Broncho-Pleuro-Gastro-Colonic Fistula: A case report / 대한흉부외과학회지

A fistula between the respiratory and gastrointestinal systems is generally caused by infection and trauma. We experienced a 51-year old man with a broncho-pleuro-gastro-colonic fistula. He complained of chronic foul odor during respiration. He had suffered a traumatic diaphragmatic rupture 30 years ago. The infection of the diaphragm caused necrosis of the right lower lobe of the lung. It also caused a broncho-pleural fistula. The infection also created adhesion and a perforation of the gastric cardiac portion and the colonic splenic flexus portion of the gastro-intestinal track. We performed left lower lobectomy of the lung, reconstruction of the diaphragm and gastro-intestinal reanastomosis.

Surgery for a Muscular Type Ventricular Septal Defect via Right Apical Ventriculotomy: A case report / 대한흉부외과학회지

Apical muscular ventricular septal defects (VSDs) are relatively rare conditions among all the different types of VSDs. Apical VSDs are difficult to treat because of they are difficult to visualize through a trans-atrioventricular approach, and especially in infants. Treatment by left ventriculotomy is associated with long-term ventricular dysfunction. Catheter-based intervention still shows less than satisfactory results and this type of intervention may not be possible in small infants. This report describes the benefits of right apical ventriculotomy in terms of successful closure of the lesion without harming the ventricular function.

Thoracoscopic Bleb Ligation in Patients with Primary Spontaneous Pneumothorax / 대한흉부외과학회지

BACKGROUND: Video assisted thoracic surgery has been widely accepted for the treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: We retrospectively reviewed the medical records of 89 primary pneumothorax patients who had undergone thoracoscopic bleb ligation from February 2002 to June 2006, and we assessed the patients for recurrence. The mean follow-up period was 65 months. RESULT: Pneumothorax recurred in 7 patients (8%) during the follow-up period. CONCLUSION: Thoracoscpic bleb ligation might be an acceptable alternative technique for treating primary spontaneous pneumothorax.

Outcome Comparison of Instrumented Posterolateral Fusion and Posterior Lumbar Interbody Fusion with Cages for Surgical Management of Lumbar Spondylolisthesis in Adults

For the primary fusion of adult's lumbar spondylolisthesis the authors performed either posterolateral fusion(PLF) with transpedicular screw fixation, or posterior lumbar interbody fusion(PLIF) with cages and transpedicular screw fixation, on 75 patients during five years between Jan. 1993 and Dec. 1997. The outcomes were retrospectively reviewed with emphasis on comparison of the results of these two surgical methods. Between patients treated with PLF(PLF group) and PLIF(PLIF group) there were no differences in distribution of preoperative variables such as patients' age and gender, type, level, grade of spondylolisthesis, and symptom durations. Mean follow-up period was 22.3 months in PLF group(n=44) and 17.4 months in PLIF group(n=31) (p<0.001). The rate of fusion was 85% in PLF group, and 94% in PLIF group(p=0.292). The postoperative outcome, expressed as mean follow-up score of Prolo scale, was 6.86 in PLF group and 7.42 in PLIF group(p=0.007). The variables that were associated with the outcomes were the level of spondylolisthesis(p=0.001) and the type of fusion (p=0.023). Variables such as age, gender, type and grade of spondylolisthesis, preoperative symptom duration, radiological findings of fusion status, change in disc height, and change in sagittal angle were not associated with the outcomes. The complication rate was 11% in PLF group and 19% in PLIF group. Overall successful results, defined by 7 or more in follow-up score of Prolo scale, were seen in 68% of PLF group and 87% of PLIF group(p=0.098). It is concluded that better surgical outcomes were obtained by PLIF methods in adults with lumbar spondylolisthesis, but with regards to the incidence of complications, although mostly minor and reversible, was more frequent in PLIF group.