• Journal of Chest Surgery
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• 제38권5호
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• pp.371-376
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• 2005

배경: 저자는 원발성 자연 공기가슴증 환자에서 고식적인 비디오흉강경하 쐐기절제술이 흉강경을 이용한 변형된 소절개술식보다 우수한가를 결정할 목적으로 후향적으로 연구를 하였다. 대상 및 방법: 원발성 자연 공기가슴증을 보인 $14\~35$세 사이의 160명의 환자를 대상으로 하였다. 환자는 수술기법과 수술 접근법에 의해서 고식적인 흉강경하 쐐기절제술군(A군: 80예)과 흉강경을 이용한 변형된 소절개술식을 이용한 군(B군: 80예)으로 분류하였다. 모든 환자에서 술 후 늑막강 첨부의 찰과상과 탈크 도포를 수행하였다. 이 연구는 수술시간, 수술 후 사용한 진통제의 사용일수, 수술 첫날 공기누출이 없는 수, 흉관 삽관일과 병원 입원일, 그리고 술 후 합병증, 추적기간 동안의 만성 흉통과 일상생활로 복귀할 때까지의 기간 그리고 또한 추적기간 동안에 수술동측에서의 재발을 평가하였다. 결과: 양 군사이에서 연구한 평가요소 중 어느 것에서도 의의 있는 차이는 없었다. 결론: 고식적인 비디오 흉강경하 쐐기절제술과 흉강경을 이용한 변형된 소절개술식은 원발성 자연 공기가슴증 환자의 수술적 치료에 있어서 유사한 결과를 야기하였다. 합병증의 발생률도 낮고, 통각도 장기 추적동안에 받아들일 만 하였다. 따라서 흉강경을 이용한 변형된 소절개술식 또한 가치 있는 대체수술 기법으로 보인다.

• Journal of Chest Surgery
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• 제27권9호
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• pp.808-811
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• 1994

We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

• 한국임상수의학회지
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• 제27권1호
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• pp.107-112
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• 2010

A 3-years-old female Pointer was evaluated for anorexia, dyspnea and exercise intolerance for 10 days. Auscultation revealed muffling of heart sound. There were leukocytosis, anemia, hypoalbuminaemia and hyperglobulinaemia on the blood profiles. Radiography showed severe pleural effusion. Thorax ultrasonographs described traped pleural effusion, pericardial effusion and collapsed right lung lobe(s). On CT images, thoracic neoplasia and lung torsion were ruled-out. Thoracocentesis with thoracoscopy and bacterial culture revealed pyothorax and pleuritis. The diagnosis of pyothorax in dogs and cats is based on clinical signs, radiography, thoracocentesis and cytology and culture of the exudate. In this case, various diagnostic medical imaging techniques (radiography, ultrasonography, CT and thoracoscopy) were used for diagnosis of pyothorax.

• Journal of Chest Surgery
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• 제36권10호
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• pp.748-753
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• 2003

배경: 폐결절은 경우에 따른 특히 경피침생검이 기술적으로 어렵거나 검사 후 병리세포검사로 확진이 되지 않는 경우에 대부분에서 흉강경을 이용한 조직검사를 요한다. 그러나 결절의 크기나 작거나 폐실질 깊숙이 위치한 경우에는 술 전 또는 술 중에 결절의 위치를 파악하기 위한 여러 가지 방법 등이 이용된다. 따라서 저자들은 폐결절을 경피침생검 시 방사선 비투과성 백금조각(이하 결절표시기)을 생검 전 또는 생검 후에 결절 내 또는 결절주위에 위치하여 병리조직검사에서 확진이 어려운 경우에 흉강경수술 시 재차 술 전 폐결절표시 과정을 피하는 방법을 고안하여 전향적으로 평가하였다. 대상 및 방법: 흉부 CT검사하여 경피침생검과정에 생검침을 결절내부 또는 결절인접부위에 위치한 경우에 결절 표시기를 생검침내부에 위치한 후 스타일렛을 이용하여 결절표시를 서서히 밀어 넣어 결절 내 혹은 인접부위에 위치한 것을 CT검사에서 확인한 다음 결절의 생검검사를 한다. 결과: 1999년 5월부터 2000년 5월 사이에 26명의 환자에서 28 결절을 대상으로 1예를 제외하고 모두에서 결절표시기를 결절 내 혹은 주위에 위치하였다. 이중 7건은 생검을 하지 않고 흉강경수술을 위하여 결절표시기를 위치하였고, 21건의 흉강경수술 중 18예(85%)에서 결절의 위치파악을 파악하거나 결절절제시 충분한 여유를 확보하기 위하여 수술 중 이동용 방사선 투시기를 이용하였다. 결론: 흉강경수술이 예상되는 폐결절에 대한 저자들의 방침이 흉부 CT검사하 폐결절 위치 표시과정을 생략함으로써 의료비, 시간을 절감할 수 있는 효과적인 방법으로 생각한다.

