagnosis was possible in all patients operated for diagnosis and /or treatment.[4/4,100%] Two complications occurred in two patients: 1 transient Horner,s syndrome,1 anhydrosis of left arm. Compared with those of conventional thoracotomy done for mediastinal mass during previous 2 years[May 1991 - April 1993], operative results of VATS were better in all aspects. For mediastinal mass, we concluded that VATS can be done with less morbidity,less complication,less blood loss,shorter operation time and hospital stay,and not more expensive in cost than conventional thoracotomy. Noticeably, we think that VATS is the operation of choice for the diagnosis and palliation of malignant mediastinal mass.

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Clinical Analysis of Spontaneous Pneumothorax -Comparison of VATS Versus Limited Thoracotomy- (자연기흉에서 비디오흉강경과 개흉술에 의한 기포제거술의 비교)

  • 이서원;이계선;정진악;금동윤;안정태;이재원
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.369-373
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    • 1998
  • The bullectomy through the limited transaxillary thoracotomy and video-assisted thoracic surgery(VATS) had been used in operative management of spontaneous pneumothorax from Jan. 1994 to July 1997. The study comprised a retrospective review of 42 cases which were treated by limited thoracotomy, and 61 cases treated by video-assisted thoracoscopic sugery. We retrospectively reviewed annual incidnce of bullectomy. Analysis of video-assised thoracoscopic surgery and open bullectomy including age, sex, operative sites, surgical indications, associated diseases, operative time, posoperatve complications and hospital courses. There was no significant difference for operation time in two groups, 98.3${\pm}$38.4 minutes in thoracotomy and 95.7${\pm}$31.5 minutes in VATS. Prolonged air leakage over 7 days was observed in 8 cases from thoracotomy group, 4 cases from VATS group. 3 cases of recurrent pneumothorax were found from VATS group, but no recurrence was occurred from open bullectomy group. There were significant differences in postoperative hospital stay (8.0${\pm}$3.9 day in thoracotomy vs 5.9${\pm}$2.4day in VATS(P=0.001)), and indwelling period of chest tube after operation( 5.8${\pm}$3.0day in thoracotomy vs 4.0${\pm}$2.0day in VATS(P=0.0006)).

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Video-Assisted Thoracoscopic Excision of Mediastinal Masses (비디오 흉강경을 이용한 종격동 종양 절제술)

  • 박순익;김동관;유양기;김용희;박기성;박창률;박승일
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.807-811
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    • 2002
  • Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

Thoracic Extradural Cavernous Hemangioma Mimicking a Dumbbell-Shaped Tumor

  • Jeong, Won Joo;Choi, Il;Seong, Han Yu;Roh, Sung Woo
    • Journal of Korean Neurosurgical Society
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    • v.58 no.1
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    • pp.72-75
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    • 2015
  • Dumbbell-shaped spinal extradural cavernous hemangioma is rare. The differential diagnosis of dumbbell-shaped spinal tumors based on magnetic resonance imaging includes schwannoma and lymphoma. Here, we report a dumbbell-shaped spinal extradural cavernous hemangioma with intrathoracic growth on T2-3 in a 64-year-old man complaining of right side infrascapular area back pain with no neurologic deficit. The cavernous hemangioma was resected through combined video-assisted thoracoscopy and laminectomy without a fusion procedure. The patient had tolerable operative wound pain with no neurologic deficit after surgery. Based on magnetic resonance imaging findings and a review of the literature, we discuss cavernous hemangioma among the differential diagnosis of paravertebral dumbbell-shaped spinal tumors and the importance of complete resection.

Surgical Treatment of Spontaneous Pneumothorax by Thoracoscopic Wedge Resection with Fibrin Glue (비디오흉강경을 이용한 자연기흉의 치료시 국소적 Fibrin Glue 도포)

  • 신화균
    • Journal of Chest Surgery
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    • v.33 no.10
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    • pp.812-816
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    • 2000
  • Background ; To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. Material and Method : All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. Result : There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. Conclusion : Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.

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VATS Resection of Giant Leiomyoma of the Esophagus -1 case- (흉강경을 이용한 식도의 거대 평활근종 절제술 -치험 1예-)

  • 황호영;한국남;김주현;김영태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.715-717
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    • 2004
  • A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day.

Aberrent Thoracic Duct Cyst in Postrior Mediastinum

  • Park, Soo Jin;Park, Seonng Yong;Choi, Ho
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.225-227
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    • 2015
  • Thoracic duct cysts in the upper portion of the diaphragm are mostly found in the neck and are rarely found in the mediastinum. Thoracic duct cysts should be differentiated from other mediastinal tumors or cysts, and surgical treatment is required to avoid the development of chylothorax if the cyst ruptures. Herein, we report the case of a patient with a thoracic cyst located just above the diaphragm that was treated with surgical resection.

A Central Diaphragmatic Eventration with Accessory Hepatic Lobe Causing Cardiac Compression. (간 부엽에 의해 심장압박이 동반된 선천성 횡격막 거상증)

  • 오봉석;송상윤;서홍주;임영혁;김보영
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.972-975
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    • 2001
  • A case of congenital diaphragmatic eventration on the right and central tendinous portion with accessory hepatic lobe causing direct compression of the right heart is presented. We have performed the video assisted thoracoscopic plication of the right hemidiaphragm and eliminated the mass effect of the accessory hepatic lobe.

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Video-Assisted Thoracic Surgery Segmentectomy

  • Kim, Ha Eun;Yang, Young Ho;Lee, Chang Young
    • Journal of Chest Surgery
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    • v.54 no.4
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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.

Successful Diagnosis and Treatment of a Pancreaticopleural Fistula in a Patient Presenting with Unusual Empyema and Hemoptysis

  • Kim, Eunji;Ahn, Hyo Yeong;Kim, Yeong Dae;I, Hoseok;Cho, Jeong Su
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.174-177
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    • 2019
  • Pancreaticopleural fistula (PPF) is a rare complication in patients with pancreatitis. Its symptoms are similar to those of empyema or pleural effusion; therefore, it is important to consider PPF in the differential diagnosis. Herein, we describe the diagnosis and treatment of PPF in a patient presenting with unusual empyema and delayed hemoptysis.