Is prophylactic treatment of contralateral blebs in patients with primary spontaneous pneumothorax indicated?

Objectives: More than 50% of patients with primary spontaneous pneumothorax have contralateral blebs/bullae, and about a quarter will develop a contralateral pneumothorax. The purpose of this prospective study was to determine the need for elective treatment of asymptomatic contralateral blebs/bullae in patients presenting with primary spontaneous pneumothorax.

Methods: From May 2006 through June 2008, results from 35 patients with ipsilateral primary spontaneous pneumothorax without contralateral blebs receiving unilateral video-assisted thoracic surgery, 35 patients with ipsilateral primary spontaneous pneumothorax with contralateral blebs receiving unilateral video-assisted thoracic surgery, and 16 patients with ipsilateral primary spontaneous pneumothorax receiving bilateral video-assisted thoracic surgery for positive contralateral blebs were collected.

Needlescopic video-assisted thoracic surgery for primary spontaneous pneumothorax.

Minimally invasive surgery is the current trend of approach in various fields. Since May 2006, our team has started implementing needlescopic video-assisted thoracic surgery as the standard surgical treatment for primary spontaneous pneumothorax. During a seventeen-month period, 62 consecutive patients with primary spontaneous pneumothorax were operated on.

Video-assisted extrathoracic bleb excision: an ultra-minithoracotomy for primary spontaneous pneumothorax.

Video-assisted thoracic surgery (VATS) is the treatment of choice for uncomplicated primary spontaneous pneumothorax (PSP). In this study, we design a modified thoracoscopic procedure and compare it with the standard VATS. Between January 2001 and July 2003, fifty-two consecutive patients with PSP were managed with the modified procedure, called video-assisted extrathoracic bleb excision (VAEB).

Is video-assisted thoracic surgery indicated in the first episode primary spontaneous pneumothorax?

Primary spontaneous pneumothorax (PSP) is a very common disease and recurrence is a major concern for the post-first-time victims. Owing to the convenience and popularity of video-assisted thoracoscopic surgery (VATS), should we still wait for recurrence before we perform this minimal invasive procedure to cure the disease? Between 1997 and 2002, 51 patients of PSP from the first episode received VATS the day after their admission at Kaohsiung Medical University Hospital. Forty-five patients (90%) were found to have blebs (mostly above the upper lobe).

Treatment of palmar hyperhidrosis: T(4) level compared with T(3) and T(2).

Objective: The aim of this study was to compare the outcomes of 3 different levels of sympathectomy.

Summary Background Data: Most surgeons still perform T(2) or T(2-3) sympathectomy for palmar hyperhidrosis, but both these treatments can cause severe side effects. Some recent articles have advocated T(4) sympathectomy and obtained satisfactory results.

Retrospective comparison of needle thoracoscopy and conventional thoracoscopic surgery to treat primary spontaneous pneumothorax.

Objective: To retrospectively compare needle video-thoracoscopic surgery (NVTS) with conventional video-thoracoscopic surgery (CVTS) for the treatment of primary spontaneous pneumothorax.

Methods: The charts of 9 female and 66 male patients with onset of primary spontaneous pneumothorax between July 1999 and December 2005 were reviewed. Twenty-two patients in the NVTS group were treated with NVTS, using a needle-shaped thoracoscope and instruments (3-mm in diameter), and assisted by one 10-mm standard port, whereas 53 patients in the CVTS group were treated using conventional endoscopic devices with a 10-mm thoracoscope.

Characteristics of thymoma successfully resected by videothoracoscopic surgery.

Purpose: The inclusion criteria were established for a videothoracoscopic resection of early-stage thymoma. We retrospectively evaluated the validity of these criteria in the treatment of early-stage thymoma.

Methods: The computed tomography (CT) image characteristics and clinical information comprised these criteria.

Early video-assisted thoracic surgery for primary spontaneous hemopneumothorax.

