The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Volume 13 , Issue 7
Showing 1-19 articles out of 19 articles from the selected issue
  • Kan Okabayashi, Yoshifumi Makimoto, Toshikazu Konno, Osamu Ichiguchi, ...
    1999 Volume 13 Issue 7 Pages 811-817
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    Palmar hyperhidrosis, the etiology of which is unclear, is an embarrassing disorder especially for younger persons. Although open thoracic surgery for palmar hyperhidrosis has been described, its clinical application has been rare due to its invasiveness. Recent developments in endoscopic surgery have made the procedure to be reliable, safe and minimally invasive. The purpose of this paper is to report our clinical procedures and outcome. During the period between July 1997 and January 1999, 75 patients (36 males, 39 females) suffering from palmar hyperhidrosis underwent sequential bilateral thoracoscopic sympathectomy (Th 2-4) at our institution. Under general anesthesia in the semi-Fowler position, two small holes were made at the axilla. The invasiveness of this procedure, including cosmetic factor, has decreased according to the caliber of the thoracoscope. The main symptom of palmar hyperhidrosis dramatically resolved with a high improvement ratio (99.3%), and also that of sole hyperhidrosis is 54.7%. Compensatory sweating, which is the most troublesome complication of the procedure, occurred in 64% of the patients. Neuralgia and pen-operative bleeding were relatively common complications but there was no mortality or Horner's syndrome. Many patients were highly satisfied with this procedure, with the satisfactory score reaching 93.2 points out of 100.
    Download PDF (1685K)
  • Mikio Watanabe, Yoshihiko Osaka
    1999 Volume 13 Issue 7 Pages 818-822
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    Between January 1990 and June 1999, 10 patients were admitted to our hospital because of tuberculous abscess in the chest wall. Seven patients were men and three were women. Three cases had a past history of pulmonary tuberculosis and one was suffering active pulmonary tuberculosis. Acid-fast bacilli were identified in nine cases. Chest CT examination revealed an oval low density mass with localized pleural thickness in the chest wall. Surgical treatment was performed in all cases without any complications. Two cases relapsed and surgical treatment was needed again. Physical and chest CT examinations are useful for diagnosis. Recently pulmonary tuberculosis is not decreasing in Japan, so tuberculous abscess of chest wall may continue to occur in future.
    Download PDF (1212K)
  • Toshio Fujimoto, Akira Yamanaka, Takashi Hirai
    1999 Volume 13 Issue 7 Pages 823-827
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    We report 9 cases of mediastinal cysts extirpated under thoracoscopy and assess the usefulness of video-assisted thoracic surgery (VATS) for this disease entity.
    From April 1993 to March 1998, a total of 9 patients (total 10 operations) who underwent VATS for mediastinal cysts were evaluated. The patients, who comprised 5 males and 4 females, ranging from 42 to 58 years of age, had four bronchogenic cysts, two thymic cysts, one cystic lymphangioma, one mesothelial cyst and two serous epithelial cysts of unknown origin. At operation, three trocars were used in six cases, four trocars in one case, and mini-thoracotomy was added in two cases. In the other one, a portion of the right second costal cartilage was excised from a small parasternal skin incision at the anterior chest and one trocar was used for visualization. The mean operation time was two hours twenty-seven minutes. The mean hospitalization period was 13.9 days. All are alive with no recurrences or complications.
    We conclude that VATS is a feasible and efficacious method for resection of mediastinal cysts.
    Download PDF (585K)
  • Motohiro Nishimura, Yasushi Iwasaki, Tsunehiro Ii, Daishirou Kato, Sho ...
    1999 Volume 13 Issue 7 Pages 828-831
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    Late-onset myasthenia gravis is rare and only 5 cases in patents over 80 years of age have been reported in the Japanese literature.
    An 82-year-old man with chief complaints of a nasal voice and dysphagia was diagnosed as having myasthenia gravis (Osserman IIB). He had an anterior mediastinal tumor on chest CT and X-ray, with an elevated serum level of antiacetylcholine receptor antibody (2.9ng/ml). An extended thymectomy was performed. The resected specimen was a yellowish, elastic soft mass 5 cm in diameter, including a cystic component 1.5 cm in diameter. After the operation, the patient's symptoms improved markedly and his serum antiacetylcholine receptor antibody decreased to 0.9ng/ml. He was discharged on the 22nd postoperative day without any complications and has been in complete remission for one year since the surgery.
    Download PDF (612K)
  • Morio Ohta, Keiichiro Genka, Kiyoshi Ishikawa, Masayuki Kuniyoshi, Tsu ...
    1999 Volume 13 Issue 7 Pages 832-837
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    An 18-year-old woman was admitted to our hospital with hemoptysis and abnormal shadow on chest X-ray.
