No abstract available.
Thoracoscopy*

No abstract available.
Thoracoscopy*

BACKGROUND: The purpose of this paper is to present a guideline for beginning video-assisted thoracic surgery (VATS) lobectomy to junior surgeons, and to review the first year experience of a new surgeon performing VATS lobectomies who had not performed a VATS lobectomy unassisted during his training period. MATERIALS AND METHODS: A young surgeon opened a division of general thoracic surgery at a medical institution. The surgeon had performed about 100 lobectomies via conventional thoracotomy during his training period, but had never performed a VATS lobectomy unassisted while under the supervision of an expert. After opening the division of general thoracic surgery, the surgeon performed a total of 38 pulmonary lobectomies for various pulmonary diseases from March 2009 to February 2010. All data were collected retrospectively. RESULTS: There were 14 lobectomies via thoracotomy, 14 VATS lobectomies, and 10 cases of attempted VATS lobectomies that were converted to open thoracotomies. The number of VATS lobectomies increased from the second quarter (n=0) to the third quarter (n=5). The lobectomies that were converted from VATS into thoracotomies decreased from the second quarter (n=5) to the third quarter (n=1) (p=0.002). CONCLUSION: It can take 6 months for young surgeons without experience in VATS lobectomy in their training period to be able to reliably perform a VATS lobectomy.
Learning ; Learning Curve ; Lung Diseases ; Organization and Administration ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy

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 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*

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+/-0.4 days. The mean postoperative hospital stay was 3.4+/-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.
Chest Tubes ; Hemopneumothorax ; Humans ; Hyperhidrosis ; Length of Stay ; Pneumothorax ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

A 24 year old man visited our hospital, because an intrapulmonary foreign body had been found incidentally. Simple chest X-ray showed a 5 cm sized foreign body of metallic density, and chest CT confirmed the foreign body, which was like a sewing needle, in the left upper lobe. We performed a simple extraction of the foreign body using VATS (Video Assisted Thoracic Surgery). After the operation, the patient was discharged without any complications.
Foreign Bodies ; Humans ; Needles* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Young Adult

The bullectomy through the limited transaxillary thoracotomy and video-assisted thoracic surgery (VATS) had been used in operative management of spontaneous pneumothorax from Jan. 1994 to July 1997. The study comprised a retrospective review of 42 cases which were treated by limited thoracotomy, and 61 cases treated by video-assisted thoracoscopic sugery. We retrospectively reviewed annual incidnce of bullectomy. Analysis of video-assised thoracoscopic surgery and open bullectomy including age, sex, operative sites, surgical indications, associated diseases, operative time, posoperatve complications and hospital courses. There was no significant difference for operation time in two groups, 98.3+/-38.4 minutes in thoracotomy and 95.7+/-31.5 minutes in VATS. Prolonged air leakage over 7 days was observed in 8 cases from thoracotomy group, 4 cases from VATS group. 3 cases of recurrent pneumothorax were found from VATS group, but no recurrence was occurred from open bullectomy group. There were significant differences in postoperative hospital stay (8.0+/-3.9 day in thoracotomy vs 5.9+/-2.4day in VATS (P=0.001)), and indwelling period of chest tube after operation ( 5.8+/-3.0day in thoracotomy vs 4.0+/-2.0day in VATS (P=0.0006)).
Chest Tubes ; Length of Stay ; Operative Time ; Pneumothorax* ; Recurrence ; Retrospective Studies ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy*

BACKGROUND: Video-assisted thoracoscopic surgery is good indication of secondary spontaneous pneumothorax. This method usually required general anesthesia and single-lung ventilation with collapse of other lung. But, risks of general anesthesia and single-lung ventilation must be considered in high-risk patients. MATERIAL AND METHOD: Between September 1999 and August 2001, 15 high-risk patients were treated by vedio-assisted thoracoscopic surgery under epidural anesthesia. RESULT: Video assisted thoracoscopic surgery was successfully performed in 15 patients. Duration of postoperative air-leakage was 4.3days, Significance of complication was none, No recurrence of pneumothorax was encountered. CONCLUSION: Video-assisted thoracoscopic surgery can be performed safely under epidural anesthesia for treatment of secondary spontaneous pneumothorax in high-risk patients.
Anesthesia, Epidural* ; Anesthesia, General ; Humans ; Lung ; One-Lung Ventilation ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted ; Thoracoscopy