• 제목/요약/키워드: thoracotomy

검색결과 755건 처리시간 0.029초

수술후 재발한 기흉의 임상적 고찰 (Clinical Evaluation of Recurrent Pneumothorax after Surgical Lnterventions)

  • 백효채
    • Journal of Chest Surgery
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    • 제27권8호
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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.

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"DUMBBELL" 신경종양 -1례 보고- ("DUMBBELL" Neurilemmoma -A Case Report-)

  • 박진석;임승평;김관태
    • Journal of Chest Surgery
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    • 제27권6호
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    • pp.502-505
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    • 1994
  • Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.

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Thoracoscopic Removal of Ectopic Mediastinal Parathyroid Adenoma

  • Kim, Young Su;Kim, Jhingook;Shin, Sumin
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.317-319
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    • 2014
  • Ectopic mediastinal parathyroid adenomas or hyperplasias account for up to 25% of primary hyperparathyroidism cases. Most abnormal parathyroid glands are found in the superior mediastinum within the thymus and can be removed through a cervical incision; however, a few of these glands are not accessible using standard cervical surgical approaches. Surgical resection has traditionally been performed via median sternotomy or thoracotomy. However, recent advancement in video-assisted thoracic surgery techniques has decreased the need for sternotomy or thoracotomy to remove these ectopic parathyroid glands. Here, we report a successful case of video-assisted thoracoscopic removal of a mediastinal parathyroid adenoma.

흉부 자상 환자에서 발생한 심장 열상 (A Case of Cardiac Laceration due to Anterior Thoracic Stab Injury)

  • 우원기;장지영;이승환;이창영;이재길
    • Journal of Trauma and Injury
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    • 제27권3호
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    • pp.71-74
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    • 2014
  • Among chest trauma patients, cardiac laceration is a rare, but severe, condition requiring prompt management. Depending on the patient's hemodynamic status, early detection rate of a cardiac laceration may or may not be occur. If a possibility of cardiac laceration exists, an emergent thoracotomy should be performed. Furthermore, patients who experience a cardiac laceration also experience different kinds of complications. Therefore, close follow-up and monitoring are required. Herein, we report a 41-year-old man with a left atrium and a left ventricle laceration caused by a thoracic stab injury.

경흉부 관통상에 대한 경부와 정중흉골절개술을 이용한 치험 1례 (Emergency Repair Using Cervico-median Sternotomy for Cervicothoracic Penetrating Injury)

  • 이현주;김현구;최영호
    • Journal of Trauma and Injury
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    • 제21권2호
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    • pp.136-139
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    • 2008
  • A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-year-old woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).

폐결핵에 의한 전폐자가절제 환자에서의 흉부 자상 치험 1례- (Penetrating Chest Trauma in Autopneumonectomy Status due to Pulmonary Tuberculosis : 1 Case Report)

  • 홍윤주
    • 한국응급구조학회지
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    • 제9권1호
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    • pp.89-93
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    • 2005
  • Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

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Surgical Ligation of Patent Ductus Arteriosus Using the Descending Aortic Approach in Two Dogs

  • Kim, Dae-Hyun;Hong, Sung-Hwa;Myung, Hyunwook;Son, Dong-ju;Nam, Aryung;Jung, Sung-Yong;Hwang, Jung-Yeon;Jee, Hyun-Choul
    • 한국임상수의학회지
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    • 제37권1호
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    • pp.42-45
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    • 2020
  • Surgical ligation is the treatment of the choice in patients with patent ductus arteriosus (PDA). This case series presents two cases of PDA, one with and one without persistent left cranial vena cava (PLCVC), treated with surgical ligation through the descending aortic approach with mini-thoracotomy. There were no specific complications during the surgical procedures. The descending aortic approach would be an alternative method for dissection of the PDA.

Temporary Right Ventricular Assist Device Insertion via Left Thoracotomy after Left Ventricular Assist Device Implantation

  • Park, Ilkun;Cho, Yang Hyun;Chung, Su Ryeun;Jeong, Dong Seop;Sung, Kiick;Kim, Wook Sung;Lee, Young Tak
    • Journal of Chest Surgery
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    • 제52권2호
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    • pp.105-108
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    • 2019
  • Right heart failure is a relatively common complication after left ventricular assist device (LVAD) implantation. Severe right heart failure can be managed by temporary right ventricular assist device (RVAD) implantation. However, trans-sternal RVAD insertion requires a subsequent third sternotomy for cannula removal. Herein, we present a case of RVAD insertion via a left anterior mini-thoracotomy after LVAD implantation in a patient with alcohol-induced cardiomyopathy.

A Case Report of Resection of a Mediastinal Paraganglioma: Why All the Fuss?

  • Staunton, Laura Mary;Casey, Laura;Young, Vincent K.;Fitzmaurice, Gerard J.
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.174-176
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    • 2022
  • Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

좌측 후측방개흉술을 이용한 관상동맥 우회 재수술 치험 1예 (Redo CABG through a Left Posterolateral Thoracotomy - A case report-)

  • 송창민;김미정;정성철;김우식;신용철;김병열
    • Journal of Chest Surgery
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    • 제41권3호
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    • pp.366-368
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    • 2008
  • 관상동맥 우회수술 후 협심증이 재발한 46세 남자 환자로 입원 후 시행한 관상동맥조영술 상에서 과거에 없었던 첫 번째 대각지의 폐쇄가 확인되어 좌측 후측방개흉술을 이용한 관상동맥 우회 재수술을 시행하였다. 우측와위에서 좌측 후측방개흉술을 시행하였고 심폐바이패스 없이 우측 요골 동맥을 이용하여 하행 흉부 대동맥과 대각지 사이에 문합을 시행하였다. 술 후 시행한 다중검출 전산화 단층 촬영을 이용한 관상동맥조영술상에서 문합부위에 이상이 없음을 확인하였다. 대각지에 국한된 병변을 가진 환자에서 좌측 후측방개흉술을 통해 관상동맥 우회 재수술을 시행하여 만족할만한 결과를 얻었기에 보고하는 바이다.