• Journal of Chest Surgery
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• 제21권2호
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• pp.307-315
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• 1988

A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.

• Journal of Chest Surgery
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• 제27권3호
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• pp.221-225
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• 1994

Video-assisted thoracic surgery[VATS] has recently evolved as an alternative to thoracotomy for several thoracic disorders. Between March 1993 and September 1993, 42 patients underwent VATS at Gil General Hospital. They were diagnosed as spontaneous pneumothorax in 34[81.0%], mediastinal mass in 5, congenital lobar emphysema in 1, traumatic hemothorax in 1, and sarcoidosis in 1. For pneumothorax, wedge resection of bullae or blebs was done in 18 patients, wedge resection and limited parietal pleulectomy in 13, and only pleulectomy in 2. And excision for mediastinal mass in 5, hematoma evacuation for chronic hemothorax in 1, biopsies of mediastinal lymph node and lung for confirming sarcoidosis in 1, and lobectomy of left upper lobe for congenital lobar emphysema in the child of 12 years. The period of chest tube drainage and postoperative hospitalization averaged 3.8 days [range, 1 to 11 days] and 5.9 days [range, 2 to 18 days]. Three complications occurred in 3 patients with pneumothorax [7.1%, 2 recurrent pneumothorax and 1 postoperative bleeding], and the conversion to open thoracotomy was done in 1 due to massive air leak. The causes of postoperative air leak were speculated and the techniques for saving expensive Endo-GIA staplers are described in this paper. VATS is safe and offers the benefits of reduced postoperative pain and rapid recovery. Our experience indicates a markedly expanded role for VATS in the diagnosis and treatment of various thoracic diseases.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.527-530
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• 2011

Purpose: Liver transplantation is a groundbreaking section in the field of surgery. Nowadays over 90% of success rate is accomplished and life expectancy of the patients has been elongated. Patients are now seeking for surgical procedures including cosmetic plastic surgery. But these patients take immunosuppressive medication and steroids, which can increase the risk of wound infection, and delay wound healing. By reviewing the case of a 21-year-old liver transplant recipient who underwent mastopexy due to breast ptosis, we discussed about the matters we should consider when performing surgery in liver transplantation recipients. Methods: The patient was a 21-year-old female who received liver transplantation from her father. She was exposed to massive amount of steroids and immunosuppressants, which led to breast ptosis. The vertical and short horizontal incision mastopexy using a medial-based pedicle was done, 29 months after the liver transplantation. Results: On postoperative day 1, she was discharged. On day 10, sutures were removed and taping was applied. There was no sign of wound infection, wound dehiscence, hematoma or bleeding. The patient was followed up at 3, 6 and 9 months after the operation. Mild recurrence of the glandular ptosis was observed but revision was not required. Conclusion: We were able to successfully operate without any complications in the liver transplant recipient. With special attention and consideration, cosmetic plastic surgery can be safely performed in organ transplantation recipients.

• Journal of Chest Surgery
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• 제26권6호
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• pp.475-482
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• 1993

90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

• Journal of Chest Surgery
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• 제10권2호
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• pp.327-336
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• 1977

A chinical analysis was performed on 383 ases of hest injurjes eperienced at Department of thoraci Surgery, Seoul National University Hospital during 21 year period From 1957 to 1977. Of 383 patients o hest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle frcture, 26 of lung contusion, 17 of diaphragmati laceration, 14 of hemoperiardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury paiens were traffi accident vitims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt hest injuries the patients with five or more rib fractures had a 85 per ent incidence of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis (46 cases) and closed thoracotomy (125 cases) but open thoracotomy had to be done on 90 cases (23.5%) because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronhial rupture. The over all mortality was 2.87 per cent (11 among 383 cases), 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Chest Surgery
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• 제10권2호
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• pp.337-342
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• 1977

A clinical analysis was performed on 383 cases of chest injurjes experienced at Department of Thoracic Surgery, Seoul National University Hospital during 21 year period from 1957 to 1977. Of 383 patients of chest injuries, 209 cases were result from nonpenetrating injuries whereas 175 were from penetrating injuries, and there were 258 cases of hemothorax or/and pneumothorax, 162 of rib fracture, 33 of foreign body, 26 of clavicle fracture, 26 of lung contusion, 17 of diaphragmatic laceration, 14 of hemopericardium, 14 of flail chest and others. Stab wound was the most common in penetrating injuries and followed by gunshot and shell fragments. The majority of nonpenetrating chest injury patients were traffic accident victims. and fails accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 16 and 50 years, and 321 patients were male comparing to 62 of female. In blunt chest injuries the patients with five or more rib fractures had a 85 per cent incidence-of intrathoracic injury and 19 per cent had an intraabdominal organ damage, whereas those with four or less rib fractures had a 69 per cent and a 6 per cent incidence respectively. The principal associated injuries were cerebral contusion on 19 cases, renal contusion on 10, liver laceration on 7, peripheral vessel laceration on 5, spleen laceration on 3 and extremity fracture on 18 patients. The principles of therapy for early complications of chest trauma were rapid reexpansion of the lungs by thoracentesis [46 cases] and closed thoracotomy [125 cases] but open thoracotomy .had to be done on 90 cases [23-5%] because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic laceration and bronchial rupture. The over all mortality was 2.87 per cent [11 among 383 cases], 8 cases were from penetrating injuries and 3 from nonpenetrating injuries.

