• Title/Summary/Keyword: left thoracotomy

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Clinical Evaluation of Open Thoracotomy in Spontaneous Pneumothorax (자연기흉의 개흉술에 관한 임상적 고찰)

  • Go, Yeong-Ho;Son, Dong-Seop
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.470-474
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    • 1993
  • A clinical evaluation was performed on 56 patients[ 60 cases ] of open thoracotomy in spontaneous pneumothorax who were admitted and treated at department of Thoracic and Cardiovascular Surgery, Chung Ang University, Yong San Hospital during the past 3 years from March 1990 to February 1993. The results were as follows. 1. The sex ratio was male predominence [ M:F = 7:1 ]. 2. The most common age group were 2nd, 3rd decades. 3. The most common chief complaints were dyspnea and chest pain [46.3% ]. 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax [ 78.3%], secondary tuberculosis [ 18.3%], and others [ 3.4% ]. 5. The site of spontaneous pneumothorax was 50% in right, 40% in left, and 10% in both. 6. The state of activity on attack was almost in the usual life [ 98.3% ]. 7. Average height was 172.5 $\pm$ 5.39 cm in male and 164.0 $\pm$ 3.51 cm in female, average weight was 59.1 $\pm$ 7.06 kg in male and 52.0 $\pm$ 4.97 kg in female. 8. The common indications of open thoracotomy were recurrence [ 34.4% ] and persistent air leakage [ 17.8% ]. 9. The operative procedures were bullectomy [ 73.3% ], partial resection [ 11.7% ], lobectomy [ 11.7% ], and others [ 3.3% ]. 10. The most frequent location of bulla or bleb were apical segment of RUL [ 43.3 % ] and apicoposterior segment of LUL [ 40.0% ]. 11. The number of visible bulla or bleb were mainly 1 to 5, and size was about 1 to 3 cm.

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Treatment of Flail Chest and a Fixation Technique of Flail Segments (Flail Chest 의 치료와 늑골고정술)

  • 김근호
    • Journal of Chest Surgery
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    • v.8 no.1
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    • pp.37-44
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    • 1975
  • Authors have reviewed the records of seven patients of multiple rib fractures with severe flail chest who were admitted to Hanyang University Hospital during the 3 years period from 1972 through 1975. Of the seven patients studied, automobile accidents led to the injuries in 4 cases, two patients were injured in fall from a tree and on the ox-heading. All who had a blunt trauma without any open wound on the chest. The numbers of the fractured ribs accounted for 6 to 9 of the ribs including double fractures from 3 to 5 ribs. The left side fractures occurred in the 6 patients and in the right only one patient. Thus the flail segment was more often located in the left antero-lateral position than in the right lateral position [the ratio was 6:1].. All cases had associated injuries. The injuries and multiple fractures were the most common associated injuries occurring in four and five of the patients respectively. The patients were classified as having associated head injuries when they were admitted in comatose or semicomatose state. When a major degree of instability of the thoracic cage exists, adequate respiratory change is not possible. For this reason the tracheostomy was performed in five patients in an acutely injured patient with flail chest only after an endotracheal tube has been inserted or after an endotracheal suction. All patients had secondary complications in the pleural cavity, such as hemothorax or hemopneumothorax with or without intrapulmonary hemorrhage and subcutaneous emphysema. Therefore, closed thoracostomy was performed in five patients in the emergency room. The thoracotomy was required in four patients: immediate operation without closed thoracostomy was performed in two patients and the thoracotomy was indicated in two patients after closed thoracostomy, because of increasing intrathoracic hemorrhage. As to the fixation of the flail segments, authors employed two techniques; one was towel clip traction of the flail segments and the other was intramedullary insertion of Kirschner`s wire in to the double fractured rib fragments for the fixation of the flail segments [Kirschner`s wire fixation]. Because` of an different results in the course of treatment between two techniques, data from patients with towel clip traction was compared with those from patients with thoracotomy and Kirschner`s wire fixation of the flail segments. Of the three patients with towel clip traction, two patients required bronchoscopic toilet due to lung atelectasis which developed because of inadequate motion of thoracic cage and poor expectoration. This was in contrast to the four patients with thoracotomy and Kirschner`s wire fixation, who didn`t these complication because of adequate motion of the thoracic cage and subsequent good expectoration.

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Clinical Evaluation for the Bronchiectasis (기관지확장증의 임상적 고찰)

  • Jeong, Seong-Un;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1007-1013
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    • 1995
  • We managed 80 patients of bronchiectasis from Jan.1983 to Dec.1992 admitted to the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. We evaluated clinically these patients and summarized as follows. Alpha-hemolytic streptococcus was the most commonly found bacterial strain in microbial study. For the conservative treatment, first generation cefalosporins, aminoglycosides and ampicillin were used as antibiotic therapy in this order of frequency. The preoperative final diagnosis was made by bronchography and HRCT. In the image study saccular type bronchiectasis was 47.1%, cylindrical 27.5%, mixed 17.6% and varicose 7.8%. Anatomically left side involvement was more frequent than the right as 61.2% to 38.8% and the most commonly invading lobar area was left lower. Reversibility after conservative treatment for all the types of bronchiectasis was 66%. Surgical treatment were done in 50 cases, among these left lower lobectomy was 38.0%, left lower lobectomy with ligular segmentectomy 22.0%, right middle and lower bilobectomy 16.0%, right lower lobectomy 10.0%, left pneumonectomy 10.0%, right pneumonectomy 4.0%. In 10 cases, there remained some lesion in the other sites of lung parenchyme after first attempt surgical resection because the distribution of lesion is too broad to resect out in single thoracotomy hoping improvement by medical management.

