• Journal of Chest Surgery
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• v.30 no.11
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• pp.1111-1116
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• 1997

In a period from Sep 1994 to Sep 1996, 38 patients were treated for spontaneous pneumothorax by video-assisted thoracic surgery(VATS). 31 male and 7 female patients with ages between 17 and 79(mean 30.0 years). No death occured. The postoperative complication rate of VATS was 7.9%(3/38). We noted no recurrence of pneumothorax, 3 wound dehiscence, 3 persistent air leak(>7days) in the patients. We compared theses results with thoracoscopic surgery of spontaneous pneumothorax in 38 cases(Group A), with cases of 21 patients(Group B) performed by the thoracotomy in the same period. There have been no recurrence in groud A, and one recurrence in group B at a median follow-up of 14.37$\pm$7.48 months and 16.81 $\pm$7.12 months, respectively. There was no significant difference in the duration of operation time including induction time between VATS and thoracotomy, but postoperative hospital stay and chest tube drainage periods were all less for these undergone VATS. Postoperative complication was less in group A(3/38=7.9%, 3 cases with persistent air leak >7days, all developed wound dehiscence, too), than in group B(9/21=42.9%, 8 cases with persistent air leak more than 7days, including 2 wound dehiscence, one recurrence, and the other one case of empyema). In our experience, VATS has the effectiveness of thoracic surgery for treating thoracic problems, has resulted in surgical intervention in spontaneous pneumothorax.

• Journal of Chest Surgery
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• v.56 no.4
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• pp.240-243
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• 2023

Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.

• 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.43 no.6
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• pp.669-674
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• 2010

Background: Spontaneous hemopneumothorax is characterized by the accumulation of air and more than 400 mL of blood in pleural cavity without any apparent cause. It is a rare disease and can cause life-threatening situation. We analyzed clinical reviews of two medical centers to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with 18 spontaneous hemopneumothorax patients was made. Result: These 18 patients were comprised of 15 male and 3 female with average 24.6 years (range 15~46 years). Almost patients (16) underwent a closed thoracostomy initially and 15 patients received video-assisted thoracic surgery (VATS). Mean postoperative chest tube removal was 2.9 days and one complication was post-removal pneumothorax. During the follow-up periods there were no other complications and recurrence. Conclusion: Proper initial diagnosis and management of spontaneous hemopneumothorax prevent significant hypovolemic shock. Video-assisted thoracic surgery should be considered an early surgical management in spontaneous hemopneumothorax. However conservative manage without bleb excision may be effective in selected patients.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.59-62
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• 2009

Background: Pleural drainage following video-assisted thoracic surgery has traditionally been achieved with largebore, semi-rigid chest tubes. Recent trends in thoracic surgery have been toward less invasive approaches for a variety of diseases. The purpose of this study was to evaluate the safety and efficacy of drainage by means of small, soft, and flexible 14Fr Blake drains. Material and Method: Between December 2007 and March 2008, 14Fr silastic Blake drains were used for drainage of the pleural cavity in 37 patients who underwent a variety of video-assisted thoracic surgical procedures at our institution. Result: The average postoperative length of hospital stay was 3.26 days (range, 2~12 days), Blake drains were left in the pleural space for an average of 3.15 days (range, 1~7 days), and the average amount of drainage was 43.8 ml/day. The maximal amount of blood removed daily by a Brake drain was as much as 290 mL. There were no drain-related complications. Blake drains seemed to cause less pain while in place, and particularly at the time of removal. Conclusion: The use of a Blake drain following minor thoracic surgery appeared to be safe and effective in drainage of fluid or air in the pleural space, and were associated with minimal discomfort.

• Journal of Chest Surgery
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• v.43 no.5
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• pp.542-545
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• 2010

Extramedullary hematopoiesis is a common compensatory mechanism of chronic anemia, but an asymptomatic posterior mediastinal mass is rarely diagnosed as an extramedullary hematopoiesis after surgical resection. The differential from neurogenic tumors is important, but fine needle aspiration biopsy is not recommended because of the difficulty of approach and risk of bleeding. Although diagnosis and treatment can involve resection via thoracotomy, video-assisted thoracic surgery may also be a useful strategy. We performed video-assisted thoracic surgery on a 59-year-old man for posterior mediastinal extramedullary hematopoiesis, with no evidence of recurrence or related hematologic diseases.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.454-457
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• 2010

A 42 year old male was admitted for a bony mass on the posterior arc of the left $6^{th}$ rib, which was detected in a multiphasic health screening test. According to the chest computed tomography scan and bone scan, osteochondroma was suspected. He underwent VATS rib resection. There was no vessel or nerve injury. The patient was discharged without any complication on the $4^{th}$ post operative day. The pathological diagnosis was benign fibrous histiocytoma. Generally, posterolateral thoracotomy is needed for rib resection, but we found that there was no difficulty in doing this kind of surgery under a thoracoscopic approach, which has the advantage of better cosmesis.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.812-816
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• 2000

Background ; To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. Material and Method : All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. Result : There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. Conclusion : Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.

• Tuberculosis and Respiratory Diseases
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• v.59 no.5
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• pp.556-560
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• 2005

지방종은 아주 흔한 양성종양이지만 흉막에서 발생한 지방종은 드물다. 대부분 무증상이며 우연히 발견되는 경우가 많다. 단순 흉부 X-선 사진상 양성종괴의 모습을 보이며, 전산화 단층촬영에서 특징적인 균질한 지방으로 구성된 종양의 모습을 보인다. 흉막의 지방종의 경우 다른 종양이나 악성 종양을 배제하기 위하여 개흉술을 통한 종양의 제거를 해왔으나 수술 후 통증이 적고 회복이 빠른 흉강경으로 지방종을 제거한 53세 여자환자 1례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1047-1051
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• 1994

Airway obstruction may be caused by extreme mediastinal shift and rotation after right pneumonecotmy or after left pneumonecotomy in the presence of right aortic arch.We experienced such a complication after right pneumonectomy, so called right postpneumonectomy syndrome. The patient was 28 years old female, and 4 month ago she had undergone right pneumonecotomy via video assisted thoracoscopic surgery[VATS] for endobronchial tuberculus dissemination and secondary pulmonary infection. She was treated by mediastinal repositioning which were composed of substernal fixation of pericardium and insertion of expandable prosthesis of 1000 cc capacity. She had good postoperative course and now she feels no obstructive symptoms.