• Journal of Chest Surgery
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• v.26 no.6
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• pp.475-482
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• 1993

90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.49-54
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• 1969

Four cases of pleural mesothelioma were treated surgically. The tumors from all cases were microscopicaly malignant, although only in one case the tumor was found to be diffuse in growth. The diagnosis made before operation were exudative pleurisy, empyema or lung cancer with no tumor cells found in examination of pleural fluid, sputum or the specimen of pleuraI biopsy. In two cases only the tumors were resected, and in other two cases pneumonectomy and pleuropneumonectomy were performed. Irradiations added in two cases postoperatively were found not to be beneficial. Postoperative recurrence of tumor growth were found in three cases within two months after surgery, and in one case no evidence of recurrence was noted four and a half months after resection of the tumor.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.125-132
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• 1995

Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the pleural fluid cytology specimens examined, 34 specimens were positive in 27 patients. The lung was the most frequent primary site(44%), followed by the stomach (12%), lymphoreticular neoplasm(12%), pancreas(3%) and colon(3%). And the cases of unknown primary site with positive pleural biopsy alone were 24%. Among trio ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms. were carcinomas of ovary(32%), stomach(22%), colon(6%), breast(3%), pancreas(3%), and lung(3%) and lymphoreticular neoplasms(3%) The metastatic tumor was predominantly adenocarcinoma type in both pleural(82%) and ascitic(91%) fluid. The study of metastatic adeno- carcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1013-1024
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• 1989

One hundred and seventy two patients of primary lung cancer, confirmed by tissue diagnosis at the Dept. of Thoracic and Cardiovascular Surgery in Korea University Hospital between June 1973 and August 1988, were evaluated and restaged with New International TNM classification, and the actuarial survival rate was obtained using Kaplan-Meier equation. The results of analysis were as follows. 1. Male to female ratio was 3.8:1, and prevalent age groups were sixth and seventh decades [76.4 %]. 2. The most common subjective symptom was cough [55.2 %], and 67.4 % of all patients were visited to hospital less than 6 months of symptoms. 3. Positive rates for tissue diagnosis were 100% in open chest or metastatic lymph node biopsy, 80 % in mediastinoscopic biopsy, 60 % in pleural biopsy, 59 % in pleural fluid cytology, 36% in bronchoscopic biopsy, and 22 % in sputum cytology. 4. The order of frequency of cell type was squamous cell carcinoma [53.0%], adenocarcinoma [22.0 %], small cell carcinoma [14.5 %], and so on. 5. Operability and resectability were 44% and 62% respectively, but they were improved recently. 6. Open and closure was done in 44 % of operated patients, uni or bilobectomy in 38 % and pneumonectomy in 24 %. 7. Overall operative mortality rate was 2.6 %. 8. The order of frequency of stage level was S3b [42.0 %], S3a [25.1 %], S1 [15.6%], and so on. 9. Distant metastasis, i.e. stage 4, was noted in 9.5 % of cases, and the sites of frequency were bone, brain, skin, and so on. 10. Actuarial survival rate was 1 year 48.2%, 2 year 36.9%, 3 year 31.2%, and 5 year 20.8%. According to above listed factors, 5 year survival rate was highest in squamous cell carcinoma, lobectomized cases, stage 1, NO in TNM system, and resectable cases. But T factor in TNM system and radiation therapy in nonresectable cases did not show statistical significance in life expectancy.

• Journal of Chest Surgery
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• v.56 no.1
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• pp.1-5
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• 2023

Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient's impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.579-580
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• 2024

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.355-358
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• 2011

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.316-318
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• 2013

Thoracoscopic needle aspiration is a good alternative for a centrally-located solitary pulmonary nodule (SPN) suspected of being lung cancer without severe pleural adhesion. The authors report the technique of thoracoscopic needle aspiration biopsy in a SPN just in the medial aspect of the truncus anterior pulmonary artery and the right upper lobe bronchus.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.714-718
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• 1993

Tracheobronchopathia osteoplastica(TPO) is a rare disorder characterized by submucosal cartilaginous or bony projections into the tracheobronchial lumen with sparing of the posterior membranous portion of tracheobronchial tree. The etiology of TPO is still unknown. A 44-year-old male was admitted to Seoul Paik Hospital Inje University due to left chest pain for 10 days. On the past history he had sufferred from symptoms of bronchitis for several months. He showed radiologically massive pleural effusion in left lung field. Pleural biopsy revealed chronic pleuritis with hemorrhage. Bronchoscopic findings showed multiple intraluminal portruding nodule from just below the vocal cord to carina and both main bronchi. Pathology of bronchoscopic biopsy showed abnormal proliferation of atypical bony and carilagious nodules in the tracheal submucosa. We experianced a case of tracheobronchopathia osteoplastica involving the trachea and main bronchus in 44-year old male, associated with massive pleural effusion. This report is a case of TPO with review of literature.

• Tuberculosis and Respiratory Diseases
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• v.75 no.4
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• pp.150-156
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• 2013

Background: Thoracoscopic pleural biopsy is often required for rapid and confirmative diagnosis in patients with suspected pleural tuberculosis (PL-TB). However, this method is more invasive and costly than its alternatives. Therefore, we evaluated the clinical utility of the chest computed tomography (CT)-based bronchial aspirate (BA) TB-polymerase chain reaction (PCR) test in such patients. Methods: Bronchoscopic evaluation was performed in 54 patients with presumptive PL-TB through diagnostic thoracentesis but without a positive result of sputum acid-fast bacilli (AFB) smear, pleural fluid AFB smear, or pleural fluid TB-PCR test. Diagnostic yields of BA were evaluated according to the characteristics of parenchymal lesions on chest CT. Results: Chest radiograph and CT revealed parenchymal lesions in 25 (46%) and 40 (74%) of 54 patients, respectively. In cases with an absence of parenchymal lesions on chest CT, the bronchoscopic approach had no diagnostic benefit. BA TB-PCR test was positive in 21 out of 22 (95%) patients with early-positive results. Among BA results from 20 (37%) patients with patchy consolidative CT findings, eight (40%) were AFB smear-positive, 18 (90%) were TB-PCR-positive, and 19 (95%) were culture-positive. Conclusion: The BA TB-PCR test seems to be a satisfactory diagnostic modality in patients with suspected PL-TB and patchy consolidative CT findings. For rapid and confirmative diagnosis in these patients, the bronchoscopic approach with TB-PCR may be preferable to the thoracoscopy.