• Title/Summary/Keyword: 비디오흉강경수술

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Video-Assisted Thoracoscopic Surgery for Fibrinopurulent Empyema (섬유농성 농흉의 비디오 흉강경을 이용한 치료)

  • 손정환;모은경;지현근;김응중;신호승;신윤철
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.404-410
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    • 2003

  • Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.

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Clinical Evaluation of Video-assisted Thoracoscopic Surgery (비디오 흉강경을 이용한 흉부 수술의 임상적 고찰)

  • 김은규;양현웅;최형호;최순호
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.513-517
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    • 1998

  • Video-assisted thoracoscopic surgery has recently evolved as an alternative to thoracotomy for several thoracic disorders. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indication. Using video-assisted operative thoracoscopy, we operated on 33 patients during the 2 years of our experience from June 1993 to June 1995. They were diagnosed as recurrent pneumothorax in 16, visible bulla on X-ray in 6, prolonged air leakage(longer than 7days) in 4, bilataral pneumothorax in 3, hyperhidrosis in 2, previous contralateral pneumothorax in 1, primary hemopneumothorax 1. The average duration of chest tube placement was 2.1${\pm}$0.4 days. The mean postoperative hospital stay was 3.4${\pm}$0.6 days. The complication was persistent air leakage(longer than 48 hours) in 3 case. Video-assisted thoracic surgery is safe, decreased pain, and shortens hospital stay.

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