• Journal of Chest Surgery
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• v.29 no.10
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• pp.1133-1137
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• 1996

From September 1994 to October 1995, we are reporting clinical results of 67 patients whom underwent video-assisted trio rabic surgery(VATS). 1. They were diagnosed as spontaneous pneumothorax In )5, diffuse interstitial lung disease in 9, empyema in 7, hemothorax in 5, malignant pleural effusion in 3, hyperhidrosis in 3, foreign body in chest cavity in 2, mesothelioma in 1, miliary tuberculosis in 1 and organizing pneumonia in 12. In pneumothorax, bullectomy in 33 and open bellectoiny in 2 due to pleural adhesion was done Hemostasis in 5, irrigation in 7, foreign body removal in 2, talcum powder insufrlation in 3, sympathectomy 3 as done. Thoracoscopic biopsy watt done In 12 3. For pneumothorax, operation was indicated as recurrent pneumothorax in 18, persistent air leak in 12, visible bullae In chest X-ray in 5. 4 Thoracoscopic biopsy was done in 12. They were interstitial pulmonary fibrosis in 9, miliary tuberculosis in 1, mesothelioma in 1, and organizing pneumonia in 1 .Among interstitial pulmonary fibrosis, usual interstitial pneumonia were 2 and diffuse interstitial pneumonia were 7. 5. Wo complication was found in 6) patients among 67 patients. The complication was found in 4 patients (2 persistent air leak, 2 contralateral lung atelectasis). We concluded that VATS was safe and beneficial in reducing postoperative complication and the role of thoracic surgery will increase markefdly.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.388-392
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• 1998

Hyperhidrosis is one of abnormalities in autonomic nervous system, it has been treated with dermatologic principles or thoracic sympathectomy via thoracotomy. But these techniques were rather ineffective or invasive. Recently, Video Assisted Thoracoscopic Surgery(VATS) is widely applided in thoracic surgical area, and palmar & axillary hyperhidrosis is not the exception. From August 1995 to February 1997, 52 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic sympathectomy with VATS in the department of thoracic & cardiovascular surgery, Inje university, Pusan Paik Hospital. There were 27 men and 25 women and the mean age was 22 years. Mean operating time was 172 min and unilateral sympathectomy via minithoracotomy was applied in one patient due to severe pleural adhesion. Mean postoperative hospital stay was 2.6 days. During mean 12.5 months follow-up, there was no recurrence of sweating in the both hands. Thirty patients(57.7%) complained moderate degree of compensatory sweating, but the discomfort was decreased in severity. 83.8% of all patients were satisfied with the result of operation.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.621-625
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• 2001

For many years, 10mm videothoracoscope has been widely used in bullectomy of primary spontaneous pneumothorax. However we used a 2mm videothoracoscope to minimize operative wound. Thus, we compared the clinical results of bulllectomy using 2mm videothoracoscope with bullectomy using 10mm videothoracoscope. Material and method: We analyzed 118 patients who underwent VATS for primary spontaneous pneumothorax from April, 1998 to December, 2000. 2mm videothoracoscope was used in 53 patients(Group A) and 10mm videothoracoscope was used in 65 patients(Group B). The mean age was 20.2$\pm$6.9 years old in group A and 20.1$\pm$6.1 years old in group B. The mean follow up was 10.9$\pm$3.8 months in group A and 11.4$\pm$4.3 months in group B. Result: The operation time was shorter in group A than group B(55.7$\pm$22.9 minutes, 71.2$\pm$21.4 minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than group B(7.2$\pm$3.2 days, 9.2$\pm$3.6 days, p<0.05). The duration of postoperative chest tube indwelling was shorter in group A than group B(4.7$\pm$3.1 days, 6.3$\pm$2.8 days, p<0.05). The duration of postoperative air leakage(0.6$\pm$2.1 days, 1.0$\pm$2.4 days, p>0.05), the amount of analgesics(1.38$\pm$1.0 ampules, 1.7$\pm$1.4 ampules, p>0.05), the amount of analgesics(1.38$\pm$1.0 ampules, 1.7$\pm$1.4 ampules, p>0.05), postperative complications(2 cases, 7cases, p>0.05) and recurrences(1 case, 1 case, p>0.05) were not statistically different between two groups. Operative wound was smaller in group A than B. Conclusion: There were non adverse results in group A than group B. Furthermore, bullectomy using 2mm videothoracoscope brought us minimized operative wound and good cosmetic results. Thus, we could recommend bullectomy using 2mm videothoracoscope in primary spontaneous penumothorax.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.160-165
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• 2004

Successful treatment of multi-loculated pleural effusion or thoracic empyema requires effective drainage and definitive diagnosis of causative organism. The purpose of this study was to assess the efficacy of the video-assisted thoracoscopic surgery in the management of thoracic empyema or multi-loculated pleural effusion after chest tube drainage treatment had failed. Material and Method: Between April 2000 and July 2002, 20 patients with thoracic empyema or multi-loculated pleural effusion that failed to chest tube drainage or other procedures who underwent an operation. All patients were assessed by chest-computed tomogram and underwent video assisted thoracoscopic drainage, debridement, biopsy and irrigation of pleural cavity. Result: In 18 cases (90%), underwent successful video-assisted thoracoscopic surgery. In 2 cases, decortications by mini-thoracotomy were necessary. The ratio of sex was 4 : 1 (16 male: 4 female), mean age was 48.9 years old (range, 17∼72 years), mean duration of postoperative chest tube placement was 8.2 days (range, 4∼22 days), mean postoperative hospital stay was 15.2 days (range, 7∼33 days). Causative disease was tuberculosis, pneumonia, trauma and metastatic breast cancer, There were no major postoperative complications. Symptoms improved in all patients and were discharged with OPD follow up. Conclusion: In an early organizing phase of empyema or multi loculated pleural effusion, video-assisted thoracoscopic drainage and debridement are safe and suitable treatment.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.142-148
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• 1998