Introduction: Primary spontaneous hemopneumothorax (PSHP) is a rare surgical emergency. The aim of this study was to compare the previous strategy of tube thoracostomy followed by thoracotomy when complications developed with early video-assisted thoracic surgery (VATS) for PSHP.

Methods: Between November 1989 and May 2005, a total of 24 consecutive patients with PSHP were retrospectively reviewed.

Revisit of 1997 TNM staging system--survival analysis of 1112 lung cancer patients in Taiwan.

Background: There is neither a nation-wide nor a large-scale, multi-institutional lung cancer database available for stage-by-stage survival analysis in Taiwan at present.

Methods: Using the data element provided by the International Association for the Study of Lung Cancer, the Taiwan Lung Cancer Society initiated a project to include native lung cancer patients into a global database. A total of 1112 Taiwan lung cancer patients treated in 7 medical centers were enrolled.

Expandable metal stents as an alternative treatment of cuff-related tracheal stenosis in tracheostomy-dependent ventilated patients: a prospective study of nine cases and description of the complications.

Background And Aims: In long-term intubated patients, cuff-related tracheal injury is occasionally complicated by tracheal stricture. To keep the airway patent, bougienage and deployment of stents are adopted in patients unfit for surgery.

Materials And Methods: Prospectively, nine episodes of cuff-related tracheal stricture in nine tracheostomy-dependent ventilated patients were treated with pre-stenting bougienage, followed by implantation of expandable metal stents (EMS).

Different outcomes between two sides after bilateral sympathetic ganglion interruption for hyperhidrosis.

Background: Although the determination of the correct ganglion under direct vision through thoracoscopy by an experienced surgeon is almost unerring, there is still a 4.3% rate of clipping at the unintended level.

Methods: Through the review of the most recent patients (N = 117) with various sympathetic disorders undergoing thoracoscopic sympathetic interruption over different ganglions by clipping, we found that 5 cases were clipped at the unplanned level.

Perforated diverticulum: rare complication of interposed substernal colon.

Substernal colon interposition is a good reconstruction option after salvage surgery for caustic ingestion injury. Although redundancy and reflux sometimes complicate these cases, there have been no reports in the English literature of perforated diverticula in interposed colon segments. We report a 23-year-old man who underwent substernal colon flap reconstruction after caustic ingestion injury.

The outcome of ganglion clipping in hyperhidrosis and blushing.

A total of 114 patients with various sympathetic disorders underwent endoscopic sympathetic block over different thoracic ganglions by the clipping method. The advantages of this method include the recognition of the clipped level, changeability, and reversibility. However, 4.

Videothoracoscopic resection of stage II thymoma: prospective comparison of the results between thoracoscopy and open methods.

Study Objectives: Although videothoracoscopic (VTS) resection of Masaoka stage I thymoma has been reported to be a less invasive method than open thoracotomy and to achieve a comparable surgical outcome, the usefulness of this method in the treatment of stage II thymoma has not yet been prospectively evaluated. We therefore compared the VTS and open (median sternotomy) methods to see whether VTS resection could be used as successfully to treat stage II thymoma disease.

Design, Setting, And Patients: Patients (11 women and 11 men) with stage II thymoma were prospectively enrolled between November 1999 and September 2004.

Giant fibrolipoma in the mediastinum: an unusual case.

A 50-year-old man presented with a middle and posterior mediastinal mass on chest radiograph and computed tomography. Surgical exploration revealed a large dumbbell-shaped lipomatous lesion. Histologic examination confirmed this to be a fibrolipoma.

Overexpression of circulating c-met messenger RNA is significantly correlated with nodal stage and early recurrence in non-small cell lung cancer.

Background: The c-met receptor and its ligand hepatocyte growth factor have been shown to be involved in tumor invasiveness and metastasis. Overexpression of c-met has been demonstrated in lung cancer tissues and cell lines, but the expression of c-met in peripheral blood (circulating c-met) has not been addressed. The molecular monitoring of circulating c-met could be helpful for selecting patients for adjuvant therapy.