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Left Ventricular Pseudoaneurysm after Valve Replacement

  • Lee, Jun Ho;Jeon, Seok Chol;Jang, Hyo-Jun;Chung, Won-Sang;Kim, Young Hak;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.63-66
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    • 2015
  • We present a case of left ventricular pseudoaneurysm, which is a very rare and fatal complication of cardiac procedures such as mitral valve replacement. A 55-year-old woman presented to the Department of Thoracic and Cardiovascular Surgery at Hanyang University Seoul Hospital with chest pain. Ten years prior, the patient had undergone double valve replacement due to aortic regurgitation and mitral steno-insufficiency. Surgical repair was successfully performed using a prosthetic pericardial patch via a left lateral thoracotomy.

Hamartoma of the Lung -One case Report- (페에 발생한 Hamartoma -1예 보고-)

  • Kim, Yong-Gil;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.298-300
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    • 1980
  • The hamartoma is the most common benign tumor of the lung, but the incidence is very low. Most of hamartomas are revealed accidentally as coin lesion of routine chest X-ray because of no symptoms usually. The differential diagnosis should include tuberculoma, bronchogenic carcinoma, and other forms of tumor. Definitive diagnosis usually is established at exploratory thoracotomy. In this report, we present one case of a 42-year-old female having hamartoma of the left lower lobe of the lung that removed successfully and confirmed histopathologically. Her postoperative course was uneventful. She was discharged in good condition.

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Dumbbell Neurogenic Tumor (Dumbbell 신경종양 -1례 보고-)

  • 김병구
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.872-875
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    • 1995
  • Dumbbell neurogenic tumor is a rare disease, arising about 10 % of mediastinal neurogenic tumor. We report a 31 year old man who was suffered from paresthesia and weakness of lower extremities for about 8 months. Chest x-rays revealed a dumbbell shaped mass shadow in left lower posterior mediastinum. MRI demonstrated a well defined dumbbell shaped mass in the mediastinum of T7 level, including spinal cord compression by the extended tumor into the spinal canal and enlarged intervertebral foramen. The patient underwent one-stage combined resection of the tumor through the thoracotomy and laminectomy, simultaneously. The tumor was confirmed as neurilemmoma. The postoperative course was smooth and uneventful.

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Closed Digital Reduction of Posttraumatic Lung Hernia (외상 후 폐장탈출의 폐쇄손가락정복)

  • Park, Ki-sung
    • Journal of Trauma and Injury
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    • v.25 no.3
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    • pp.91-93
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    • 2012
  • Postraumatic lung hernia is a rare occurrence. A number of cases reported in the literature have been treated with early thoracotomy to repair partial protruded lung and pleura to prevent strangulation and incarceration. We present a case of a 45-year-old patient of left posttrumatic lung hernia, in which closed digital reduction was successful. The strategy of the management approach could be established by further accumulated experience.

Pulmonary Lymphangiomyomatosis - A Case Report - (폐림프관근종증 치험 1례)

  • 정수상;박병률;이종수;양석숭
    • Journal of Chest Surgery
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    • v.26 no.2
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    • pp.160-162
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    • 1993
  • Pulmonary lymphangiomyomatosis is rare but extremely interesting condition caused by progressive widespread smooth muscle proliferation in the perilymphatic regions throughout the lungs. The patient was a 25-year-old female. She had angiofibromas in the face, and angiomyolipoma in the left kidney which was removed 5 years earlier. Three years ago she started having severe dyspnea with bilateral pneumothoraces. Treatment was initiated with bilateral closed thoracotomies followed by open thoracotomy through median sternotomy and lung biopsy, which revealed the diagnosis of pulmonary lymphangiomyomatosis. Recurrence of pneumothorax was treated by repeated chemical pleurodesis with tetracycline. She has been in good condition during medroxyprogesterone administration for 3 years.

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Congenital Esophageal Stenosis due to Tracheobronchial Remnants (기관기관지 잔유물로 인한 선천성 식도 협착증 -수술치험 1례-)

  • 조은희
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.939-941
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    • 1995
  • Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis.A 19-month-old male was presented an appearence of underdevelopment and mild dehydration state due to persistent vomiting since 5 months after his birth. Esophagogram revealed an abrupt narrowing of lower esophagus with dilatation above it. The operation method was aesection of esohageal stenosis and end to end anastomosis through left seventh thoracotomy. The postoperative course was uneventful.

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Rapidly Grown Huge Mediastinal Benign Teratoma ; one case report (빠르게 성장한 거대 종격동 양성기형종)

  • 조성우;지현근;안현성;신윤철;남은숙
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.521-524
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    • 2000
  • The benign teratoma is usually slow growing tumor, but we expirienced a case of primary huge mediastinal benign teratoma that had grown very rapidly, maximally during 3 years. The 14-year-old female patient was admitted to our hospital because of abnormal chest X-ray that showed 10$\times$10cm sized well definded mass with multiple calcificactions. but the mass was not present in chest X-ray perfomed on 3 years prior to admission. Under the diagnosis of teratoma, complete surgical resection was done by the left thoracotomy. The result of pathology was benign teratoma.

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