• Title/Summary/Keyword: 우측개흉술

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Clinical Analysis of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에 대한 임상적 고찰)

  • 권영무;신현종
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.517-523
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    • 1997
  • The records of 14 patients with traumatic diaphragmatic rupture seen at Dongguk University Hospital from February 1992 through December 1995 were reviewed. Ten patients were male and four were female(M:F=2.5:1). The age distribution ranged from 17 to 73 years with the mean age of 41.7 years. The 14 patients included 12 who had blunt trauma(traffic accident 11, crushing injury 1) and 2 with penetrating diaphragmatic rupture(stab wound 2). Of those 12 blunt trauma, 7 patients(58.3%) were left sided and 5(41.7%) involved the right hemidiaphragm. The diagnosis was made preoperatively in 8 patients (57.1%) and during surgery in 6(42.9%). All right-sided injuries were repaired through a thoracotomy and left-sided defects were corrected through a laparotomy in 6, laparotomy and thoracotomy in 1. There were 2(14.3%) operative deaths that were caused by myocardial infarction and the sequelae of combined injuries.

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Redo CABG through a Left Posterolateral Thoracotomy - A case report- (좌측 후측방개흉술을 이용한 관상동맥 우회 재수술 치험 1예)

  • Song, Chang-Min;Kim, Mi-Jung;Jeong, Seong-Cheol;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.366-368
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    • 2008
  • We report there on a 46-year-old male patient whose angina recurred after a coronary bypass graft (CABG). Occlusion of the first diagonal branch was found on performing a coronary angiogram (CAG), and this occlusion had not previously been present. So, a redo-off pump CABG was performed via a left posterolateral thoracotomy. The anastomosis was made between the descending thoracic aorta and the diagonal branch by using the right radial artery. On the Multi-detector computerized tomography (MDCT) coronary angiogram conducted after the operation, it was confirmed that there was no abnormality in the anastomosis site. A Redo-CABG was successfully performed via left posterolateral thoracotomy in the patient whose disease was only at the diagonal branch.

Cardiac Rupture Combined with Massive Right Hemothorax by Blunt Chest Trauma -A report of two cases- (흉부둔상환자에서 중증우측혈흉을 동반한 심장파열 -치험 2례-)

  • 정은규;이병욱;윤용한;백완기;김광호;류송현;김혜숙;김정택
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.173-175
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    • 2001
  • 흉부둔상에 의한 심장파열은 50% 이상의 치사율을 갖는 질환으로 응급실에 도착하기 전에 사망하는 경우가 대부분이다. 일반적으로 전형적인 심장압전을 동반하기 때문에 이학적 소견이나 심장초음파 또는 흉부전산화 단층촬영으로 진단이 가능하다. 그러나 저자의 경우와 같이 심장압전의 징후가 없이 중증 우측혈흉만 있는 경우 심장파열을 진단하는 것은 어렵다. 만약 고속의 자동차사고로 인한 흉부둔상을 받은 환자에서 늑골골절이 없이 우측에 중증의 혈흉이 있어 응급개흉술을 받아야 한다면 심장파열의 가능성을 염두에두고 수술을 계획하는 것이 필요하다고 생각한다. 본 인하대학교 흉부외과학 교실에서는 흉부둔상에 의한 중증우측 혈흉과 심낭파열을 동반한 심장파열 2례를 심패바이패스와 자가수혈 장치를 이용하여 효과적으로 치료하였기에 보고하는 바이다.

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Loculated Empyema with Sternocostoclavicular Osteomyelitis and Neck Abscess -One case report- (흉늑쇄 골수염과 경부농양을 동반한 국소 농흉 - 1예 보고 -)

  • 이석열;전철우;박형주;이철세;이길노
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.215-218
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    • 2003
  • A 65-year-old male was admitted to our hospital complaining of painful swelling of right sternocostoclavicular area. In the past history, he had no specific disease including trauma. After admission, chest CT and neck CT showed right empyema and right cervical abscess. Empyemectomy was performed through open thoracotomy and fistulous tract was detected on right parietal pleura and right sternocostoclavicular area. Osto-myelitis was also detected on right sternocostoclavicular area and removal of right cervical abscess, partial resection of proximal clavicle, resection of chondral portion of 1st rib, and partial resection of manubrium were performed. Empyema that extends from sternocostoclavicular osteomyelits, as in this case, is rare. Herein we report a case of loculated empyema with sternocostoclavicular osteomyelitis and neck abscess.

