Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Thoracic Wall ; surgery

Usually, Bullectomy with VATS requires three ports on a chest wall for thoracosope,endo lung grasper, and endo auto-suture. However, in some case, the author could successfully accomplish operation using the endo-loop through two ports on a chest wall. The technique reduces postoperative pain and decreases operative wound.
Lung ; Pain, Postoperative ; Pneumothorax ; Thoracic Surgery, Video-Assisted* ; Thoracic Wall ; Wounds and Injuries

Nonossifying fibromas are not uncommon, but those described in the rib are unique. We report the case of a 15-year-old patient with symptoms of chest wall pain for 5 days who underwent a video-assisted thoracoscopic rib resection for a 2.5-cm rib mass. Unexpectedly, pathological results revealed a nonossifying fibroma of the rib. The results showed excellent cosmesis and new bone formation because of the preservation of the overlying periosteum.
Adolescent ; Fibroma* ; Humans ; Osteogenesis ; Periosteum* ; Ribs* ; Thoracic Surgery, Video-Assisted* ; Thoracic Wall

We report a case of an entrapped lung after the pectus bar repair of a pectus deformity. The entrapped lung was found incidentally during video-assisted thoracoscopic surgery (VATS) for pneumothorax. Based on VATS exploration, multiple bullae seemed to be the cause of the pneumothorax, but the entrapped lung was suspected to have been a cause of the air leakage.
Congenital Abnormalities ; Incidental Findings* ; Lung* ; Pneumothorax ; Thoracic Surgery, Video-Assisted* ; Thoracic Wall* ; Thoracoscopy ; Thorax*

Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.
Fascia ; Hematoma ; Hemothorax ; Pleura ; Pleural Cavity ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thoracoscopy ; United Nations

We report a case of early intrathoracic migration of Kirshner wire (K-wire), which had been-used for fixation of proximal humerus fracture. A 74 year-old-woman visited the emergency room due to sudden onset of dyspnea. A chest x-ray and CT scan taken at the emergency room demonstrated 3 K-wires that had been applied to the proximal humerus fracture, 1 K-wire in the anterior chest wall, and mild pneumothorax of the right lung. An emergency removal of K-wire using thoracoscopy was performed and a chest tube was inserted for the treatment of pneumothorax during thoracic surgery. We removed residual 3 K-wires from the right proximal humerus and fixed right proximal humerus fracture by open reduction and internal fixation using a proximal humerus locking plate. We think that if a proximal humerus fracture is fixed using smooth K-wire, patients require close follow-up with the use of x-ray until the K-wire has been removed, in addition, it is very important to take steps to prevent K-wire migration.
Chest Tubes ; Dyspnea ; Emergencies ; Humans ; Humerus ; Lung ; Pneumothorax ; Thoracic Surgery ; Thoracic Wall ; Thoracoscopy ; Thorax

Gorham-Stout disease (GSD) was first described by Gorham and colleagues in 1954, but its precise mechanism and cause remain to be elucidated. In this condition, voluminous and potentially fatal chylous effusions into the thorax can occur. Herein, we describe a case of GSD in which the patient presented with massive pleural effusions and mottled osteolytic bone lesions. We performed multiple operations, including thoracic duct ligation using video-assisted thoracoscopic surgery and thoracotomic decortication, but these procedures did not succeed in preventing recurrent pleural effusion and chest wall lymphedema. After administering sirolimus (0.8 mg/m2, twice a day) and propranolol (40 mg, twice a day), the process of GSD in this patient has been controlled for more than 2 years.
Chylothorax ; Humans ; Ligation ; Lymphedema ; Osteolysis, Essential ; Pleural Effusion ; Propranolol ; Sirolimus ; Thoracic Duct ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thorax

Surgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.
Flail Chest/surgery* ; Humans ; Male ; Middle Aged ; Polypropylenes ; Surgical Mesh ; Sutures ; Thoracic Wall/surgery*

OBJECTIVETo investigate reasonable surgical therapy for conjoined twins.

METHODSTwo pairs of gastrothoracopagus were admitted in July 2004 and April 2005 respectively. The first pair was separated by emergency surgery for the rupture of umbilical hernia resulting in the exposure of intestines. The thoracic and abdominal wall was repaired with local skin flaps, and the secondary wound was covered with artificial skin. Skin expanders were embedded in thoracic and abdominal wall 2 months after birth in the second pair. The surgical separation was performed one month after. The deficiencies of pericardium, sternum and abdominal wall were reconstructed by allogenic grafting of pericardium, porous polyethylene implant and monofilament polypropylene patch respectively. The thoracic and abdominal wall was repaired with expanded rotation skin flap.

RESULTSThe first twins died of respiratory failure and circulatory and respiratory failure 2 hours and 39 hours after the separation respectively. Both of the second pair survived and were discharge after healing.

CONCLUSIONSThe separation of gastrothoracopagus should be performed after skin expansion in the interest of the closure of wound. It's better to use porous polyethylene implant and monofilament polypropylene patch to reconstruct the sternum and abdominal wall respectively.

Abdominal Wall ; abnormalities ; surgery ; Fatal Outcome ; Female ; Humans ; Infant ; Infant, Newborn ; Reconstructive Surgical Procedures ; Thoracic Wall ; abnormalities ; surgery ; Twins, Conjoined ; surgery

Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any part of the body. Excessive sweating has a strong negative impact on the quality of life for many persons. From June 1992 to May 1996, 211 cases of thoracoscopic thoracic sympathectomy were performed in the Department of Thoracic Surgery, Yongdong Severance Hospital, Seoul, Korea. Among the 211 cases, 192 patients had palmar hyperhidrosis, and 19 cases had facial hyperhidrosis. There were 121 males and 90 females, and the ages ranged from 10 to 67 years(average: 24.82 years old). The average operation time and the average postoperative hospital stay were 91.94 minutes and 4.31 days, respectively. Perioperative courses were uneventful, and all the patients had immediate and complete relief of symptoms with mild compensatory sweating on the chest wall and the back. Even though a thoracoscopy has the possibility of emergency conversion to a thoracotomy and technical difficulties still exist, especially in patients with facial hyperhidrosis, our experience indicates that video-assisted thoracoscopic thoracic sympathectomy is a very safe and useful procedure for hyperhidrosis.
Emergencies ; Female ; Humans ; Hyperhidrosis* ; Korea ; Length of Stay ; Male ; Quality of Life ; Seoul ; Sweat ; Sweating ; Sympathectomy* ; Thoracic Surgery ; Thoracic Wall ; Thoracoscopy ; Thoracotomy