Video-assisted thoracic surgery(VATS) is emerging as a viable alternative to thoracotomy when surgical treatment of spontaneous pneumothorax is required. 20 patients with spontaneous pneumothorax underwent bullectomy between July 1995 and May 1996. The patients were divided into two groups : Control group ; the patients who received with mid-axillary approach(n=10), Experimental group ; the patients who received with VATS (n=10). The results were as follows ; 1. The total sex distribution was male predominance (male:female=17:3). Mean age of control group was 29.6$\pm$9.8 years and experimental group was 27.2$\pm$11.9 years. 2. The mean period of postoperative chest tube indwelling duration and hospital stay were 3.3$\pm$0.8 days and 7.9$\pm$1.2 days in control group and 2.1$\pm$0.9 days and 5.2$\pm$3.1 days in experimental group(p=0.005 and p=0.02). 3. The mean time of operation, vital signs and arterial blood gas analysis did not showed any statistical differences between the groups. 4. Percent recovery of tidal volume and forced vital capacity were significantly improved in experimental group comparing with control group (p<0.05). 5. The patients undergoing VATS experienced significantly less postoperative pain and limitation of motion. In conclusion, VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.

• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.

• 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.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.362-368
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• 2007

Background: Spontaneous pneumothorax patients with blebs or bullae are considered to be good candidates for operation, and various objective diagnostic modalities have been performed for detection of blebs and bullae. This study was performed to compare the efficacy of thoracoscopic examination with using a minimally invasive 2 mm thoracoscope with high-resolution computed tomography (HRCT) for treating primary spontaneous pneumothorax. Material and Method: From June 2001 to March 2002, 34 patients with spontaneous pneumothorax undewent study with 2 mm video-thoracoscopic examination and HRCT. We regarded a blob larger than 5 mm in diameter as significant. Standard thoracoscopic wedge resection was performed in 18 patients with significant blob via a 2 mm video-thoracoscopic examination. 1 patient incurred bleeding, and the remaining 15 patients were treated with pleural drainage. Result: Multiple or single blob lesions were detected by 2 mm video-thoracoscope in 52.9% (18/34) of the patients with primary pneumothorax. For a total of 19 patients who were operated on, the diagnostic accuracy of the 2 mm video-thoracoscopic examination for bullae and blob was 94.7% (18/19), which was superior to that of HRCT (73.7%, 14/19). At a mean follow-up of $30{\pm}3$ months, no recurrence occurred in both the operative group and the non-operative group. Conclusion: 2 mm video-thoracoscopic examination under local anesthesia has higher diagnostic accuracy than HRCT, and it is a useful alternative for determining the operative indications for spontaneous pneumothorax.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.910-915
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• 1996

The bullectomy through transaxillary minithoracotomy and video assisted thoracic surgery(VATS) have been widely used in treatment of spontaneous pneumothorax. The study comprised a retrospective review of 1 13 consecutive cases of whom underwent bullectomy through transaxillary minithoracotomy at Shinchon Severance Hospital(group T) and 129 consecutive cases of whom underwent thoracoscopical bullectomy at Youngdong Severance(group V) between January 1992 to Jun 1994. This study compare the clinical and economic resuts of group T and group V There were no significant differences for operation time, indwelling periods of chest tube, hospital stay, complication rate and rate of recurrence in the two groups. The times of parenteral analgesics use and treatment cost were significant less in group T.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.33-38
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• 2010

Background: The use of video-assisted thoracic surgery (VATS) to perform major pulmonary resection with systematic node dissection (SND) for lung cancer by is commonly used in clinics. However, the feasibility of SND by VATS remains controversial. Video-assisted mediastinal lymphadenectomy (VAMLA) increases the quality of mediastinal lymph node staging in lung cancer. The video-mediastinoscope allows systematic lymphadenectomy by bimanual preparation. This study was conducted to assess safety and usefulness and clinical feasibility of VAMLA expanding Linder-Dahan mediastinoscope with VATS lobectomy for left sided lung cancer. Material and Method: Between February 2004 to April 2008, a total 50 patients who underwent VATS lobectomy for left sided lung cancer were analyzed retrospectively. Thirty patients (group A) underwent VAMLA followed by VATS lymphadenectomy and 20 patients (group B) underwent VATS lymphadenectomy for SND. Result: There were no statistical differences in operation times, chest tube indwelling times, or hospital days between the 2 groups. The number of dissected total nodes (p=0.001) and N2 nodes (p=0.013) were higher in group A than in group B, but there was no difference in N1 nodes. Postoperative complications included 2 prolonged air leakages (${\geq}$10 days) in each group, one pneumonia in group A, and one vocal cord palsy in group B. There were no early operative mortalities. Conclusion: Mediastinal staging of resectable lung cancer is performed by VAMLA. This new technique is the basis for VATS lobectomy particularly for left-sided lung cancer, because a higher percentage of mediastinal lymph nodes undergo complete resection using VAMLA.