• 제목/요약/키워드: thoracotomy pain

검색결과 153건 처리시간 0.028초

종격동 종양 25례 에 대한 임상적 고찰 (Report of 25 Cases of Mediastinal Tumors)

  • 김광택
    • Journal of Chest Surgery
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    • 제12권4호
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    • pp.424-428
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    • 1979
  • Clinical observation were performed on 25 cases of Mediastinal tumors or Cyst, those were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Korea University Hospital, during the 6 years period from March 1973 to March 1979. The following results are obtained. Of 25 cases, 19 patients were males and 6 patients were females. Range of age varied widely from 2 years to 72 years. Approximately 28% were younger than 15 years of age at the time of diagnosis. The common subjective symptoms of the patients were anterior chest pain [36%], coughing [27%], dyspnea and a few incidence of hemoptysis. Diagnostic procedures were posteroanterior and lateral chest roentgenorgrams, Chest tomograms, Brochograms, Esophagograms, Mediastinoscopy, Scalene and Axillary Lymph node biopsy, and Needle aspiration biopsy. In the histological distribution on Mediastinal tumors in order of frequency, Neurogenic tumor 6 cases [25%], Lymphoma 5 cases [21%], Bronchogenic cyst 4 cases [17%], Pericardial cyst 2 cases [8.3%], Teratodermoid tumor 2 cases [8.3%], and each one case of Rhabdomyosarcoma, Seminoma, Cavernous hemangioma, Anthracosis, Tuberculoma were noted respectively. Of 24 cases of the histologically confirmed Mediastinal tumors, 6 cases [24%] were malignant. Thoracotomy for removal of tumor or cyst was performed on 17 cases and offered cure of all benign tumors. In 6 cases of malignant tumors, Chemotherapy with Vincristine, Cyclophosphamide and Prednisolone was given to 1 case Lymphoma. There was no case of postoperative mortality.

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식도암의 외과적 요법에 관한 연구 (surgical treatment of esophageal cancer)

  • 김용진;김주현
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.819-828
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    • 1984
  • Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

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식도중복증의 1례 (Duplication of the Esophagus -Report of A Case-)

  • 홍기우
    • Journal of Chest Surgery
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    • 제7권2호
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    • pp.169-174
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    • 1974
  • Duplication of the alimentary tract, especially of the esophagus, have been regarded as rare cong- enital anomalies. However, they are being reported with increasing frequency in the literature. In the . ,- past they have been described by a variety of names, such as "enteric cysts", "intestinal cysts", "giant diverticula", "`mediastinal cysts of foregut origin" "enterogenous cysts" and other descriptive terms. . Most authorities now agree that these anomalies are best described by the term "duplications of the alimentary tract. The duplications [of the alimentary tract] are spherical or tubular structures which poses a well developed smooth muscle layer and are lined with a mucous membrane from any part of the alimentary tract. They may occur at any place in the digestive tube from the tongue to the rectum and usually are intimately attached to some portion of the alimentary tube. We have experienced a duplication of the esophagus in 14 years old middle schoolboy. He complained dysphagia, eructation and substernal pain associated with intermittent high fever and chilliness, increasing in severity for recent three weeks. Routine chest X-ray film revealed nore markable abnormal finding but esophagogram. revealed marked narrowing of the esophagus throughout with a large blind pouch in lower half with fistulous communication at mid portion of the esophagus. On thoracotomy, a large infected blind pouch communicating with the lumen of normal esophagus proximally, Was extended from the level of 5th to 10th thoracic spine. The duplicated segment of the esophagus has a common muscular .wall and proximal communication with the adjacent esophagus. The infected, duplicated esophagus was segmentally resected, and esophagogastrostomy with pyloroplasty was done by displacing the stomach into the right thoracic cavity through midline laparotomy. His Postoperative course was uneventful and discharged without complication.

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Ultrasound-Guided Posterolateral Approach for Midline Calcified Thoracic Disc Herniation

  • Tan, Lee A.;Lopes, Demetrius K.;Fontes, Ricardo B.V.
    • Journal of Korean Neurosurgical Society
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    • 제55권6호
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    • pp.383-386
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    • 2014
  • Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

Experiences of Video-assisted Thoracic Surgery in Trauma

  • Noh, Dongsub;Lee, Chan-kyu;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • 제30권3호
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    • pp.87-90
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    • 2017
  • Purpose: Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area. Methods: From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively. Results: Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients. Conclusions: VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.