    Chest X-ray film revealed complete atelectasis of the left lower lobe. Bronchoscopic examination showed complete obstruction of the left lower lobe bronchus by a polypoid tumor. Biopsied specimen of the tumor was diagnosed as a low-grade malignant mucoepidermoid carcinoma. Left lower lobectomy with bronchoplasty was performed. The polypoid tumor was 20×13 mm in size and protruded from the bronchial wall into the orifice of left B6. Postoperative histological examination revealed no metastases in the mediastinal lymphnodes. The postoperative course was uneventful. One year and 6 months has passed with no evidence of recurrence. The clinical and pathological features of 29 cases of mucoepidermoid carcinoma under the age of 40 years reported in the Japanese literature were reviewed.
    Download PDF (1751K)
  • Iimo Mikami, Makoto Gomibuchi, Daisuke Okada, Kiyoshi Koizumi, Shigeo ...
    1999 Volume 13 Issue 7 Pages 838-843
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    We encountered a rare case of von Recklinghausen's disease with hemothorax. A 51-year-old male with von Recklinghausen's disease consulted us for chest discomfort. A chest roentgenogram revealed left pleural effusion, and he was admitted to our hospital. Pleural fluid aspiration revealed blood in transition to an empyema. The cause of the hemothorax and its association with neurofibromatosis were not diagnosed preoperatively. His left lung function was extremely poor and no tumor could be seen intraoperatively. Therefore, left panpleuropneumonectomy was performed. He has been asymptomatic for 30 months after the operation. We have observed the patient extremely carefully because of the risk of rebleeding.
    Download PDF (1920K)
  • Koichi Fujiu, Ryuzo Kanno, Hiroyuki Suzuki, Yutaka Shio, Ryo Satoh, Ak ...
    1999 Volume 13 Issue 7 Pages 844-849
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 39-year-old man was admitted to our hospital with a 6-month-history of leg weakness, and numbness of the lower trunk and both legs. Romberg sign was positive. Chest X-ray showed round mass 3.5 cm in diameter at the upper mediastinum. Chest CT demonstrated a heterogeneously-enhanced posterior mediastinal tumor at the T3-T4 level which extended into the spinal canal via the intervertebral foramen. MR imaging showed a hypointense mass on T1-weighted and heterogeneous hyperintense mass on T2-weighted. Angiography showed that the tumor was stained with the left 3rd intercostal artery. An extradural part of the mass was removed by laminectomy from T1 to T4. However, profuse bleeding during the operation made us schedule the second look for the intrathoracic mass two months later. The pathologic diagnosis of both lesions was angiolipoma. 23 months after the first operation, the patient was followed in our clinic without any sign of recurrence and without neurological complications.
    Download PDF (1683K)
  • Kazutoshi Kotani, Ryohei Higashi
    1999 Volume 13 Issue 7 Pages 850-853
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    Three cases of thymic cyst were treated by operation. Some tumor markers were elevated in the cystic fluid. CEA and SLX were elevated in all cases. CA19-9 and SCC were elevated in 2 cases. CA 125 was elevated in 1 case. Immunohistological analysis showed the epithelial cells lining the cyst to contain CA 125 in 2 case and CA19-9 in 1 case. Immunohistological analysis showed the epithelial cells lining the cyst to contain CEA in no case.
    I think that the results indicate that the concentration is very important cause for elevation of tumor markers in the thymic cyst.
    Download PDF (988K)
  • Masaaki Sano, Osamu Tanamura
    1999 Volume 13 Issue 7 Pages 854-857
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 73-year-old man consulted our hospital with a complaint of dyspnea on exertion.
    He was diagnosed with primary cervical tracheal adenoid cystic carcinoma by chest X-ray, CT and bronchoscopy.
    Although a cricotracheal anastomosis after cylindrical tracheal resection was performed, the tumor infiltrated beyond the 1st tracheal cartilage. He received 70 Gy. irradiation postoperatively. The clinical course after radiotherapy was uneventful without any recurrence of the tumor. Because a case of adenoid cystic carcinoma infiltrating to the larynx is considered rare, we reported our case.
    Download PDF (1373K)
  • Norikazu Urabe, Yoshihiko Kageyama, Katsuya Watanabe
    1999 Volume 13 Issue 7 Pages 858-861
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    Salvage surgery was performed on a 52-year-old woman with cT4N0M0 squamous cell carcinoma. She presented with fever and cough, and the chest X-ray film showed atelectasis of the upper right lobe. Computed tomography (CT) showed tumor infiltration of the superior vena cava (SVC), so the tumor was diagnosed as cT4N0M0. Although restaging after two cycles of chemotherapy with cisplatin and etoposide plus irradiation (60 Gy) revealed downstaging to cT2N0M0, she refused surgical treatment. At 16 months after therapy, CT showed local progression. Therefore, right pneumonectomy and partial resection of the SVC was performed. She is currently alive. and disease free at 57 months after the start of chemoradiotherapy and 34 months after this operation.
