• Journal of Chest Surgery
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• v.29 no.8
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• pp.910-915
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• 1996

The bullectomy through transaxillary minithoracotomy and video assisted thoracic surgery(VATS) have been widely used in treatment of spontaneous pneumothorax. The study comprised a retrospective review of 1 13 consecutive cases of whom underwent bullectomy through transaxillary minithoracotomy at Shinchon Severance Hospital(group T) and 129 consecutive cases of whom underwent thoracoscopical bullectomy at Youngdong Severance(group V) between January 1992 to Jun 1994. This study compare the clinical and economic resuts of group T and group V There were no significant differences for operation time, indwelling periods of chest tube, hospital stay, complication rate and rate of recurrence in the two groups. The times of parenteral analgesics use and treatment cost were significant less in group T.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.471-474
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• 1995

A total of 20 patients underwent bullectomy in the spontaneous pneumothorax between October 1993 and August 1994. The patients were divided into two groups: Control group; the patients who received with mid-axillary approach[n=10 , Experimental group; the patients who received with video-assisted thoracic surgery [n = 10 . The results were as follows; 1. The total sex distribution was male predominence [M :F=6:1 . Mean age of control group was 31.6$\pm$ 10.1 age and experimental group was 24.3$\pm$ 5.5 age. 2. The operative times were 117.0 $\pm$ 32.6min in control group and 102.5$\pm$ 38.4min in experimental group [not significant . 3. The indwelling period of postoperative chest tube and hospital stay were 4.5$\pm$ 2.6 days and 8.3 $\pm$ 1.8 days in control group, $1.5\pm$ 0.5 days and 3.1 $\pm$ 0.3 days in experimental group[p=0.0018, < 0.0001 . 4. In control group, injection times of pain-killer were 1.7$\pm$ 0.7 times/day at operative day and 0.4$\pm$ 0.6times/day at postoperative 1 day. In experimental group, there were 0.3$\pm$ 0.7times/day at operative day and 0.1 $\pm$ 0.3times/day at postoperative 1 day[p=O.O002 at operative day, not significant at postoperative 1 day .

• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.16-20
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• 2020

Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11^th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.204-208
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• 1993

The review of 68 patients, who were diagnosed as spontaneous pneumothorax during the period from Dec, 1991. to Jul, 1992. were performed thoracoscopy of 70 cases under local anesthesia with 1% lidocaine at the department of thoracic & cardiovascular surgery, HanYang University Hospital. Clinical data on distribution of Age & Sex, Location, Frequency of Reccurrence and other aspects of pneumothorax were summerized.37 cases were treated by thoracoscopic management and closed thoracostomy. As thoracoscopic management, Electrocauterization of bullae or blebs[37 cases], Endo-clip application [2 cases], Removal of foreign body[1 case] were performed. 31 cases were cured by open thoracotomy. The thoracotomy indications under thoracoscopic finding were followed as: 1. Severe pulmonary adhesion and destroyed lung parenchyme 2. multiple bullae or blebs on several areas 3. finding of pulmonary tuberculous caseous lesion 4. persistant air leakage after 7 days from thoracoscopic management Excision, wedge resection of bullae or blebs was performed in most cases [22 cases], 2 cases by median sternotomy and Segmentectomy of 7 cases were carried out depending on the pathologic change of lung.There was no operative mortality and Follow-up for all patients were showed good results.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.683-688
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• 1994

The most common cause of spontaneous pneumothorax is a ruptured bleb, which occurs mostly in young patients and they are usually treated by tube thoracostomy. Recurrence frequently occurs and these patients require some form of surgical intervention. From March 1990 to February 1994, we have experienced 19 cases of recurrent pneumothorax in 16 patients among 347 patients who underwent 423 surgical interventions. The name of first operation after thoracotomy were bullectomy in 4 cases, bullectomy and pleurodesis in 3 cases, bullectomy, pleurodesis in addition to application of tissue sealant in 1 case. Thoracoscopic operations were performed as follows: bullectomy in 2 cases,electroablation plus tissue sealant in 4 cases, electroablation, tissue sealant and pleurodesis in 1 case,and in 4 cases, only tissue sealant was applied. The average age of patients are 21.5 years, and bilaterally operated patients and patients. who received tissue sealant or tissue sealant plus electrocauterization only had higher incidence of recurrence. The patients who needed chest tube insertion longer than 5 days after the first operation were 52.6 %, and 82.3 % recurred within one month of the first operation.

