• Journal of Yeungnam Medical Science
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• 제29권1호
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• pp.9-13
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• 2012

Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.

• Journal of Chest Surgery
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• 제28권2호
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• pp.150-155
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• 1995

For study the influencing factors to the complication after pneumonectomy, authors performed retrospective analysis in 33 patients managed surgically from February 1985 to February 1994 in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital.Among 33 patients, the underlying diseases were distributed 15 patients[45.5% pulmonary tuberculosis, 14[42.% lung cancer and 4[12.1% bronchiectasis. Numbers of complication according to the underlying disease after pneumonectomy were 8 in pulmonary tuberculosis, 2 in lung cancer and 1 in brochiectasis. Study was analyzed on age, sex distribution, etiology of underlying diseases and operated sides contributing to the complication. The results were characterized that the rate of occurrence of complication after pneumonectomy was not affected by age, sex and operated side differences but affected by the underlying disease.The development of complication after pneumonectomy in patients with pulmonary tuberculosis revealed statistically borderline significance comparing to the others[p=0.07 .

• Journal of Chest Surgery
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• 제28권5호
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• pp.510-512
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• 1995

Reexpansion pulmonary edema following treatment of pneumothorax and pleural effusion is a rare complication. However, because of possibility of its fatal outcome, physicians must be aware of this complication and every effort must be made to prevent its occurrence. We experienced 5 cases of reexpansion of pulmonary edema. One was complete tension pneumothorax and became death despite of intensive management. Remained four were 3 pneumothoraces and 1 pleural effusion and discharged without event, fortunately.

• Journal of Chest Surgery
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• 제26권8호
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• pp.620-626
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• 1993

Determination of preoperatibe pulmonary function is crucial in avoiding complications from pulmonary resection, especially pneumonectomy. Postoperative morbidity and mortality were correlated with the preoperative results of five widely used tests of pulmonary function in 40 patients who underwent pneumonectomy for bronchiectasis, pulmonary tuberculosis, and carcinoma of the lung. Factors analyzed following operation included 30-day mortality, the incidence of arrhythmia, the frepuency of respiratory complications, and the number of individuals requiring prolonged mechanical ventilation. There were statistically significant differences[p<0.001]in mean values among FVC, FEV1, FEV1/FVC and MVV. But the difference of the FEF25-75% was not statistically significant.

• Journal of Chest Surgery
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• 제39권2호
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• pp.134-139
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• 2006

배경: 식도암 수술 후 발생하는 합병증은 매우 다양하다. 이 중 호흡기 합병증은 환자의 경과에 지대한 영향을 미치며 사망에 이르게 할 수 있는 중요한 합병증이다. 이에 수술 후 호흡기 합병증에 관여하는 인자들을 비교 분석하였다. 대상 및 방법: 1996년부터 2001년 8월까지 근치적 식도암 수술을 시행받은 환자 88명 중 수술 중 사망한 1예를 제외한 87명을 대상으로 후향적 조사를 하였다. 호흡기합병증이 발생한 군(group A, 28예)과 발생하지 않은 군(group B, 59예)으로 나누어 두 군을 비교, 분석하였다. 통계 처리는 Fisher's exact test로 검증하였다 걸과 호흡기 합병증은 28예에서 발생하여 $32.2\%$의 호흡기 합병증 발생률을 보였다. 환자의 과거력, 수술시간, 문합방법, 술 전 폐기능, 병기, 술전 항암요법의 유무 등은 두 군간 유의한 차이가 없었다. 호흡기 합병증이 발생한 군에서 환자의 나이가 유의하게 많았으며(p=0.001) 경부 문합의 빈도가 유의하게 높았다(p=0.023). 수술 직후 상용적인 인공호흡기 치료를 받은 예는 호흡기 합병증이 발생하지 않은 군에서 유의하게 높았다(p=0.007). 호흡기 합병증 발생군에서 흉관 거치기간, 재원기간이 유의하게 길었다(p=0.011, p=0.001). 수술 사망은 모두 5예에서 발생하여 $5.7\%$의 수술 사망률을 보였는데 모두가 호흡기 합병증에 의한 것이었고 폐렴이 4예로 가장 많았다. 폐렴이 발생한 환자들의 객담 배양검사에서 MRSA (methicillin resistant staphylococcus aureus)가 가장 많이 검출되었으며 폐렴으로 사망한 4예 모두 MRSA 폐렴에 의한 것이었다. 결론: 식도암 수술 후 발생한 호흡기 관련 합병증이 수술 사망의 주된 원인이었으며 환자의 나이가 많은 경우, 경부문합인 경우가 호흡기 합병증 발생의 위험인자였다. 수술 직후 상용적인 인공호흡기의 사용이 호흡기 합병증 예방에 도움이 될 것으로 생각하며 MRSA에 의한 병원 감염의 예방이 호흡기 합병증과 수술 사망을 줄이는 데 도움이 될 것이라 생각한다.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.202-205
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• 2015

