• Title/Summary/Keyword: thoracic

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Surgical Treatment of Postinfarction Posterobasal Left Ventricular Aneurysm - Report of 2 cases- (심근경색 후 발생한 후기저부 좌심실류의 외과적 치험 -2예 보고 -)

  • Kim, Jae-Hyun;Na, Chan-Young;Kim, Woong-Han;Oh, Sam-Sae;Baek, Man-Jong;Whang, Sung-Wook;Kang, Chang-Hyun;Lee, Cheul;Chang, Yun-Hee;Jo, Won-Min;Seo, Hong-Ju;Park, Young-Kwan;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.975-978
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    • 2003
  • At least 88 percents of ventricular aneurysms result from anterior infarction, while the remainder follow inferior infarction. Posterior infarction that produce a distinct left ventricular aneurysm is unusual. We report two operative cases of postinfarction posterobasal left ventricular aneurysms, one with a true aneurysm and the other with a false one.

Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data

  • Kang, Chang Hyun;Bok, Jin San;Lee, Na Rae;Kim, Young Tae;Lee, Seon Heui;Lim, Cheong
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.311-317
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    • 2015
  • Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.

Historical Perspectives of Korean Society for Thoracic and Cardiovascular Surgery: Inauguration and Activities of the Historical Records Preservation Committee

  • Park, Kook-Yang;Lee, Sungsoo;Chang, Byung-Chul;Oh, Tae Yun
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.191-194
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    • 2019
  • The Korean Society for Thoracic and Cardiovascular Surgery (KTCVS) was founded in 1968 and celebrated the 50th anniversary of its founding in 2018. The launch of the KTCVS may seem somewhat recent, given that the American Association for Thoracic Surgery was founded in 1917. However, considering the circumstances of the Korean medical community after the Japanese occupation (1910-1945), World War II (1940-1945), and the Korean War (1950-1953), this apparent delay is understandable. Even before the foundation of the KTCVS, the early pioneers of thoracic and cardiovascular surgery promptly adopted medical technologies from more advanced countries such as the United States, and contributed significantly to both cardiac and thoracic surgery despite difficult circumstances. In 2012, before the 50th anniversary of the founding of the KTCVS, members shared the opinion that objective records of the activities of the early pioneers should be identified and preserved, and reacted positively towards the necessity for historians who would preserve such records. With this background, the Historical Records Preservation Committee of the KTCVS (hereinafter, referred to as 'the Committee') was launched. The Committee published a white paper on the history of thoracic and cardiovascular surgery in 2015 and held an exhibition of the achievements of the pioneers at the 50th anniversary of the founding of the KTCVS. The Committee also published a book entitled "The history of Korean thoracic surgery with photographs: celebrating the 50th anniversary of the society." The Committee will keep making efforts to find and preserve materials related to activities during the early development of thoracic and cardiovascular surgery in Korea.

Immediate Effects of the Downhill Treadmill Walking Exercise on Thoracic Angle and Thoracic Extensor Muscle Activity in Subjects With Thoracic Kyphosis (내리막 경사로 트레드밀 걷기 훈련이 흉추 뒤굽음증의 흉추각도와 흉추기립근 활성도에 미치는 영향)

  • Lee, Jun-hyeok;Jeon, Hye-seon;Kim, Ji-hyun;Park, Joo-hee;Yoon, Hyeo-bin
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.1-7
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    • 2019
  • Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

Surgery for Diaphragmatic Hernia Repair: A Longitudinal Single-Institutional Experience

  • Siwon Oh;Suk Kyung Lim;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Jhingook Kim;Young Mog Shim;Junghee Lee
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.171-176
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    • 2023
  • Background: This study analyzed and described the clinical characteristics and surgical outcomes of diaphragmatic hernia (DH) repair according to the operative approach. Methods: After excluding cases with a combined approach and hiatal hernias, we analyzed 26 patients who underwent DH repair between 1994 and 2018. The baseline and perioperative characteristics of the thoracic approach group and the abdominal approach group were described and analyzed. Results: Fifteen of the 26 patients were treated through the thoracic approach, including 5 patients who underwent video-assisted thoracic surgery (VATS). Eleven patients underwent the abdominal approach. The thoracic approach was associated with a longer duration of DH than the abdominal approach (2 vs. 0.1 months), herniation of the right-sided abdominal organs, and herniation of the retroperitoneal organs. During the median follow-up of 23 months, there was no recurrence of DH. Conclusion: The surgical approach should be chosen considering the duration of DH and the location of herniated organs. VATS might be a safe and feasible option for repairing DH.

Trends in Heart Valve Surgery in Korea: A Report from the Heart Valve Surgery Registry Database

  • Choi, Jae Woong;Kim, Joon Bum;Jung, Yoo Jin;Hwang, Ho Young;Kim, Kyung Hwan;Yoo, Jae Suk;Lee, Sak;Lee, Seung Hyun;Sung, Kiick;Je, Hyung Gon;Lim, Mi Hee;Chang, Byung-Chul;Hong, Soon Chang;Lee, Heemoon;Shin, Yoon Cheol;Kim, Jae Hyun;Lim, Cheong
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.388-396
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    • 2022
  • Background: In this study, we present recent trends in heart valve surgery in Korea through analyses of data from the Korea Heart Valve Surgery Registry (KHVSR). Methods: We enrolled 8,981 patients who were registered in the KHVSR from 2017 to 2020. Yearly trends in patients' baseline characteristics, surgical profiles, and early mortality rates were explored. The observed/expected mortality ratio (O/E ratio), calculated from the actual mortality in the KHVSR and the predicted mortality estimated using the EuroSCORE II, was also analyzed. Results: The proportion of aortic valve surgery significantly increased from 56.8% in 2017 to 60.3% in 2020. The proportion of all combined procedures and minimally invasive surgery significantly increased over the 4-year study period. The operative mortality rate was 2.9% in the entire cohort, while mitral valve repair showed the lowest mortality risk (0.9%). The mortality rates of isolated aortic valve replacement (AVR) significantly decreased from 2.1% in 2017 to 0.8% in 2020 (p=0.016). Overall, the O/E ratio was 0.784 (95% confidence interval [CI], 0.677-0.902) demonstrating significantly lower actual mortality risks than expected based on the EuroSCORE II. In particular, the O/E ratios were as low as 0.364 (95% CI, 0.208-0.591) for isolated AVR. Conclusion: The recent data from the KHVSR showed increasing trends for complex procedures and minimally invasive surgery in heart valve surgery in Korea, and demonstrated remarkably low risks of operative mortality.

Can Right-Handed Surgeons Insert Upper Thoracic Pedicle Screws in much Comfortable Position? Right-Handedness Problem on the Left Side

  • Akyoldas, Goktug;Senturk, Salim;Yaman, Onur;Ozdemir, Nail;Acaroglu, Emre
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.568-573
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    • 2018
  • Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.