• Journal of Chest Surgery
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• 제26권2호
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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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• 제25권12호
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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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• 제31권2호
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• pp.162-167
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• 1998

저자들은 1976년 1월 부터 1997년 3월 까지 21년간 외상성 횡격막 파열 52례 중 지연성 외상성 횡격막 탈장 6례를 치험 하였는데 이중 남자는 4례, 여자는 2례였으며 우측은 1례였다. 둔상에 의한 경우는 5례였고 자상은 1례였다. 수술은 모두 개흉술을 시행 하였고 복부로 절개를 연장한 경우가 1례 있었다. 외상성 흉부 손상을 입었을 때 횡격막 파열을 의심하는 것이 중요하며 흉강경을 이용하여 진단및 치료를 할 수 있다.

• Journal of Chest Surgery
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• 제42권4호
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• pp.497-501
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• 2009

배경: 비디오흉강경하 폐 쐐기절제수술 후 흉관을 통한 지속적인 공기유출과 흉수배액은 퇴원할 준비가 되어있는 환자의 흉관 제거를 지연시킬 수 있다. 저자는 Heimlich valve가 부착된 Panda Pneumothorax set를 장착하여 외래에서 흉관 관리를 시행한 37명의 환자를 관찰하였다. 대상 및 방법: 2005년 1월부터 2007년까지 294명에서 비디오흉강경하 폐 쐐기절제술과 흉막유착술을 시행하였다. 이중 37명의 환자가 Panda Pneumothorax set with Heimlich valve를 이용한 외래에서의 흉관 관리를 위한 대상에 적합하였다. 환자들은 쓰여진 주의사항을 받았고 Panda set사용에 대한 믿음을 보여 주었다. 환자들은 공기누출과 흉수배액의 만족할만한 소실 후 흉관 제거를 위해서 병원에 복귀하였다. 결과: Panda Pneumothorax set를 착용하고 퇴원한 환자[평균 4.7$\pm$1.4일(3$\sim$6일)]는 착용하지 않았던 환자[평균 입원일은 6.2$\pm$5일(4$\sim$9일)]와 비교할 때 보다 장기간의 입원을 하였다. 그리고 또한 Panda Pneumothorax set환자의 경우 퇴원 후 외래에서 평균 9.8$\pm$1.6일(8$\sim$15일)만에 성공적으로 흉관을 제거할 수 있었다. 주요한 합병증은 없었으며 4명의 환자에서 사소한 합병증을 보였다. 36/37명(97.3%)에서 순탄하고 성공적인 외래에서의 흉관 관리를 경험하였다. 걸론: Panda set를 이용한 성공적인 외래에서의 흉관 관리를 선택된 36명의 환자에서 성실히 수행할 수 있었다. 이런 프로그램은 결과적으로 명백한 병원비 절약을 이룰 수 있었고 조기퇴원을 가능케 하여 환자의 만족감을 증가시켰다.