• Journal of Chest Surgery
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• v.31 no.10
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• pp.999-1003
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• 1998

Background: Thoracoscopic sympathetic block in palmar hyperhidrosis has merits in its immediate responsiveness and recovery. In palmar hyperhidrosis, the level of sympathetic chain to be blocked has been somewhat obscure. Materials and methods: To compare the results of T2 with T2,3 sympathetic block, we retrospectively studied 192 patients (T2 group: 84, T23 group: 108) operated on at SNUH with palmar hyperhidrosis between April 1994 and July 1997. We reviewed medical records and recently interviewed the patients by telephone call. Sex and age distribution between two groups showed no significant differences. We performed sympathectomy at the early phase of the syudy until April 1997, and after then, we adopted sympathicotomy rather than sympathectomy. Results: All patients showed symptomatic improvement after the operation. Mean operation times of T2, T23 groups were 61.3$\pm$22.5min, 82.7$\pm$24.8min, respectively(p<0.01). Early postoperative complications, such as Horner's syndrome or chest tube insertion, were not different in two groups. There were no statistical differences of late complications such as compensatory truncal hyperhidrosis, gustatory sweating, and phantom sweating. No patient experienced recurrence of palmar hyperhidrosis during the study period. The only difference was the extent of compensatory truncal hyperhidrosis. The compensatory sweating occurred from axilla to suprapatella in T2 group whereas its extent was from nipple to suprapatella in T23 group. Conclusions: We concluded that T2 thoracic sympathetic block is mandatory for the treatment of primary palmar hyperhidrosis.

• Proceedings of the KTCVS Conference
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• 1995.10a
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• pp.74-74
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• 1995

• Proceedings of the KTCVS Conference
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• 2004.06a
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• pp.7-10
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• 2004

• Proceedings of the KTCVS Conference
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• 1993.06a
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• pp.56-56
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• 1993

• Journal of Chest Surgery
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• v.34 no.2
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• pp.118-124
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• 2001

배경: 승모판막재건술이 승모판막치환술보다 술후 좌심실기능이 보다 향상될 수 있으며 또한 수술사망율과 인공판막에 관련된 합병즈인 혈전색전증, 심내막염 및 항응고제사용에 따른 출혈빈도는 낮다고 하였다. 방법: 1996년 1월부터 2000년 5월까지 승모판막폐쇄부전으로 진단된 환자 87례를 대상으로 재건술군 59례, 치환술군 28례로 나누어 비교분석하였다. 결과: 술전 환자들의 NYHA 기능분류, 흉부 X-선상 심흉곽의 비, 심초음파상 좌심실박출계수는 두 군간에 유의한 차이가 없었다. 원인질환은 양군에서 퇴행성 병변이 가장 많았다. 체외순환시간은 재건술군에서 유의하게 길었으나 수술사망은 양군에서 없었다. 술후 NYHA 기능분류, 흉부 X-선상 심흉곽의 비는 향상되었으나 두 군간에 차이가 없었으며 술후 좌심실박출계수는 두 군에서 감소되었으나 유의한 차이는 없었다. 결론: 이상의 결과로 승모판막폐쇄부전에 대하여 재건술이 치환술처럼 비교적 안전하게 시행될 수 있는 술식으로 사료된다.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1081-1084
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• 1998

Background: Esophageal surgery in esophageal cancer has low curative resection rate and its resut has not improved even after the extended lymphnode dissection. To evaluate the effectiveness of cervical lymph node dissection, we compare the node of cervical lymph node metastasis in patients esophageal cancer. Materials and methods: We studied a series of 32 patients who underwent operation for thoracic esophageal carcinoma at our institution. The 25 patient who underwent curative surgery were divided into two groups. Both groups A and B underwent transthoracic esophagectomies with mediastinal and abdominal lymphadenectomies only, but group B also underwent bilateral lower neck node dissection. Results: The rate of operative complications did not differ significantly between two groups. No operative and hospital mortalities were noted in either group. However, the mean anesthetic time was significantly longer in group B(mean: 90 minutes). Neck node metastasis was revealed in 27% of group B. Conclusions: Therfore, neck node dissection is meaningful for surgical treatment of the thoracic esophageal carcinoma. The longterm survival rate should be compared later.

• Proceedings of the KTCVS Conference
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• 1998.10a
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• pp.53-53
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• 1998

• Proceedings of the KTCVS Conference
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• 1998.10a
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• pp.7-7
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• 1998

• Journal of Chest Surgery
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• v.42 no.3
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• pp.355-360
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• 2009

Background: Benign teratoma is mostly asymptomatic, but this tumor rarely ruptures into the adjacent structure such as the pleural space, pericardium, lung parenchyma or tracheobronchial tree. Thus, it is important to differentiate ruptured teratoma from unruptured teratoma. This study evaluated the difference between ruptured and unruptured benign teratoma. Material and Method: Twenty-four cases of surgically resected benign teratomas were reviewed retrospectively. The clinical symptoms, chest CT findings and operative findings of the ruptured teratoma were compared with those of the unruptured teratoma. Especially, the tumor size, wall thickness, location of the mass, internal septation, homogeneity, calcification and ancillary findings were evaluated on CT. Result: Of the 24 patients, 7 patients were diagnosed with ruptured teratoma. Severe symptoms were more commonly found for ruptured teratoma than for unruptured teratoma. The ruptured teratoma had a tendency to display calcification and such ancillary findings as collapse or consolidation of the lung parenchyma. For the ruptured teratoma, the resection was performed by sternotomy or thoracotomy, and more lung resection was included. Conclusion: Calcification within the mass and changes in the lung parenchyma on the preoperative CT findings can be diagnostic signs of a ruptured teratoma. The demonstration of ruptured teratoma is important not only for making the early diagnosis, but also for the surgical planning.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.813-817
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• 1999

Background: Conventional thoracoscopic thoracic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively embarrassing compensatory hyperhidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection. The purpose of this study was to assess the result of the limited thoracoscopic sympathetic nerve transection in hyperhidrosis. Material and Method: From May to August 1998, 17 patients underwent limited transection of the sympathetic nerve. For 9 patients with facial hyperhidrosis, we transected only the interganglionic fiber between the first and the second ganglion, whereas the conventional method cuts two interganglionic fibers. Eight patients with palmar hyperhidrosis underwent limited transection of the interganglionic fiber between the second and third ganglion. Result: Sixteen patients had improved symptom postoperatively. There was a recurred facial sweating in 1 patient 1 month after the operation. Among the 9 facial hyperhidrosis patients, postoperative compensatory hyperhidrosis was severe in 4, moderate in 4 and minimal in 1. But in 8 cases of palmar hyperhidrosis compensatory hyperhidrosis was moderate in 3, and minimal in 1, none in 4. Facial sweating was not disturbed postoperatively in all of the palmar hyperhidrosis patients. Conclusion: Limited sympathetic nerve transection is a practical and less invasive method for the treatment of localized hyperhidrosis and may reduce the incidence of compensatory truncal hyperhidrosis and facial anhidrosis in case of palmar hyperhidrosis.