• Journal of Chest Surgery
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• 제34권5호
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• pp.422-425
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• 2001

We performed thoracoscopic resection for diagnosis in 41 year-old-female presenting with multiple pulmonary nodules in both lung fields, which was detected incidentally on routine chest x-ray and followed by additional exmaminations including chest CT scan and percutaneous needle aspiration biopsy under the presumptive diagnosis of metastatic cancer. During thoracoscopy, the result of the frozen section analysis of multiple masses revealed strong evidence of leiomyoma. In her past medical history, she had undergone myomectomy, and hysterectomy, 7 year ago and 10 year ago, respectively. Based on permanent, special staining of specimen, estrogen receptor assay and review of past specimen of uterine myoma the final diagnosis was benign metastasizing leiomyomata from uterine myoma, the report was very uncommon in Korean and English literatures. The patient has been followed up for 2 year without special therapy, such as hormonal therapy.

• Journal of Chest Surgery
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• 제32권3호
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• pp.330-332
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• 1999

좌측 횡격막 거상증을 가진 40세 여자 환자에게 흉강경을 이용하여 횡격막 주름성형술을 시행하였다. 술후 흉부 X선 사진에서 좌측 횡격막의 하강과 좌측폐의 팽창을 확인할 수 있었다. 횡격막 거상증 환자에게 흉강경을 이용하여 수술하면 최소 침습적 수술이 갖는 여러 장점을 환자에게 제공할 수 있다.

• Journal of Chest Surgery
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• 제27권3호
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• pp.226-229
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• 1994

VATS is now used by many thoracic surgeons and in various anatomic locations such as lung parenchyme, pleura and mediastinum, etc. VATS of mediastinal masses has special characteristics compared to that of other diseases. Those are no positional changes of the mass during collapse of the lung and close proximity of the mass to major vascular structures, nerves and other vital organs. From 1992. July to 1993. August, 10 mediastinal masses were treated with video assisted thoracoscopy. There were five males and five females, ages ranged from 11 years to 65 years with average 37.7 17.7 years old. Of the 10 patients, 4 were bronchogenic cysts, 2 were teratoma, and the others were thymoma, neurilemmoma, pericardial cyst, and thymic cyst. Needle aspiration was done in large cysts and the working thoracotomy[or utility thoracotomy] was done in large solid masses for the purpose of easy dissection, easy handling and easy delivery of the mass. The average operation time were 155.6 6.8 minutes and the duration of air leakage were 1 2.2 days. The duration of the chest tube drainage were 3.3 2.6 days. The lengths of the postoperative hospitalization were 5.1 2.7 days which were shorter than those of 12 mediastinal masses treated with conventional thoracotomy during the same periods [p<0.05]. There was 1 patient converted to thoracotomy because of a bleeding at innominate vein. 3 postoperative complications were occured. Those were persistent air leakage for 7 days, diaphragmatic palsy and hoarseness which were recovered within 1 month. We conclude that mediastinal mass can be excised with video assisted thoracoscopy and the posthospitalization is reduced. But careful attention is required for avoiding injury to major vascular structures, nerves, and other vital organs.

• Journal of Chest Surgery
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• 제26권1호
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• pp.44-46
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• 1993

There are several methods for managing pneumothorax through thoracoscope. Among them, electric cautery of bleb or bulla is very simple to do and can be done through the conventional thoracoscope. It is cosmetically excellent because it needs only incision. It is economically cheap comparing other methods because it does not need staplers or clips and other disposables. However, this method has been controversial for its success rate because of the ability of sealing off the air-leaking from the lung tissue. To evaluate the success rate, 29 cases of pneumothorax treated by electric cautery and instillation of oxytetracyline solution through the thoracoscope were analyzed. Among 29 patients, 18 were male and 11 female ranging 17 to 43 years old. The indications for thoracoscopy were recurrence in 20 cases and persistence in 9 cases. The underlying casuses of pneumothorax were bleb in 10 cases and bulla with bleb or not in 19 cases. Twenty one cases were successful [4%] and 8 cases were failed. The failed 8 cases were explored from 14 to 28 days after thoracoscopy.Six cases were explored through transaxillary minithoracotomy and 2 were done through limited posterolateral thoracotomy. The causes of failure were the necrotic lung tissue occured by excessive electric cautery in 6 cases and the necrotic lung tissue and residual bulla in two cases. In 10 bleb cases, 9 were successful [90.0%]. But in 19 cases of bulla, 12 were successful [63.2%]. In conclusion, the success rate of electric cautery through thoracoscope was 72. 4% and the causes of failure were lung necrosis and residual bulla. The success rate of the bleb cases was higher than that of the bulla cases.

• Journal of Chest Surgery
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• 제46권6호
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• pp.461-463
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• 2013

We report the case of a 72-year-old female with persistent atrial fibrillation who underwent a totally thoracoscopic ablation. A successful normal sinus conversion was achieved.

• Journal of Chest Surgery
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• 제33권4호
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• pp.306-309
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• 2000

Background: The purpose of this study was to evalute the diagnostic value of 2mm video thoracoscopy for primary spontaneous penumothorax. Material and Method: During the period of March to June 1999, we prospectively analyzed 33 consecutive patients suffering from primary spontaneous pneumothorax. 2mm video-assisted thoracoscopy was compared with the operative finding. We observed recurrence during the mean follow-up of 3months. Result: Blebs were present in 24 patient(73%: 24/33). These were treated by 10mm video-assised thoracoscopic stapling. Nine pateints with no bleb were treated with pleural drainage. There were no significant differences in the bleb finding. No recurrence occurred during the follow-up period. Conclusion: A 2mm video thoracoscopic examination for primary spontaneous pnumothorax is a useful alternative in deciding the operative indication.