• Journal of Chest Surgery
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• v.26 no.2
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• pp.89-95
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• 1993

30 patients with spontaneous pneumothorax underwent videothoracoscopic treatment between March and July 1992. The patients ranged in age from 16 years to 62 years (mean age, 30.4 years) and the incidence according to age group was highest as 50 % in the adolescence between 21 and 30 years old. The indications of the therapeutic videothoracoscopy for spontaneous pneumothorax were recurrence (30.8％), persistent air leak (30.8％), visible blebs on the chest X-ray (20.4％), tension pneumothorax (15.4％), and bilaterality (2.6％). Intraoperative scopic findings were as follows; blebs (87.1％), pleural adhesion (45.2％), and pleural effusion (22.6％). The operation was performed under general anesthesia with one lung intubation guided by flexible fiberoptic bronchoscopy. Procedures included bleb and/or wedge resection, tetracycline pleurodesis with mechanical abrasion, and parietal pleurectomy. Successful treatment was obtained in 66.7％ (20/30) and the mean postoperative hospital stay of the successful cases was 5 days. Videothoracoscopy also provided the benefits of lesser postoperative pain, rapid recovery, short hospitalization, and smaller scar of wound by reduced trauma on access. The total 13 postoperative complications were occured in 10 patients, which showed somewhat higher rate than that of other reports because of lack of experiences in the earlier period, however, it had decreased progressively as experiences were accumulated and instruments were improved in the later period. The operative mortality was absent. Conclusively, videothoracoscopy is a new interesting modality of surgical treatment of spontaneous pneumothorax and also can be extensively applicable in the diagnosis and treatment of other thoracic surgery.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1502-1507
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• 1992

Between February and July 1992, videothoracoscopic bullectomy was performed in nineteen patients with primary spontaneous pneumothorax. The indications of this surgery are recurrent in 12, persistent airleakage in 4 and previous contralateral pneumothorax in 3 patients. For the good operative field, we used double lumen endotracheal tube and put the CO2 gas into the thoracic cavity to make the lung collapse. We usually apply the endoGIA or electric cauterization for handling the bleb or bullae and there were 9 cases with of endoGIA only, 4 electric cauterization only and 6 both procedures. To evaluate the advantage of the Videothoracoscopic surgery, we compared surgical results with that of the tho-racotomy group[19 patients]. There were significant differences in operative time[93.8$\pm$41.9 min and 17.1$\pm$53.9 min, p< 0.01] and postoperative airleakage duration[35.6$\pm$113.3 hours and 117.9$\pm$214.4 hours, p<0.05] between the Videothoracoscopy and thoracotomy group. Tube indwelling time was shortened in Videothoracoscopy group[p<0.05]. The hospital stay was very short[p<0.01] and the patients needed analgesic injection less frequentley in videthoracoscopic group[p<0.05] In conclusion, we prefer the Videothoracoscopic procedure to the thoracotomy in uncomplicateed patients with pneumothorax because of simple procedure and good results.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.162-167
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• 1998

Between January 1976 and March 1997, six patients with delayed presentation of traumatic diaphragmatic hernia occured among the 52 patients of traumatic diaphragm rupture, of whom four males and two females, five by blunt trauma and one by stab wound, one was right side and the rest were left side. In all patients, reduction of herniated organs was accomplished by thoracotomy or thoracotomy with extension to abdomen. Suspicion of the diaphragmatic ruture from the acute traumatic chest injured patient is important and we can use the videothoracoscopy for evaluation and treatment of the traumatic diaphragm rupture

• Journal of Chest Surgery
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• v.42 no.4
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• pp.497-501
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• 2009

Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.