심막에 발생한 다발성 중피종 1예 (Multi-loculated Pericardial Mesothelioma -A case report-)

  • Yang, Hong-Seok;Hwang, Jung-Joo;Joo, Hyun-Cheol;Lee, Mi-Kyeong;Paik, Hyo-Chae;Cho, Sang-Ho
    • Journal of Chest Surgery
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    • 제38권5호
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    • pp.392-395
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    • 2005
  • Primary pericardial mesothelioma is extremely rare and the incidence is low among the mesotheliomas that originate from other parts of the body. The prognosis of the tumor is unfavorable due to its late presentation, difficulties in early diagnosis and complete resection, and the limited treatment options. Herein, we report a case of pericardial mesothelioma. The patient is a 55-year-old woman who presented with chronic cough and dyspnea. During the examination, pericardial effusion was found and pericardial window formation was followed. She visited our hospital because of persistent dyspnea, with right shoulder and chest pain. Four discrete masses were discovered in the chest CT. CT guided-fine needle aspiration biopsy was negative for malignancy. Right exploratory thoracotomy and partial resection of 3${\times}$3 cm mass abutting pericardium was performed and was histologically diagnosed as malignant mesothelioma, biphasic type. Pericardial mesothelioma is rare, but it should be remembered as an important differential diagnosis in patients with persistent pericardial effusion and symptoms of dyspnea and constrictive pericarditis.

종격동염과 동반된 결합조직염식도염의 치료 (Treatment of Phlegmonous Esophagitis Combined with Mediastinitis)

  • 이호석;박진수;김영대
    • Journal of Chest Surgery
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    • 제40권10호
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    • pp.711-714
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    • 2007
  • 결합조직염식도염은 식도의 점막하층과 근육층의 세균감염에 의해 발생하며 드문 질환이며 높은 사망률을 보인다. 69세 남자가 7일간의 흉통과 발열을 주소로 내원하였다. 흉부전산화단층촬영에서 종격동의 확장, 식도 주행을 따라 있는 식도벽의 비후와 공기 음영, 우측 흉수가 관찰되었다. 환자는 우측 개흉술을 통해 배농, 죽은조직제거술, 천공된 식도 근육층의 1차 봉합술을 시행 받았다. 추가 수술은 없었으며 퇴원시 식도 누출과 연하장애 없이 경구 식이는 원활하였다.

흉막에 발생한 국소성 섬유성 종양 1예 (A Case of Localized Fibrous Tumor of the Pleura)

  • 김용환;나석주;곽문섭
    • Tuberculosis and Respiratory Diseases
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    • 제48권3호
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    • pp.388-393
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    • 2000
  • 저자들은 우측 흉통과 기침을 주소로 내원한 57세 남자환자에서 우측 폐하부에 $12{\times}8cm$ 가량의 종괴를 단순 흉부 X-선 촬영과 흉부 CT 촬영등으로 진단후 좌측 개흉술로 치료한 국소성 섬유성 종양을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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흉벽에 발생한 양성 신경초종 1예 (A Case Report of Neurilemmoma of the Chest Wall)

  • 이태영;박재석;성영란;김완수;이재경;박미경;김도섭;허갑도
    • Tuberculosis and Respiratory Diseases
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    • 제44권3호
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    • pp.649-654
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    • 1997
  • 저자들은 우상복부동통을 내원한 흉부 x선상 정상이었던 43세 여자 환자에서 흡입침생검술로 확진하여 개흉술로 완전절제한 우하흉부에 발생한 신경최종 1예를 경험하고 함께 보고한다.

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벽측늑막의 활막육종 - 1예 보고 - (Synovial Sarcoma of the Parietal Pleura -One case report -)

  • 송인학;이승진;박형주;이철세;이길노;이석열
    • Journal of Chest Surgery
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    • 제38권6호
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    • pp.454-456
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    • 2005
  • 흉통을 주소로 내원한 34세 남자 환자에서 흉부 컴퓨터 단층촬영상 좌측 흥부에 종괴와 흉막수가 발견되었다. 개흉술을 실시하여 벽측늑막에서 기원된 종괴를 제거하였으며 종괴는 저분화 활막육종으로 진단되었다. 벽측늑막에서 기원한 활막육종은 드문 질환으로 저자들은 이를 치험하였기에 보고하는 바이다.