• Title/Summary/Keyword: 흉강경수술

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Video-Assisted Thoracic Surgery Lobectomy for Non-Small Cell Lung Cancer: Experience of 133 Cases (폐암에서의 흉강경 폐엽절제술 치험 133예)

  • Kim, Hyeong-Ryul;Cho, Jeong-Su;Jang, Hee-Jin;Lee, Sang-Cheol;Choi, Eun-Suk;Jheon, Sang-Hoon;Sung, Soak-Whan
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.615-623
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    • 2009
  • Background: We evaluated the feasibility and the efficacy of Video-Assisted Thoracic Surgery (VATS) lobectomy for treating patients with non-small cell lung cancer (NSCLC) and we compared the outcomes of VATS lobectomy with those of open lobectomy. Material and Method: From 2003 to March 2008, 133 NSCLC patients underwent VATS lobectomy. The patients were selected on the basis of having clinical stage I disease on the chest CT and PET scan. The outcomes of 202 patients who underwent open lobectomy (OL group) for clinical stage I NSCLC were evaluated to compare their results with those of the patients who underwent VATS lobectomy (the VL group). Result: The number of females and the number of patients with adenocarcinoma and stage IA disease were greater in VL group (p<0.05). There was no operative mortality or major complications in the VL group. Conversion to thoracotomy was needed in 8 cases (6%), which was mostly due to bleeding. The chest tube indwelling time and the length of the postoperative hospital stay were significantly shorter in the VL group (p<0.001). The number of dissected lymph nodes and the size of tumor were significantly smaller in the VL group (p<0.001). For the pathologic stage I patients, there was no significant difference in the three-year survival rates between the two groups (p=0.15). Conclusion: VATS lobectomy is a safe procedure with low operative mortality and morbidity. VATS lobectomy is feasible for early stage NSCLC and it provides outcomes that are comparable to those for open lobectomy. Further long-term data are needed.

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.

Video-Assisted Thoracoscopic Excision of Mediastinal Masses (비디오 흉강경을 이용한 종격동 종양 절제술)

  • 박순익;김동관;유양기;김용희;박기성;박창률;박승일
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.807-811
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    • 2002
  • Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

Thoracoscopic Bleb Ligation in Patients with Primary Spontaneous Pneumothorax (일차 자연 기흉의 치료를 위한 흉강경하 폐기포 결찰술)

  • Mun, Sung-Ho;Jang, In-Seok;Lee, Chung-Eun;Kim, Jong-Woo;Choi, Jun-Young;Rhie, Sang-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.133-138
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    • 2010
  • Background: Video assisted thoracic surgery has been widely accepted for the treatment of primary spontaneous pneumothorax. Material and Method: We retrospectively reviewed the medical records of 89 primary pneumothorax patients who had undergone thoracoscopic bleb ligation from February 2002 to June 2006, and we assessed the patients for recurrence. The mean follow-up period was 65 months. Result: Pneumothorax recurred in 7 patients (8%) during the follow-up period. Conclusion: Thoracoscpic bleb ligation might be an acceptable alternative technique for treating primary spontaneous pneumothorax.

Video Assisted Thoracoscopic Thoracic Sympathectomy for Palmar Hyperhidrosis (비디오 흉강경을 이용한 수장부 다한증의 흉부 교감신경절 절제술)

  • 류지윤;한일용;조광현
    • 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.

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