The Effect of Thoracoscopic Sympathicotomy at the 4th Rib (R4) for Treating Palmar Hyperhidrosis / 대한흉부외과학회지

BACKGROUND:Thoracoscpic sympathicotomy is an effective treatment for essential hyperhidrosis. Patients are generally satisfied with the surgery at the early post operative period, but they suffer from recurrence and compensatory sweating at the late post operative period. There are many sympathicotomy methods for minimizing recurrence and the compensatory sweating. We compared the outcome from between the R3 and R4 sympathicotomy methods for the symptoms, satisfaction, recurrence and compensatory sweating. MATERIAL AND METHOD: From January 1999 to July 2007, 39 cases of thoracoscopic sympathicotomy at the 3rd rib (R3) and 72 cases of thoracoscopic sympathicotomy at the 4th rib (R4) for treating palmar hyperhidrosis were compared for the early and late satisfaction, the compensatory sweating and recurrence. RESULT: There is no difference of gender and age for the 2 groups. Early satisfaction was reported by 94.9% of the R3 patients and by 98.7% of the R4 patients. 84.6% of the R3 patients reported late satisfaction and 87.5% of the R4 patients reported late satisfaction. There were no significant differences between the groups for the early and late satisfaction. But there was a difference between the groups for compensatory sweating (23.1% in the R3 group and 9.7% in the R4 group (p=0.020)). The reoperation rate due to recurrence was 5.1% in the R3 group and 4.2% in the R4 group. There was no significant difference between the groups for recurrence. CONCLUSION: R4 sympathicotomy has excellent therapeutic results for compensatory sweating as compared to R3 sympathicotomy for treating palmar hyperhidrosis.

Repair of Postinfarct Subacute Left Ventricular Free Wall Rupture Using Fibrin Glue / 대한흉부외과학회지

The mortality of left ventricular free wall rupture after acute myocardial infarction is high; however, subactue myocardial rupture can be diagnosed by echocardiogram and the use of the intraaortic balloon pump reduces the incidence of re-rupture. Bleeding from subacute myocardial rupture can be managed by employing fibrin glue and several patches. We report here on a case of successfully managed case of subactue left ventricular free wall rupture after acute myocardial infarction with using the sutureless technique and fibrin glue.

Clinical Analysis of Primary Malignant Lymphoma of the Lung / 대한흉부외과학회지

BACKGROUND: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. MATERIAL AND METHOD: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2006. They all had malignant lymphoma on the pathologic examination of the lung with no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. RESULT: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seen with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. CONCLUSION: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

Innominate Artery Rupture after Blunt Chest Trauma / 대한흉부외과학회지

A rupture of an innominate artery caused by blunt trauma is relatively rare because this artery is short and protected by the chest bony cage. This report describes a 25-year-old man who suffered a traffic accident, that resulted in an innominate artery rupture, which was detected by a chest computed tomogram and angiogram. This patient underwent urgent surgery through a right clavicular incision and median sternotomy without a cardiopulmonary bypass due to multiple injuries. An approximately 3 cm sized injury was found from the innominate artery to the proximal right subclavian artery and the origin of the common carotid artery. The injured lesion was repaired with a saphenous vein patch. After surgery, he was discharged from hospital without complications.