Sympathetic hypertensive syndrome: a possible surgically curable type of hypertension.

Poorly controlled hypertension was incidentally cured after performing an endoscopic sympathetic block (ESB) in a patient with hyperhidrosis craniofacialis (HHC). A survey of the literature indicated that 30% to 40% of essential hypertension is of sympathetic origin. Patients with facial sweating associated with hypertension were then studied to determine whether blood pressure is lowered after performing ESB.

T4 sympathectomy for palmar hyperhidrosis: an effective approach that simultaneously minimzes compensatory hyperhidrosis.

Compensatory hyperhidrosis (CH) is the most troublesome side effect after T2 sympathectomy for palmar hyperhidrosis (PH). The aim of this study was to evaluate whether T4 ganglion interruption for PH is an effective approach that can simultaneously minimize the rate of CH. Between July 2001 and July 2003, 84 PH patients undergoing bilateral thoracoscopic T4 sympathectomy were followed up in the outpatient clinic and by telephone questionnaire.

Different impact from betel quid, alcohol and cigarette: risk factors for pharyngeal and laryngeal cancer.

The risks of betel quid chewing with or without tobacco, alcohol drinking and cigarette smoking have been well explored in the oral cavity but not in the pharynx and larynx. We conducted a case-control study to investigate the association of these three risk factors to cancers of the pharynx and larynx in Taiwan. A total cases of 148 pharyngeal cancer, 128 laryngeal cancer and 255 hospital controls, all men, were recruited.

Transthoracic or transhiatal resection for middle- and lower-third esophageal carcinoma?

Transthoracic esophagectomy (TTE) and transhiatal esophagectomy (THE) are two common methods of resection for esophageal cancer. Although many studies have been performed in Western countries, there are still controversies over which method is the better procedure. In this study, postoperative improvement in dysphagia and the degree of postoperative pain were compared.

Prospective comparison between endosuturing and endostapling in treating primary spontaneous pneumothorax.

Objective: Direct management of ruptured pulmonary blebs remains the definitive treatment for spontaneous pneumothorax. We compared endosuturing and endostapling performed via thoracoscopy to determine if suture closure of the blebs without resection was sufficient to treat primary spontaneous pneumothorax.

Methods: Nine female and forty-nine male prospective patients were prospectively enrolled into two groups between July 1999 and May 2003.

Do pulmonary hemodynamics change after effective lung volume reduction surgery for emphysema?

The improvement in lung function, exercise test, blood gas levels, and symptoms in emphysema patients after volume reduction surgery is a result of improvements in breathing mechanics. The question is, is the improvement in the condition related to pulmonary hemodynamics? Few studies have examined pre- and postoperative pulmonary pressure. This paper examines whether there is any significant change in systolic and diastolic pulmonary pressure after effective volume reduction surgery.

Video-assisted thoracoscopic suture closure of blebs to treat primary spontaneous pneumothorax.

Background And Objectives: If surgery is indicated for primary spontaneous pneumothorax (PSP), video-assisted thoracoscopic surgery (VATS) using an endoscopic linear cutter to resect the involved blebs is the most popular treatment. We tried to determine whether closure of the blebs with sutures without resection is also efficacious enough to treat PSP.

Methods: We prospectively analyzed 22 episodes of PSP in 21 patients from January 2001 to April 2002.

Exogenous lipoid pneumonia: serial chest plain roentgenography and high-resolution computerized tomography findings.

Between May 1988 and July 2002, six patients with pneumonia due to diesel, animal, or vegetable oil aspiration were admitted to Kaohsiung Medical University Hospital. The purpose of this study was to demonstrate distinctive radiographic findings of oil-induced lipoid pneumonitis on initial serial chest roentgenograms and high-resolution computerized tomography (CT) scans. Initial chest roentgenograms (n = 6), CT scans (n = 6), and roentgenography and CT follow-up studies were analyzed retrospectively by two chest radiologists and two surgeons, focusing on the pattern and distribution of parenchymal abnormalities.