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

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

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

BACKGROUND: For many years, 10mm videothoracoscope has been widely used in bullectomy of primary spontaneous pneumothorax. However we used a 2mm videothoracoscope to minimize operative wound. Thus, we compared the clinical results of bullectomy using 2mm videothoracoscope with bullectomy using 10mm videothoracoscope. MATERIAL AND METHOD: We analyzed 118 patients who underwent VATS for primary spontaneous pneumothorax from April, 1998 to December, 2000. 2mm videothoracoscope was used in 53 patients(Group A)and 10mm videothoracoscope was used in 65 patients(Group B). The mean age was 20.2+/-6.9 years old in group A and 20.1+/-6.1 years old in group B. The mean follow up was 10.9+/-3.8 months in group A and 11.4+/-4.3 months in group B. RESULT: The operation time was shorter in group A than group B(55.7+/-22.9 minutes, 71.2+/-21.4 minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than group B(7.2+/-3.2 days, 9.2+/-3.6 days, p<0.05). The duration of postoperative chest tube indwelling was shorter in group A than group B(4.7+/-3.1 days, 6.3+/-2.8 days, p<0.05). The duration of postoperative air leakage(0.6+/-2.1 days, 1.0+/-2.4 days, p>0.05), the amount of analgesics(1.38+/-1.0 ampules, 1.7+/-1.4 ampules, p>0.05), postoperative complications(2 cases,7cases,p>0.05) and recurrences(1 case, 1 case, p>0.05) were not statistically different between two groups. Operative wound was smaller in group A than group B. CONCLUSION: There were no adverse results in group A than group B. Furthermore, bullectomy using 2mm videothoracoscope brought us minimized operative wound and good cosmetic results. Thus, we could recommend bullectomy using 2mm videothoracoscope in primary spontaneous pneumothorax.
Chest Tubes ; Follow-Up Studies ; Humans ; Length of Stay ; Pneumothorax* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Wounds and Injuries

Video-assisted thoracoscopic surgery for pediatric patients has gained popularity due to better outcomes than open surgery. For this procedure, one-lung ventilation may be necessary to provide an adequate surgical field. Confirming lung isolation is crucial when one-lung ventilation is required. Recently, we experienced a case in which one-lung ventilation was confirmed by ultrasonography using the lung sliding sign and the lung pulse in an infant. Since lung ultrasonography can be performed easily and quickly, it may be a useful method to confirm lung isolation, particularly in emergency surgeries with limited time, devices, and experienced anesthesiologists.
Emergencies ; Humans ; Infant* ; Lung* ; One-Lung Ventilation ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Ultrasonography*

Myelolipoma in the mediastinum is an extremely rare entity. In this report, we present the case of a 79-year-old asymptomatic man who had three bilateral paravertebral mediastinal tumors. The three tumors were resected simultaneously using bilateral three-port video-assisted thoracoscopic surgery (VATS). There has been no evidence of recurrence within four years after the operation. Multiple bilateral mediastinal myelolipomas are extremely rare. There are no reports in the English literature of multiple bilateral thoracic myelolipomas that were resected simultaneously using bilateral VATS. We also present characteristic features of myelolipomas, which are helpful for diagnosis.
Aged ; Diagnosis ; Mediastinal Neoplasms ; Mediastinum ; Myelolipoma* ; Recurrence ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy

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