• Title/Summary/Keyword: Pulmonary Surgical Procedures

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Surgical Treatment of Pulmonary Hamartoma (폐과오종의 외과적 치료)

  • Kim, Ung-Han;Seong, Suk-Hwan;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.215-220
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    • 1994
  • From Jan. 1981 to Dec. 1993, 24 cases of pulmonary hamartoma were experienced sugically at the Department of Thoracic Surgery, College of Medicine, Seoul National University. They consisted of 11 females and 13 males. The age distribution was 24 years to 71 years with a mean age of 49 years. They included 3 cases of endobronchial hamartoma, and 21 cases of pulmonary parenchymal hamartoma. Fifty eight percent of patients [14/24] were asymptomatic. One patient had a multiple pulmonary parenchymal hamartoma, and 1 patient also had combined lung cancer. The operative procedures were 9[37.5%] wedge resections, 5[20.8%] lobectomies, 3[12.5%] enucleations, 3[12.5%] segmental resections, 2[8.3%] bilobectomies, 1[4.2%] lobectomy and segmentectomy, and 1[4.2%] lobectomy, wedge resection, and enucleation. All of the operative results were excellent and without complication.

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Change of Pulmonary Function after Pulmonary Resection (폐절제술후 폐기능 변화에 관한 연구)

  • 김용진
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.517-528
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    • 1985
  • Pulmonary function studies today are generally accepted as an integral part of the evaluation of poor-risk patients who are to have pulmonary surgery. The effect of various pulmonary surgery on lung function was investigated in 54 patients in whom comprehensive lung function test were performed before and between 2 months and 14 months after operation at the Department of Thoracic Surgery, Seoul National University Hospital. According to the result of analysis, the effect of pulmonary resection on forced flow rate was keeping with the change of lung volume, and the preoperative level of ventilatory function plays a major role in determining postoperative loss of functioning lung. Although all measures of expiratory flow [FVC, FEV1, FEFO.2-1.2, MEF50, FEF25-75] have the same percentage of reproducibility, but FEV1 shows most sensitive, reliable linear correlation with the functioning pulmonary tissue loss than other parameters. The linear regression lines derived from the correlation between preoperative [X] and postoperative [Y] FEV1 on various surgical procedures were as follows: 1. Y = 0.57X 0.03. in pneumonectomy group of lung cancer[r=0.84]. 2. Y = 0.56X + 0.33. in lobectomy group of lung cancer[r=0.79]. 3. Y = 0.69X + 0.25. in lobectomy group of pulmonary infection[r=0.91].

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Pulmonary Aspergilloma Associated Pulmonary Tuberculosis (폐결핵에 병발된 폐 Aspergilloma)

  • 심성보
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.1011-1018
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    • 1991
  • From September, 1985 to March, 1991, 33 patients under went thoracotomy for treatment of pulmonary aspergilloma with Pulmonary tuberculosis on the department of Thoracic and Cardiovascular Surgery, National Kongju Hospital. 1. There were 25 male and 8 female patients ranging from 19 to 57 years old [mean age, 36.2 years]. 2. Hemoptysis was the most common symptom [recurrent minor hemoptysis: 24cases, severe hemoptysis [200cc /day]: 4 cases, massive hemoptysis [600/day]: 4 cases]. 3. In the chest X-ray films, intracavitary fungus balls [air meniscus sign] were noted in 20 cases [61%] and upper lobe involvements were 29 cases [88%]. 4. All cases had a history of treatment with antituberculosis drugs under diagnosis of pulmonary tuberculosis for an average of 10 years and 2 months. 5. The most common indication for operation was hemoptysis [32 cases] - hemoptysis with total destroyed lung or lobe: 12cases, hemoptysis with open AFB [t-] cavity: 6cases, recurrent or massive hemoptysis: 14 cases. 6. The operative procedures was as follows - - - lobectomy . 16 cases, pneumonectomy: 8 cases, bilobectomy, segmentectomy, cavernoplasty and lobectomy with segmentectomy: each 2 cases, lobectomy with cavernoplasty: 1 case. 7. 6 complications appeared postoperatively which included empyema with BPF [2 cases], empyema [2 cases] and wound infection [2 cases]. In conclusion, surgical resection is the treatment of choice in the management of pulmonary aspergilloma associated pulmonary tuberculosis.

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Prevalence of Benign Pulmonary Lesions Excised for Suspicion of Malignancy: Could It Reflect a Quality Management Index of Indeterminate Lung Lesions?

  • Carillo, Gerardo Andres Obeso;Vazquez, Jose Eduardo Rivo;Villar, Alberto Fernandez
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.458-464
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    • 2014
  • Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.

Tracheoesophageal Shunt Voice in Total Laryngectomee (후두 전 절제 환자에서 음성재활을 위한 기관식도발성)

  • Wang, Soo-Geun;Jang, Sun-Mi
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.21-27
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    • 2008
  • Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

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Surgery on Pulmonary Tuberculosis: A Review of 19 years's Experience (폐결핵(肺結核)의 외과적(外科的) 요법(療法))

  • Hong, Chang Soo;Suh, Kyung Phill
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.133-138
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    • 1976
  • The author reviewed 263 cases of pulmonary tuberculosis operated on at the Department of Thoracic Surgery, Seoul National University Hospital during the 19 year period, from January, 1957 to December 1975. Following observations were made: 1) The sex ratio was 2.8: 1 in male's favor, and 83.6% of the patients were between 20 and 49 years of age. 2) The trends in operative procedures revealed that surgical collapse as a definitive therapy of pulmonary tuberculosis has virtually disappeared and operations required for residuals of pleural diseases have increased. 3) The overall hospital mortality rate was 3-8%. The highest mortality rate was encountered in the cases of resection and decortication with 28.6%, 4) The rate of overall postoperative complications was 24.7%, the highest being encountered in decortication with 56.4%. 5) The most frequent cause of death was bleeding, while the dead space was the most frequent complication.