Purpose: Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable. Case description: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. Literature Reviews: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces. Conclusion: Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

• 대한기관식도과학회지
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• 제17권2호
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• pp.98-103
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• 2011

Purpose Pulmonary complications continue to be the major cause of morbidity and mortality after esophageal resection. The aim of this study was to compare and analyze retrospectively the factors which effect for postoperative pulmonary complications in patients who underwent curative resection for esophageal cancer. Material and Method A total of 118 patients were enrolled in the study from January 1994 to March 2009, and patients with previous neoadjuvant chemotherapy or radiotherapy were excluded. Of the total 118 patients, 27 patients developed pulmonary complications within 30 days of their operation. the factors which effect for postoperative pulmonary complications were compared and analyzed. Results There were 7 patients in-hospital deaths. 51 patients (43.2%) developed complications, and of them, the most common complication was pulmonary complication and occurred in 27 patients (22.9%). In univariate analysis, diabetes mellitus, cervical anastomosis through the retrosternal route, old age and poor lung function were risk factors contributing to postoperative pulmonary complications (p<0.05). In multivariate analysis, statistically significant factor was old age (65 years or older). Conclusion Clinical factor for the pulmonary complications after esophagectomy of esophageal cancer was significantly associated with diabetes mellitus, cervical anastomosis through the retrosternal route, old age (65 years or older) and poor lung function (FEV1<80%). Of these, old age was the most significant factor.

• Journal of Chest Surgery
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• 제32권3호
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• pp.318-321
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• 1999

폐 절제수술후 나머지 폐엽의 뒤틀림은 드문 합병증 중의 하나이다. 저자들은 50세 좌상엽에 진균종을 가진 남자 환자에서 좌상엽의 폐엽 절제술 후 좌하엽의 뒤틀림(torsion)에 의한 폐경색이 발생하여 수술후 2일째 남아있는 좌하엽 절제수술을 시행하였으며 23일간의 인공호흡기 치료와 92일간의 영양공급 및 물리치료가 필요하였다. 폐엽절제술 후 남아 있는 폐의 뒤틀림에 의한 폐경색은 적절한 치료에도 불구하 \ulcorner사망률이 22%에 이르기 때문에 정확한 진단과 신속한 치료가 가장 중요하다.

• Korean Journal of Radiology
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• 제21권5호
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• pp.526-536
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• 2020

Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

• Journal of Chest Surgery
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• 제24권8호
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• pp.797-801
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• 1991

Reexpansion pulmonary edema following pneumothorax, atelectasis, massive pleural effusion are clinically uncommon, but sometimes life threatening progression. Reexpansion pulmonary edema is usually ipsilateral but rarely contralateral or both. Reexpansion pulmonary edema was occurred when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. The pathogenesis of the reexpansion pulmonary edema is unknown but is probably mutifactorial. The etiological factors of the reexpansion pulmonary edema are chronicity of the lung collapse, technique of the reexpansion, airway obstruction, loss of the surfactant, and pulmonary artery pressure changes. In the treatment of the chronically collapsed lung, physician must be remembered the possible events, and to prevent of the complication.