• Journal of Chest Surgery
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• v.31 no.5
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• pp.540-543
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• 1998

A patient with post-pneumonectomy empyema was treated sucessfully by modification of Clagett's operation after closure of bronchopleural fistula using a transsternal, transpericardial approach. His primary disease was pulmonary tuberculosis, and he had a past history of left upper lobe lobectomy 34 year ago. Recently recurred pulmonary tuberculosis with aspergilloma in the remaining left lung, empyema with bronchopleural fistula had developed on the post-operative 4th day after completion pneumonectomy. Closed thoracostomy was done at the lowest point of the left pleural cavity immediately. The pleural cavity was irrigated with small amount of normal saline through pigtail catheter. The 2nd operation was done by closure of bronchopleural fistula using a stapler through transsternal, transpericardial approach, and then the pleural space was irrigated with normal saline with Tobramycin which shows sensitivity to isolated organism from pleural cavity. After negative conversion of pleural fluid culture, we performed modified Clagett's operation under local anesthesia. The patient had no evidence of recurrence of empyema and discharged from hospital after 10 days of the 3rd procedure.

• Radiation Oncology Journal
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• v.25 no.3
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• pp.177-184
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• 2007

Purpose: To evaluate the palliative effect of endobronchial brachytherapy (EBB) for patients with lung cancer that previously received external beam radiotherapy (EBRT). Materials and Methods: From July 1992 to May 2003, 29 patients with a recurrent or persistent lung cancer were treated with palliative EBB at our institute. EBB consisted of three fractions (once a week) of a dose of 5 Gy using the high dose-rate remote afterloader. Symptomatic improvement was assessed subjectively, and patients were divided into two groups according to whether symptoms were improved or not. Factors such as age, performance status, duration from EBRT to EBB and the location of the tumor were compared between the improved and unimproved groups of patients. Results: Overall symptomatic improvement was found in 27 out of 52 symptoms (52%). Improvement as to the type of symptoms was seen in 41 %, 50%, 82% and 33% of patients with cough, dyspnea, hemoptysis, and obstructive pneumonia respectively. The rate of improvement of hemoptysis was more than that of cough (p<0.05). The median time to symptom relapse was 5 months. The improved patient group (n=17, 59%) had a better performance status and longer duration from EBRT to EBB than the unimproved patient group (p<0.05). Lesions located in the distal trachea and/or main bronchus were found more frequently in the improved group of patients than in the unimproved group of patients, but the difference was not statistically significant (p=0.06). Fatal complications developed in two patients (7%), which were a hemoptysis and bronchopleural fistula respectively. Conclusion: Symptom improvement was found in 60% of patients after EBB and improvement was maintained for 5 months. Palliative EBB, even when EBRT was given previously, can be effective for a patient that has an endobronchial symptom, such as hemoptysis, and for a patient with good performance and a long duration from previous EBRT to EBB.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.73-76
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• 2002

Adenoid cystic carcinoma is a very slowly growing and directly invasive cancer. The treatment of choice is complete surgical resection but if major complications associated with remaining carcinoma occur, aggressive conservative treatment to prevent complication is able to gain long term survival even though remaining carcinoma metastases to other organs. We experienced a case of surgical treatment of uncontrollable fever that caused by multiple lung abscesses due to obstruction of left main bronchus with adenoid cystic carcinoma. The post operative course was uneventful for 4 months to now.

• Journal of Chest Surgery
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• v.4 no.2
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• pp.91-94
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• 1971

Benign papillary tumors commonly arise in the upper respiratory tract but are rare in the lower respiratory tract, especially in the bronchi. Solitary benign papillary tumors arising at the bronchi,covered with stratified squamous epithelium and associated with little or no inflammatory cell response,seem to be rarest of all types of benign bronchial tumors. Only six cases of such tumors had been reported in the medical literature over the past 74 years until 1968. The following is a case report of solitary benign papilloma arising at the opening of the left main bronchus which was treated with bronchoscopic removal at Chest Surgery Depariment, N.M.C. on Sept.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.924-927
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• 1995

Main bronchial injury after blunt trauma is very rare in all bronchial injuries and the pathogenesis is variable and not well known in everycases. We report a case of complete transsection of right main bronchus by blunt trauma. This 24-year old patient was transferred from a local hospital with a chest tube. Because of the severe subcutaneous emphysema and tension pneumothorax, we inserted one more chest tube resulting no obvious interval change. With the impression of bronchial injury, we performed an exploratory thoracotomy. We couldn't proceed bronchoscopy in the operation room because of his unstable vital sign. After opening of the chest wall, we could identify completely transsected right main bronchus. We anastomosed the bronchus with 4~0 Vicryl interruptedly. After operation, the patient was recovered without any complication.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.92-94
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• 2004

Mucoepidermoid carcinoma of the lung is extremely rare. This rare tumor arise beyond the carina, usually main stem bronchi, but occasionally in lobar or segmental airways, This tumor presents with symptoms of bronchial irritation or obstruction. Distant metastasis is an uncommon, therefore complete surgical resection is the treatment of the choice. The prognosis of this tumor correlates with the histologic grade of the tumor. We experienced a case of mucoepidermoid carcinoma arising from the right middle lobe, which was treated with the right middle lobectomy, with good result. We report this case and follow-up of the patient.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.843-846
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• 1997

Congenital bronchial atresia is one of the rare bronchopulmonary anomalies which is thought to be caused by a vascular insult of uncertain timing during fefal development. It is defined as an anomaly which does not have communication between a segmental or lobar bronchus a'nd the main airway. Because of the collateral ventilation, almost all of these cases show hyperlucency of the involved segment or lobe in chest roentgenogram. We report an extremely rare case of congenita bronchial atresia with collapse of the right upper lobe which was treated by surgical resection.

• Korean Journal of Bronchoesophagology
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• v.4 no.2
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• pp.225-230
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• 1998

Mucoepidermoid carcinoma of the lung is a very rare and potentially malignant tumor that arises from submucosal gland of the trachea and bronchi. We experienced two cases of mucoepidermoid carcinoma which was located in the left main bronchus and right intermediate bronchus. They were treated with left sleeve resection and right bilobectomy. Postoperative course was uneventful, and the followed up for each of them was 3 year and 18 months without any evidence of recurrence.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.204-208
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• 2000

Endobronchial metastases from extrathoracic primary malignancies are uncommon. Breast, renal, and colonic carcinomas are primary sites most likely to give rise to endobronchial metastases. A number of other tumours have been reported as being complicated by endobronchial metastasis, including ovarian, thyroid, uterine, adrenal, testicular and prostatic carcinomas. The incidence of endobronchial metastasis has been estimated at 2% in patients who died of metastatic disease. Lung parenchymal metastases are common manifestations in patients with rectal cancer, however spread to the major airway is extremely rare. We herein report a case of endobronchial metastasis from rectal adenocarcinoma. A 69-year-old male patient who had been previously treated with surgical resection with rectal cancer presented with a 8-month history of gradually increasing dyspnea and non-productive cough. Clinical and radiological investigations revealed endobronchial metastasis involving, and penetrating, the lower carina and the left main bronchus. We confirmed endobronchial metastasis from the rectal carcinoma by bronchoscopic biopsy.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.73-76
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• 1998

We report very rare case of concurrent bronchial atresia and bronchogenic cyst. Morphologic apical segment of right upper lobe directly stemmed from right main bronchus. Bronchogenic cyst was communicating with atretic segmental bronchus and both were filled with mucus. The etiology is not well known, however it is likely that a single insult arround the 5th∼6th week causes both malformations.