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Double Outlet Left Ventricle - One Case Report - (양대동맥 좌심실기시증치험 1례)

  • 성후식
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.798-802
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    • 1987
  • Origin of both great vessels from morphological left ventricle [DOLV] is a rare cardiac anomaly which embryologic possibility has been explained by differential conal development concept and differential canal absorption concept. Recently we had surgical experience of DOLV in 4 month-age infant weighing 5.7Kg. The chief complaints on admission were cyanosis and anoxic spell during severe crying, and right heart catheterization and right ventriculogram were performed but incorrect diagnosis was made. The operative procedures were ligation of patent ductus arteriosus, patch closure of subaortic VSD aligning aorta and pulmonary artery with left ventricle, suture closure of proximal pulmonary artery and valve and the use of extracardiac valved conduit [Carpentier-Edward l4mm] from right ventricle to distal pulmonary artery. Postoperative course was uneventful and discharged in the good condition.

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Robot-Assisted Pulmonary Resection For Lung Cancer (폐암에서 로봇을 이용한 폐절제술)

  • Lee, Hyun-Sung;Jang, Hee-Jin
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.92-97
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    • 2011
  • MMinimally invasive surgery (MIS) for early stage lung cancer has been an important treatment modality. However, the ergonomic discomfort and counterintuitive instruments hindered the application of video-assisted thoracic surgery (VATS) to more advanced procedures. To improve the compliance with MIS, robotic surgery was adopted. This advance aimed to alleviate the shortcomings of VATS by maximizing the comfort of the surgeon while providing instruments that enabled technically demanding operations and three-dimensional views with increased freedom for intrathoracic movement owing to EndoWrist$^{(R)}$. In this session, we introduced the clinical applications and its results of robot-assisted thoracic surgery in the field of lung cancer surgery. In conclusion, robot-assisted pulmonary resection with lymph node dissection for lung cancer is safe as well as feasible, and it results in a satisfying postoperative outcome. Robot-assisted surgery may provide a good alternative to conventional open or thoracoscopic surgery for lung cancer, provided that the cost effectiveness and long-term prognosis are confirmed.

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Surgical Treatment of Pulmonary Aspergillosis (폐 국균증에 대한 외과적 치료)

  • 주홍돈
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1025-1029
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    • 1992
  • We experienced eleven cases of pulmonary aspergllosis treated surgically in the period from 1981 to 1992. There were 5 men and 6 women, ranging in age from 28 to 64 years [mean age 40.4 years]. The most common chief complaint of the patients was hemoptysis and blood tinged sputum[7 cases, 63.6%], On preoperativechest film, the case of cavity with fungus ball[7 cases] and only cavity[4 cases] were seen. The location of the lesion were both upper lobe[6 cases] and lower lobe[5 cases]. The underlying disease were tuberculosis[5 cases], bronchiectasis[2 cases], tuberculosis and bronchiectasis[1 case], pneumonia[1 case] and none[2 cases]. The operative procedures of pulmonary aspergillosis were lobectomy[8 cases], cavernostomy[1 case] and thoracoplasty[2 cases]. The postoperative complications were postoperative massive bleeding[reoperation, 2 cases], wound infection[2 cases] and no operative mortality.

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Surgery for Pulmonary Fungal Infections Complicating Hematological Malignancies

  • Yamamichi, Takashi;Horio, Hirotoshi;Asakawa, Ayaka;Okui, Masayuki;Harada, Masahiko
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.350-355
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    • 2018
  • Background: The complication rate of fungal disease is higher among patients with hematological malignancies. We investigated the clinicobacteriological outcomes of resected pulmonary fungal infections complicating hematological malignancies. Methods: Between 2001 and 2017, 21 patients with pulmonary fungal infections complicating hematological malignancies underwent resection, and their clinical records and survival were retrospectively reviewed. Results: The median age of the patients was 47 years, and 13 were male. The histological diagnoses were pulmonary aspergillosis (19 cases), mucormycosis (1 case), and cryptococcosis (1 case). The indications for surgery were resistance to antifungal therapy and the necessity of surgery before hematopoietic stem cell transplantation in 13 and 8 cases, respectively. The diagnoses of the hematological malignancies were acute myelogenous leukemia (10 cases), acute lymphocytic leukemia (5 cases), myelodysplastic syndrome (3 cases), and chronic myelogenous leukemia, malignant lymphoma, and extramedullary plasmacytoma (1 case each). The surgical procedures were partial resection (11 cases), segmentectomy (5 cases), lobectomy (4 cases), and cavernostomy (1 case). The size of the lesions was 0.9-8.5 cm. Fourteen cases had cavitation. There were no surgical-related deaths or fungal progression. Conclusion: Pulmonary fungal infections are resistant to treatments for hematological malignancies. Since the treatment of the underlying disease is extended and these infections often recur and are exacerbated, surgery should be considered when possible.