• Title/Summary/Keyword: thoracotomy

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One Stage Eepair of Interruption of Aortic Arch with VSD in Neonate (신생아에서 심실중격결손증을 동반한 대동맥궁 결손증의 일단계 완전 교정술 -3례 치험-)

  • 전희재
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.610-618
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    • 1995
  • Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

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The Management of Delayed Post-Pneumonectomy Broncho-Pleural Fistula and Esophago-Pleural Fistula

  • Noh, Dongsub;Park, Chang-Kwon
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.138-140
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    • 2016
  • Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy.

Minimally Invasive Redo Mitral Valve Replacement under Fibrillatory Arrest in a Patient with a Calcified Aorta and Patent Previous Bypass Grafts

  • Kim, Seung Hyun;Kim, Hak Ju;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.283-285
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    • 2018
  • A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.

Surgical Treatment of Bronchial Rupture by Blunt Chest Trauma in Children -2 cases reports- (소아에서 발생한 외상성 기관지 파열의 수술 치험 -2례 보고-)

  • Na, Guk-Ju;Kim, Gwang-Hyu;An, Byeong-Hui;Kim, Sang-Hyeong
    • Journal of Chest Surgery
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    • v.29 no.3
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    • pp.355-359
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    • 1996
  • Rupture of the main bronchus due to blunt chest trauma is very rare, especially In childhood although the incidence is increasing. Early diagnosis and primary repair not. only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced 2 cases of right main bronchial rupture caused by traffic accidents. Patients suffered from progressively developing dyspnea and subcutaneous emphysema on the neck, anteriorchest,andanteriorabdominalwall. Emergency operations were performed through right posterolateral thoracotomy incision at the 4th intercostal space. Intraoperatively, the right main bronchus completely transsected and separated. Corrective bronchoplasty was performed with end-to-end anastomosis using interrupted suture with 3-0 Vicryle and the suture line was reinforced with azygos vein and parietal pleural flap. Postoperative courses were uneventful and patients discharged without any specific pro lems.

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One-Stage Ascending, Arch. and Descending Thoracic Aorta Replacement Through Median Sternotomy (정중 흉골 절개술을 통한 상행, 궁부, 하행 대동맥 동시 치환 수술례)

  • 이재원;이용직;이상권;주석중;윤석원
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.675-679
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    • 2002
  • In patient with severe adhesion between lung and aorta, there is some limitation in approaching the distal arch or descending thoracic aorta through the usual left thoracotomy. We report a case of a successfully managed distal arch and descending thoracic aortic aneurysm through the median sternotomy without any manipulations of the lung in a 66 year old man who presented hemoptysis.

A Case of Bronchial Foreign Body With Contralateral Pneumothorax (기흉을 동반한 기도이물 1예)

  • 나기상;김무명;김광현;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.3-6
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    • 1982
  • Foreign body in the air passage is not uncommon in the field of otolaryngology. The majority of bronchial foreign bodies can be removed by bronchoscopy, but some cases may require surgical procedure. Recently, we experienced an impacted foreign body (ball-pointed pen cap) in the left main bronchus with pneumothorax on the right side. Authors tried bronchoscopic removal under the general anesthesia but failed. Lateral thoracotomy was performed by chest surgeon and foreign body was successfully removed.

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Circumferential Resection and End to End Anastomosis of Mediastinal Trachea for Long Tracheal Stenosis (주기관 긴 협착증 환자의 수술 치험)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.588-592
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    • 1992
  • Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

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Surgical Managemnet of Symptomatic Aberrant Right Subclavian Artery through Midsternotomy - A case report - (우측 쇄골하 동맥 기시 이상에 의한 기형성 연하곤란)

  • 허동명
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.785-790
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    • 1990
  • A 30-year-old male with a symptomatic aberrant right subclavian artery underwent surgical intervention on January 17, 1990. An aberrant right subclavian artery is a rare congenital anomaly, but it is the most common one of the aortic arch anomalies. This anomalous vessel usually does not produce symptoms, but occasionally symptomatic patients require surgical intervention. Although ligation and division of the aberrant right subclavian artery through left thoracotomy has been advocated by many surgeons, the ischemic symptoms of the upper extremity or the brain can occur. In the procedure described here, ligation and division of the aberrant artery and its anastomosis to the ascending aorta with Gore \ulcornerTex vascular graft was performed simultaneously through midsternotomy. With this procedure, we relieved the esophageal obstruction and established normal blood flow to the right arm. Hoarseness developed postoperatively. We consider that above symptom has been attributed to the injury of the left recurrent laryngeal nerve during dissection.

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Median Sterontomy for Bilateral Resection of Emphysematous Bullae (정중 흉골 절개술을 통한 양측의 기종성 폐포의 절제)

  • 이성윤
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.720-730
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    • 1990
  • The complicated pulmonary emphysema including “Giant bullae” and spontaneous pneumothorax often involve both lungs, and controversy exists concerning which is the more rational means of surgical treatment-bilateral simultaneous operation or two staged operation. We report three cases of the complicated bilateral bullous emphysema and two cases of bilateral spontaneous pneumothorax treated through median sternotomy. We performed the ligation of bullae, bullectomy, cystectomy, wedge resection, and left lower lobectomy through median sternotomy. No technical problems were encountered through this approach, which provided maximum benefit with one operation In conclusions, median sternotomy may be appropriate for resection of emphysematous bullae, specially in a severe COPD patient who may be poorly tolerated the superimposed loss of respiratory function due to incisional pain, because median sternotomy permit bilateral exploration, minimal impairment of pulmonary function, simultaneous restoration of pulmonary function, less incisional pain than routine lateral thoracotomy.

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Primary Cancer of the lung: Report of 160 Cases (폐암의 임상적 고찰)

  • 장순명
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.31-36
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    • 1974
  • The clinical observations on the bronchogenic cancer of one hundred sixty cases treated in the Department of Thoracic Surgery, Seoul National University Hospital are as follows: 1] Most of them,. 90 percent of the cases were over 40 years of age and male was predominated over female with sex ratio of 6 to 1. 2] The average duration of symptoms before the first examination was about 5 months arid the most common complaints were cough, chest pain, breathing difficulty and blood-tinged sputum. 3] In ninety-four cases[59%] thoracotomy was undertaken with resection of the lesion in 52 cases[33% ]. 4] Histopathological diagnoses made in 141 cases were squamous cell carcinoma in 47.5%, undifferentiated cell carcinoma in 33.3%, adenocarcinoma in 9.2,% and alveolar cell carcinoma in a single case.

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