    Download PDF (869K)
  • Mitsukuni Suenaga, Hidehiko Matsumoto, Huminori Sakamoto, Hiroki Ogawa ...
    1999 Volume 13 Issue 7 Pages 862-867
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 32-year-old female was treated with video-assisted thoracic surgery (VATS) for bronchogenic cyst in the posterior mediastinum. The tumor was peanut shaped and was located at the right side between the eighth and ninth dorsal vertebrae.
    A neurogenic tumor which consisted of two components such as blood and mucin was suspected.
    A diagnosis of bronchogenic cyst was established by resection. The monolocular upper portion was filled with white jelly and the multilocular lower portion was filled with muddy fluid. They had no communication to each other.
    According to the literature, no a peanut shaped bronchogenic cyst has been described.
    Download PDF (2641K)
  • Masazumi Watanabe, Tomohiro Abiko, Arifumi Iwamaru, Masatoshi Gika, Ka ...
    1999 Volume 13 Issue 7 Pages 868-871
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 26-year-old woman was referred to our hospital because of an abnormal shadow on the chest X-ray. Chest CT scan revealed a coin lesion (about 2.5 cm diameter) with smooth border near the right middle lobe bronchus that suggested low-grade malignant tumor or inflammatory nodule. Video-assisted thoracoscopic middle lobectomy was performed. The lesion was diagnosed as a inflammatory pseudotumor of the lung histopathologically. The patient was discharged on postoperative day 10. Lobectomy has been performed for 60% of such cases reported in the literature, but lobectomy by video-assisted thoracic surgery as a less invasive technique for the disease may become a more appropriate alternative procedure.
    Download PDF (1681K)
  • Shinji Shimatani, Shiro Yamazaki, Shuichi Sasamoto, Osamu Kudo, Tsutom ...
    1999 Volume 13 Issue 7 Pages 872-876
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 45 year-old man, whose left lateral chest had been injured about 2 weeks earlier, was admitted to our hospital. His clinical diagnosis was left clotted hemothorax and multiple rib fracture. Drainage of the thoracic space with the thoracic catheter was performed, but reexpansion of the lung was inadequate due to the presence of residual clot. So we performed video-assisted thoracic surgery (VATS) to remove the clot. We could examine the contents of the thoracic space by Video assisted thoracoscopy and performed drainage, irrigation and decortication through the minimal thoracotomy window. The post operative course was uneventful. The lung was re-expanded on the chest X-ray films, and respiratory function improved. We concluded that the clotted hemothorax after chest trauma may be a good indication for VATS.
    Download PDF (1813K)
  • Yuuichi Hashimoto, Shigeki Sugiyama, Yoshinori Doki, Kazuhiro Mino, Mo ...
    1999 Volume 13 Issue 7 Pages 877-882
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 17-year-old patient with an asymmetric pigeon chest (Robicsek type III), favorably reduced by a modified Ravitch operation, is reported.
    Among thoracic deformities, the incidence of funnel chest is higher than that of pigeon chest. Various operations such as a sternal turnover, sternal elevation, and Ravitch operation have been performed for funnel chest. These operation methods have been improved in various ways, but there seems to be no standard operation method for pigeon chest, since its frequency is lower. Pigeon chest usually causes fewer clinical problems, because the deformity protrudes forward. In the present study, we employed a modified Ravitch operation in which a wedge was added by osteotomy to the dorsal surface of the sternum body. This surgery relieved the torsion at the sternum and also enabled us to reduce the asymmetric pigeon chest relatively easily without being concerned about the hardness of the bony chest wall. As a result, this surgical procedure was useful for asymmetric pigeon chest (Robicsek type III). Five years and ten months following the operation, the subject has not suffered any recurrence of distortion.
    Download PDF (1855K)
  • Fuyuhiko Yasuda, Motoshi Takao, Min Sai, Shinji Kaneritsu, Akira Shima ...
    1999 Volume 13 Issue 7 Pages 883-887
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    We here reported three cases of post-thymomectomy myasthenia gravis (post-Tmx MG).
    The first case was a 42-year-old woman who developed post-Tmx MG two years following extended thymo-thymectomy. She had muscle pain and muscle weakness of the extremities. Her symptom was improved by administration of steroid. The second case was a 68-year-old woman who had been symptom-free for eight years after thymectomy. Following interferon administration for type-C hepatitis, she developed post-Tmx MG.