• Neonatal Medicine
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• v.18 no.2
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• pp.387-390
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• 2011

Spontaneous neonatal esophageal perforation (EP) is a rare condition. However, iatrogenic EP due to a feeding tube is not uncommon, particularly in premature infants. Iatrogenic EP can result in serious complications, such as a pneumothorax, and can be fatal. Usually a pneumothorax develops as a result of EP. However, we experienced an EP in a patient with a pneumothorax. The EP occurred after inserting a feeding tube while the patient was suffering from a pneumothorax. Thus care is needed when inserting the feeding tube in a patient with a pneumothorax.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1132-1138
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• 1995

From 1991 to 1994, we experienced 24 cases of neonatal pneumothorax who were admitted to the Neonatal Intensive Care Unit[NICU , Chosun University Hospital. The Following results were obtained.1 The incidence of neonatal pneumothorax was 0.70%, and there were 8 spontaneous pneumothoraces and 16 secondary pneumothoraces. 2 The clinical manifestation of neonatal pneumothorax was as followed. Male infant was dominant[M:F=2:1 , the onset was within 24 hours in the majority[83% , and the right side[62% was more frequent than the left side. The gestation duration and birth weight show no correlation with underlying neonatal pneumothorax. The pulmonary diseases were meconium aspiration syndrome and hyaline membrane disease, and the incidence of those was 58%. Meconium aspiration syndrome occurred earlier than hyaline membrane disease. Symptoms and signs were tachypnea[46% , cyanosis[21% , irritability[13% , chest retraction[8% and apnea[8% .3 The treatments performed were oxygen therapy[17% , thoracentesis[4% and closed thoracostomy with underwater seal drainage[79% . The Mean duration of air leakage was 11.7 hours, and the mean drainage time was 4.35$\pm$1.3day. 4 The overall hospital mortality was 33%, and the rate of complication was 46%. The complications were metabolic acidosis, atelectasis, pleural effusion, pulmonary hemorrhage and pneumonia. We concluded that the prognosis was related to the underlying pulmonary disease.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.511-515
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• 1984

In this study, 213 cases of the spontaneous pneumothorax experienced at the department of thoracic and cardiovascular surgery, Chungnam National University Hospital during from April, 1977, till Dec, 1983 were reviewed. 1.Sex ratio of the studied patients was 7.19;1 showing high incidence male patients. The incidence according to the age group showed that 20.2%, 18.3% of the patients belong to the age group 6th, 5th decade respectively. 2.The etiologic factors were as follows, tuberculous origin in 50.2%, unknown origin in 28.2%, COPD in 3.3%, bullae in 8.5%. The site was right in 47.9% and left in 44.1%, bilateral in 8%. 3.The clinical symptoms were frequently dyspnea in 35%, chest pain in 27.5%. 4.The employed method of treatment were as follow, bed rest with oxygen inhalation in 1.9%, closed thoracostomy in 95.8%, open thoracotomy in 7.98%, which bullectomy was performed in 12 cases and pneumonectomy in 3 cases and lobectomy in 1 case and decortication with simple closure of bleb was performed in remaining 1 case. 5.The duration of closed thoracostomy was longer in tuberculosis, which average duration was 11.28 days. 6.The overall recurrent rate was 12.3%.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.251-255
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• 1987

In this study, 186 cases of spontaneous pneumothorax experienced at the Dept. of thoracic and Cardiovascular surgery, chosun University Hospital during from Jan. 1978 to Mar. 1987 were analysed retrospectically. The results were as follows: 1. The sex ratio of the stadied patient was 2.5:! in male prominence and the incidence and the incidence was highest in the adolescence between 20-29 year of age. 2. The clinical symptoms were frequently Dyspnea (52.2%) and Chest pain (38.7%). The etiologic factors were as follows, Tuberculous origin in 55.9%, Unknown origin in 17.2%, Bullae in 11.8%. 3. In the method of treatment, closed thoracotomy was the most effective procedure in achieving the expansion of collapsed lung in 87.1%. Other methods were bed rest with high oxygen inhalation, thoracentesis and open thoracotomy. 4. The incidences of complication were developed in 12.4% and recurrent rates were seen in 9.7%.