• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2871-2877
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• 2013

Objectives: To evaluate the safety, efficacy, and invasiveness of lobectomy by video-assisted thoracoscopic surgery (VATS) in the treatment of stage I/II non-small cell lung cancer (NSCLC). Methods: A total of 148 patients presenting with Stage I or II NSCLC were enrolled into our study, comprising 71 who underwent VATS and 77 patients undergoing conventional thoracotomic lobectomy, in combination with systematic lymph node resection. Results: It was found that VATS was superior to conventional thoracotomy in terms of the duration of surgery, intraoperative blood loss, frequency of the need to administer postoperative analgesia, thoracic intubation indwelling time, post-operative hospital stay, and survival rate (P<0.05). We saw no obvious difference in the number of resected lymph nodes with either approach. Conclusions: VATS lobectomy is a safe and reliable surgical approach for the treatment of Stage I/II NSCLC, characterized by significantly minimal invasiveness, rapid post-operative recovery, and markedly lower loss of blood.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.116-118
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• 2009

Pericardial rupture due to blunt trauma is very rare, but can lead to serious complications. It occurs mainly on the left, is found incidentally during surgery, and is seldom discovered radiologically unless accompanied by cardiac herniation. The following case describes a 53-year-old traffic-accident victim who received emergency pericardial repair and bleeding control via an exploratory thoracotomy and an exploratory laparatomy. The patient was discharged without any complication and remained healthy at six month after injury.

• Journal of Chest Surgery
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• 제26권11호
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• pp.861-865
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• 1993

The lung cancer in patients under 40 years old is rare and reported to be more rapidly fatal than in older persons. We reviewed the records of 18 cases who younger than 40 years with histologically proven lung cancer between 1959 and 1992 at department of Thoracic Surgery in National Medical Center. There were 12 male and 6 female patients. Two male and all female patients had never smoked. The 17 cases had respiratory symptoms for a mean duration of 3 months. The squamous carcinoma was found in 7 cases[38.9%], small cell carcinoma in 4 cases[22.2%], mixed cell carcinoma in 4 cases[22.2%], adenocarcinoma in 2 cases[11.1%] and bronchoalveolar cell carcinoma in 1 case. Among the 6 resected tumors, one case was stage I, two cases were stage II and three cases were stage IIIa. The operation was considered complete and curative in 6 patients and noncurative in 6 pations because of an exploratory thoracotomy. We conclude that lung cancer in young persons is virulent and that diagnosis is frequently delayed.

• Journal of Chest Surgery
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• 제24권1호
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• pp.41-47
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• 1991

From January, 1980, to August, 1989, 23 patients underwent thoracotomy for treatment of pulmonary aspergillosis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 12 male and 11 female patients ranging from 23 years to 61 years old[mean age, 40.7 years]. The main clinical symptoms were hemoptysis[91.3%], cough[65.2%], chest pain[34.5%]. Sixteen patients[69.6%] had simple aspergilloma and 7[30.4%] had complex aspergilloma. The most common indication for operation was a hemoptysis, indeterminate mass, chronic cough, or obstructed bronchus. Anatomical location of lesion was mainly located upper lobe [82.6%] and most of cases were managed by lobectomy. Postoperative pathologic findings showed that 13 case[56.5%] were combined with tuberculosis, two were combined with bronchiectasis and two were combined with lung tumor, but 6 cases were not combined with other disease. Early complications occurred in 33.5% of patients with simple aspergilloma and in 85.7% of patients with complex aspergilloma. But there was no hospital death.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1061-1069
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• 1989