    Her symptom disappeared after extended thymectomy. The third case was a 34-year-old man who had undergone completion thymectomy at first operation. One month later, he suffered from general muscle weakness and fell into crisis requiring mechanical ventilation and plasmapheresis. Two months later, extended completion thymectomy was performed and his symptom was gradually improved. Complete total thymectomy, along with excision of perithymic mediastinal fat, should be the first-line treatment of post-Tmx MG in cases which did not undergo extended thymo-thymectomy at first operation for thymoma.
    Download PDF (1065K)
  • Shuji Sato, Akihiro Oda, Jun Asakura, Hideyuki Suzuki, Tadashi Akiba, ...
    1999 Volume 13 Issue 7 Pages 888-892
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 54-year-old male had been diagnosed with neurilemmomatosis because of previous operations of multiple cutaneous and spinal neurilemmomas. He was admitted to our hospital for increasing size of abnormal shadows on chest X-ray film for three years. Chest CT and MRI demonstrated bilateral multiple chest wall tumors. These tumors were resected simultaneously under video-assisted thoracoscopic surgery. Intraoperative findings showed four tumors arising from the right 9th intercostal nerve and two tumors from the left 10th intercostal nerve. Histological examination of the tumors revealed neurilemmoma. Neurilemmomatosis with neurilemmoma arising from the intercostal nerve is rare and bilateral multiple neurilemmomas of the chest wall are also rare.
    Download PDF (1663K)
  • Nobumasa Hamaguchi, Mitsuteru Yoshida, Masafumi Tamaki, Noriaki Fujish ...
    1999 Volume 13 Issue 7 Pages 893-897
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A case of late complication after extraperiosteal paraffin plombage is reported. The patient was a 53-year-old male, right upper lobectomy was performed 26 years previously for pulmonary tuberculosis. Postoperative empyema with bronchopleural fistula was noted. After open drainage thoracotomy, he received extraperiosteal paraffin plombage. He complained a sense of tightness in the right portion of the chest, and subcutaneous soft tumor in the right infrascapular region was observed 4 months before admission. The chest roentgenogram and CT scan revealed an expanded plombage space. CT scan and MRI revealed multiple soft tumors in the expanded plombage space. Plombaged paraffin was removed and the soft tumors were resected. The space was closed by transposition of pedicle muscle flaps obtained from the right latissimus dorsi and serratus anterior. His postoperative course was uneventful and he was discharged on the thirty-fourth day after the operation. Pathologically, vessels with dilated lumen, bleeding and degenerated tissue were noted in the soft mass. In patients who had received extraperiosteal paraffin plombage, long-term postoperative follow up should be made.
    Download PDF (1639K)
  • Seiji Matsumoto, Kazumasa Takenaka, Kazuo Maezato
    1999 Volume 13 Issue 7 Pages 898-903
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 24-year-old woman consulted a doctor for left-side back pain. Because X-ray films of the chest revealed the lytic lesion of the fifth left rib, she was referred to our hospital. A CT scan and MR image of the chest revealed a mass invading the chest wall particularly in the area of the fifth rib. A thoracoscopic picture showed a lesion at the fifth rib extensively involving the chest wall, and partial resection of the left fifth rib was performed. The histopathological examination showed markedly increased eosinophils, and a large number of histiocytes which were positive to the S-100 protein and stained brown. Total dose of 9 Gy of Local radiotherapy, oral steroids and systemic chemotherapy were used because of the extensiveness of the lesion, and as a result, the symptoms improved.
    Download PDF (2217K)
  • Shinji Kanemitsu, Motoshi Takao, Tomoaki Suzuki, Kazuya Fujinaga, Akir ...
    1999 Volume 13 Issue 7 Pages 904-909
    Published: November 15, 1999
    Released: November 11, 2009
    JOURNALS FREE ACCESS
    A 31-year-old female with multiple metastatic lung cancer from uterus cancer underwent partial resection of bilateral lungs. Persistent air leakage following partial lung resection was treated by the conservative therapy of pleurodesis with closed drainage and bronchoscopic fibrin gluing. Unfortunately, it was unsuccessful. On the 26th postoperative day, as Aspergillus fumigatus was cultured from pleural effusion, the diagnosis of aspergillus empyema due to bronchopleural fistula was confirmed. Fluconazole was intravenously given, and Amphotericin-B was infused into the empyema cavity every day. One month later, pleural fluid became serous and grew neither fungus nor bacterium. Thereafter we successfully performed closure of the bronchopleural fistula by GRFG gluing and omentopexy. We believe GRFG gluing to be an effective and curative method for bronchopleural fistula.
    Download PDF (2367K)
feedback
Top