Right Thoracotomy for Reoperation of Mitral Valve (우측 개흉을 통한 승모판 재수술)

  • 조창욱;구본일
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1342-1346
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    • 1996
  • A right thoracotomy was used for the reoperation or mitral valve of 15 patients who had previously undergone a cardiac operation through a median sternotomy. In our experience. this approach provided dn excellent exposure of the nlitral valve and easy cannulations of both cavie with minimal dissection, ilvoiding any damage of cardiac and major vessels during re-sternotomy Arterial cannulation was performed in the ascending aorta in 13 patients And in the femoral artery in 2 patients. In earlier cases, venous cannulation was done in the SVC And IVC through the right atrium and snared. In later cases, this could be done without snaginly of both cavae or by placing a silgle light-angled catheter into the right atrium. Crystalloid cardioplegic solution was infused for myocardial protection. Hypothermia was controlled at 20\ulcorner$25^{\circ}C$. For defibrillation, internal paddles were used In one patient while sterilized external paddles were used in 10 patients. In the remaining four patients. however. the heart beat spontaneously The respirator could be weaned within 48 hours alter the operation and no pulmonary complication was observed. One out of the 15 patients expired due to sudden attack of ventricular tarchycardid developed ten days after the operation, but the rest of the patients were discharged with good condition.

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Multilevel Dumbbell Tumor of the Posterior Mediastinum -1 Case Report- (다범위 종격동 Dumbbell종양 - 1례 보고 -)

  • 허동명;김병호;조재훈;강동기
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.768-771
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    • 1999
  • A 45 year old man was admitted for further examination of an abnormal shadow of the right posterior mediastinum. The patient suffered from dysesthesia in the right thoracic wall of dermatome T7. CT scan and MRI revealed that two separate tumors had developed in the right paravertebral area linked to the vertebral canal via an intervertebral foramina. One-stage removal of the tumors were performed safely through the right posterolateral thoracotomy following the resection of the rib head and vertebral pedicle. The tumors were confirmed as histologically neurilemomas. The postoperative course was uneventful.

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Mitral Valve Repair in Patient with Severe Mediastinal Shift to Right due to Pulmonary Hypoplasia - A case report - (폐 형성 저하증으로 인한 종격동의 우측 편위가 심한 환자에서의 승모판막 성형술 - 1예 보고 -)

  • Seok, Yang-Ki;Kim, Kyu-Tae;Cho, Joon-Yong;Kim, Gun-Jik;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.60-62
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    • 2007
  • Pulmonary hypoplasia is an entity of pulmonary agenesis. Pulmonary agenesis is a rare congenital anomaly, usually diagnosed soon after birth. It is commonly associated with other anomalies, mainly of the cardiovascular systems. Although it may hasten the death of a child, sometimes it is compatible with normal growth. We report a right lateral thoracotomy approach for mitral valve repair in a young woman with pulmonary hypoplasia, in whom preoperative computed tomography showed severe right side shifting of the mediastinum and total collapse of the right lung.

Benign Schwannoma of the Esophagus Removed by Enucleation (식도에서 발생한 신경초종 수술례)

  • 박승일;이용직;박창률;최인철
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.434-436
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    • 2001
  • 식도의 양성 종양은 흔하지 않았으며 이중 신경초종은 아주 드문 식도 양성종양이다. 봉원에서는 점점 심해지는 연하곤란을 주소로 내워한 52세 여자환자에서 식도에 생긴 신경초종을 우측 개흉술을 통한 종양 적출술로 성공적으로 제거 하였기에 이에 문헌 고찰과 더불어 증례 보고하는 바이다.

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Removal of an Infected Permanent Pacemaker through a Right Atriotomy without Cardiopulmonary Bypass Via a Right Thoracotomy (체외순환 없이 우측 개흉술을 통한 우심방 절개 만으로 감염된 영구심박동기의 제거 치험)

  • Choi, Kwang-Ho;Yoon, Young-Chul;Park, Kyung-Taek;Lee, Yang-Haeng;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.421-423
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    • 2010
  • A 52-year-old female presented with pain and swelling owing to recurrent inflammation on a generator pocket. She had undergone a permanent pacemaker implantation (DDD type) 7 years previously. We planned to insert a new pacemaker after removal of the previous generator and wires through a surgical approach. However, she had a history of the left modified radical mastectomy (MRM) with radiation therapy for breast cancer. For this patient, it would be difficult to care for the postoperative wound if we approached via the median sternotomy. Therefore, we decided to use a right atrial approach via a right thoracotomy. We removed the previous pacing wires through an atriotomy and inserted a new pacemaker using epicardial pacing leads without cardiopulmonary bypass.

Ligation of Thoracic Duct Via Extrapleural Approach for the Treatment of Chylothorax - Report of 1 case- (유미흉에서 늑막외층 접근법을 통한 흉관 결찰술 -치험 1예-)

  • 김성완;김덕실
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.883-885
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    • 2003
  • Traditional surgical management of chylothorax refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy. A new surgical procedure of ligation of the thoracic duct via extrapleural approach is presented. Its advantages are less invasive, no need of a new drainage tube, and easier to expose the thoracic duct than the conventional transthoracic approach. We experienced a new surgical method in the treatment of the chylothorax and report it with literatures.