A case of liposarcoma was reported in 52 year-old female. She had the operation history due to mediastinal lipoma at other Hospital before 26 months ago. Chest X-ray revealed a huge soft tissue mass- density at the entire right lung field, and left middle and lower lung field at admission. At the lateral film, the mass was located in the anterior and middle mediastinum. Transsternal bilateral thoracotomy was performed, followed by extirpation of liposarcoma, wedge resection of superior vena cava, angioplasty of superior vena cava, and then partial pericardiectomy. The post-operative treatment was 5500 rad irradiation. Post-operative course was uneventful, that was noticed by OPD follow-up for 10 months. Primary liposarcoma of the mediastinum is very rare tumor. This tumor grows to an enormous size, and symptoms are referable to compression of the contiguous intrathoracic structures. The treatment of choice is surgery in all cases. Such an approach serves to establish a tissue diagnosis, to relieve the patients* symptoms, and may results in a cure sometimes. Radiotherapy or/and chemotherapy seems to be ineffective, but should be further studied.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1228-1231
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• 1991

One of the most lethal forms of mediastinitis is descending necrotizing mediastinitis, in which infection arising from the oropharynx spreads to the mediastinum. Despite the development of computed tomographic scanning to aid in the early diagnosis of mediastinitis, the past 30 years, in large part because of continued dependence on transcervical mediastinal drainage, Although transcervical drainage is usually effective in the treatment of acute mediastinitis due to a cervical esophageal perforation, these approach in the patient with descending necrotizing mediastinitis fails to provide adequate drainage and pre-disposes to sepsis and a poor outcome. In addition to cervical drainage, aggressive, early mediastinal exploration - debridement and drainage through a subxiphoid incision or thoracotomy - is advocated to salvage the patient with descending necrotizing mediastinitis.

• Journal of Chest Surgery
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• 제24권12호
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• pp.1238-1241
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• 1991

Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

• Journal of Chest Surgery
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• 제22권2호
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• pp.364-370
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• 1989

22 Cases of traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery in Chon-Buk National University Hospital from Jan. 1979 to Oct. 1988 were reviewed in this study. Of the 22 cases, 18 were male and 3 were female, a ratio of 4.5:1. This ratio revealed high incidence in male patient. The age distribution ranged from 2 to 60 years and mean age was 31 years. The modes of injury were as follows: 11 stab wound, 5 traffic accident, 2 fall down, 2 fighting injury, 1 compression wound by sand bag, and 1 slip down injury. Useful diagnostic tools were chest X-ray with or without radiopaque dye swallowing, which was the most commonly diagnostic, UGI series, and thoracoscope. Operations were performed in 22 cases, and 18 cases were through thoracotomy. The herniated organs through the ruptured diaphragm were stomach, omentum, liver, spleen, colon, and small bowel. There were associated injuries, and the most commonly associated was rib fracture. There was no postoperative death.

• Journal of Chest Surgery
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• 제21권2호
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• pp.403-407
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• 1988

Primary tumors of the diaphragm are very rare, From a clinical point of view, they do not present a specific symptomatology and the radiologic aspect is not characteristic. Their etiology is often obscure. The authors experienced one case of primary neurofibroma of the diaphragm. The patient was 52 year old male, and detected preoperatively abnormal round mass shadow in the middome portion of the left diaphragm in routine chest X-ray. A left posterolateral thoracotomy through the 7th ICS was performed. The mass and surrounding tissues were completely removed, and diagnosed as a primary neurofibroma by the histopathologic findings. Postoperative course was uneventful.

• Journal of Chest Surgery
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• 제27권12호
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• pp.1042-1046
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• 1994

We experienced a case of traumatic aneurysm of descending thoracic aorta by an automobile accident. The patient was 23-year-old-male with a traumatic aortic aneurysm [6x12cm] on the descending thoracic aorta just distal to the origin of the left subclavian artery. Exposure was obtained through a left posterolateral thoracotomy incision in the fourth intercostal space and then partial femoro-femoral cardiopulmonary bypass was established.After aortic cross- clamping, the aneurysmal sac was opened and repaired with interposition of Dacron vascular graft and aortic cross-clamping period lasted for 100 minutes. Postoperative bleeding and vocal cord paralysis were complicated, but bleeding was controlled by reoperation and vocal cord paralysis was improved. Follow up was continued for 14months and postoperative course was uneventful.