• Journal of Trauma and Injury
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• 제30권2호
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• pp.33-40
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• 2017

Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

• Journal of Chest Surgery
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• 제12권4호
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• pp.411-417
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• 1979

During the period of 4 years from August 1, 1975 to August 1, 1979, authors have experienced 100 cases of multiple rib fractures by nonpenetrating injury at Department of Thoracic Surgery, Paik Foundation Hospital in Seoul, Korea. 1. The ratio of male to female patients with multiple rib fracture was 2.6:1 with male predominance and 84% of the total cases were between 20 and 50 years of age. 2. The most common cause of multiple rib fracture was traffic accident and falls accounted for the next largest group. 3. The most common site of rib fracture was 4th rib to 7th rib level on both hemithorax [52%]. 4. Associated injuries were cerebral contusion in 26%, clavicular fracture in 22%, long bone fracture in 22%, pelvic bone fracture in 10%, and scapular fracture in 8%. 5. Early complications and/or result of the multiple rib fractures were lung contusion in 23 cases, subcutaneous emphysema in 21 cases, hemothorax in 21 cases, hemopneumothorax in 6 cases, and flail chest in 12 cases. 6. The flail chests were managed by strapping the chest with adhesive plaster, external traction of flail segment with towel clip, ventilatory assistance for marginal clinical indications, and in cases of complicated with intrathoracic hemorrhage, wire fixation of flail segment through open thoraco-tomy. 7. The principles of therapy for hemothorax and/or pneumothorax were rapid reexpansion of the lungs by thoracentesis [11%] and closed thoracostomy [22%], but open thoracotomy had to be done on 3 cases because of massive bleeding or intrapleural hematoma and diaphragmatic rupture. 8. The over all mortality was 4% [4 among 100 cases] and the cause of all deaths was head injury.

• Journal of Chest Surgery
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• 제41권5호
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• pp.651-654
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• 2008

외상에 의해 발생하는 쇄골하동맥의 가성동맥류는 매우 드물다. 10년전 교통사고를 당한 49세 여자환자는 외부병원에서 직장검진시 우연히 발견한 종격동 종양을 진단받고 본원에서 진단 및 치료 목적으로 개흉술을 시행 받았다. 개흉술하에 종괴의 일부분을 박리하던 중 대량 출혈 소견 보여 출혈 부위를 봉합한 후 혈관촬영을 추가로 시행하였다. 좌측 쇄골하동맥 가성동맥류 진단하에 재수술을 시행하여 동맥류를 절제하고 단단문합하였다. 환자는 술 후 특별한 문제없이 술 후 11일째 퇴원하였다.

• Archives of Plastic Surgery
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• 제41권3호
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• pp.271-276
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• 2014

Background As the obese population increases in Korea, the number of patients who are trying to lose weight has been increasing steadily. In these patients, skin laxity and deformation of the body contour occurs, which could possibly be corrected by various body contouring surgeries. Here, we introduce the brachioplasty method and our experience of various body contouring surgeries performed in our center. Methods From November 2009 to August 2011, five cases of brachioplasty were performed. When the patient presented with sagging of the lateral inframammary crease and bat wing deformity in the axilla, extended brachioplasty was performed; in this case, the deformation of the axilla and lateral chest was corrected at the same time. A traditional brachioplasty was performed when contouring was needed only for skin laxity in the upper arm. Results Complications, such as hematomas or nerve injuries, were not evident. Some patients experienced partial wound dehiscence due to tension or hypertrophic scars found during the follow-up. In general, all of the patients were satisfied with the improvement in their upper arm contour. Conclusions Given the demands for body contouring surgery, the number of brachioplasty surgical procedures is expected to increase significantly, with abdominoplasty comprising a large portion of these surgeries. For the brachioplasty procedure, preparation and preoperative consultation regarding design of the surgery by experienced surgeons was important to prevent complications such as nerve damage or hematoma formation.