• 제목/요약/키워드: Pulmonary resection

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

  • 김용진
    • Journal of Chest Surgery
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    • 제18권3호
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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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내과적 치료와 함께 폐절제술을 시행하여 균음전에 성공한 Mycobacterium avium 폐질환 1례 (Successful Pulmonary Resection Combined with Chemotherapy for the Treatment of Mycobacterium avium Pulmonary Disease : A Case Report)

  • 고원중;권오정;강은해;서지영;정만표;김호중;김관민;이남용;한정호;김태성;이경수
    • Tuberculosis and Respiratory Diseases
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    • 제54권6호
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    • pp.621-627
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    • 2003
  • MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 않으며, 따라서 내과적 치료만으로 균음전에 성공하지 못하였을 때, 폐병변이 국한되어 있다면 폐절제술을 고려하여야 한다. 국내에서는 아직까지 MAC 폐질환의 치료를 위하여 폐절제술을 시행한 증례가 보고되지 않았다. 저자들은 MAC 폐질환을 진단하고 clarithromycin을 포함한 내과적 치료에 실패한 환자에서 폐절제술을 시행 후 균음전에 성공한 환자를 경험하여 이를 보고하는 바이다.

Surgical Treatment for Non-Small Cell Lung Cancer in Patients on Hemodialysis due to Chronic Kidney Disease: Clinical Outcome and Intermediate-Term Results

  • Park, Byung Jo;Shin, Sumin;Kim, Hong Kwan;Choi, Yong Soo;Kim, Jhingook;Shim, Young Mog
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.193-198
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    • 2015
  • Background: Patients on dialysis undergoing surgery belong to a high-risk group. Only a few studies have evaluated the outcome of major thoracic surgical procedures in dialysis patients. We evaluated the outcomes of pulmonary resection for non-small cell lung cancer (NSCLC) in patients on hemodialysis (HD). Methods: Between 2008 and 2013, seven patients on HD underwent pulmonary resection for NSCLC at our institution. We retrospectively reviewed their surgical outcomes and prognoses. Results: The median duration of HD before surgery was 55.0 months. Five patients underwent lobectomy and two patients underwent wedge resection. Postoperative morbidity occurred in three patients, including pulmonary edema combined with pneumonia, cerebral infarction, and delirium. There were no instances of in-hospital mortality, although one patient died of intracranial bleeding 15 days after discharge. During follow-up, three patients (one patient with pathologic stage IIB NSCLC and two patients with pathologic stage IIIA NSCLC) experienced recurrence and died as a result of the progression of the cancer, while the remaining three patients (with pathologic stage I NSCLC) are alive with no evidence of disease. Conclusion: Surgery for NSCLC in HD patients can be performed with acceptable perioperative morbidity. Good medium-term survival in patients with pathologic stage I NSCLC can also be expected. Pulmonary resection seems to be the proper treatment option for dialysis patients with stage I NSCLC.

선천성 낭성 폐질환의 수술적 치료 (Surgical Treatment of Congenital Cystic Lung Disease)

  • 이상권
    • Journal of Chest Surgery
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    • 제27권11호
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    • pp.930-937
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    • 1994
  • Pulmonary sequestration, congenital cystic adenomatoid malformation[CCAM], infantile lobar emphysema[ILE], and bronchogenic cysts are four congenital lesions that show abnormal cystic areas within the lung field in early life. They share similar embryologic and clinical characteristics, Therefore they are sometimes difficult to make differential diagnosis each other, and all require surgical treatment. From 1984 to 1993, 20 patients underwent surgical corrections under these diagnostic categories[10 bronchogenic cyst, 4 pulmonary sequestration, 4 CCAM, and 2 ILE] in the department of thoracic & cardiovascular surgery, Inje University, Pusan Paik Hospital. There were 9 females and 11 males, Ages ranged from 26 days after birth to 69 years. Among them 5 cases of bronchogenic cyst were found out incidentally, but remained all 15 cases were noted as symptomatic cases. Recurrent pulmonary infections, respiratory distress and cough with cystic lesions in chest film were the main characteristics of them. Computed tomography and aortography were available for diagnostic conformation. For all the cases surgical resection were performed: 1 pneumonectomy, 2 bilobectomy, 9 lobectomy, 7 cyst resection and 1 mass[extralobar pulmonary sequestration] resection. All surgical treatments were well tolerated with no physical limitation. There was no operative mortality, and only one postoperative complication[empyema thoracis]. All patients were followed up ranging from 4 months to 9 years. A clinical awareness of these related lesions is important for prompt diagnosis and effective surgical treatment.

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기관지 성형술 (Bronchoplastic Procedures)

  • 조건현
    • Journal of Chest Surgery
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    • 제28권8호
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    • pp.772-777
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    • 1995
  • Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

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원발성 폐동맥 육종 (Primary Pulmonary Artery Sarcoma A Case Report -A Case Report-)

  • 김성완;구본원
    • Journal of Chest Surgery
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    • 제30권10호
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    • pp.1036-1039
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    • 1997
  • 원발성 폐동맥 육종은 드물며, 흔히 폐동맥 색전증으로 오진하기 쉽다. 예후는 매우 좋지않아서 치료하지 않았을 때의 생존율이 약 1.5개월이며,수술후에도 생존율을 일년정도까지 연장할 수있다. 본 교실에서는 원발성 폐동맥 육종을 1례 치험하였기에 보고하고자 한다. 환자는 55세 여자로 주증상은 호흡곤란, 우측흉통, 및 객혈이었다. 술전 흉부 전산화단층촬영상 폐동맥 색전증과 유사한 종괴음영을 나타내었다. 수술은 부분 체외순환하에 폐동맥 성형술과 우측전폐 절제술이 시행되었다. 술후 조직학적 진단은 미분화 육종이었고, 증상은 다소 호전되었으나 술후 3개월에 원인 미상으로 사망하였다.

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폐엽절제술 후 생긴 급성폐동맥색전증에서 수술을 통한 색전 제거술 (Open Embolectomy of an Acute Pulmonary Artery Embolism after Pulmonary Lobectomy)

  • 김재준;김환욱;왕영필;박재길
    • Journal of Chest Surgery
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    • 제43권4호
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    • pp.433-436
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    • 2010
  • 폐절제후 발생하는 급성폐동맥색전증은 매우 드물지만 높은 사망률을 보인다. 이는 폐절제후 발생하는 가장 위험한 합병증 중에 하나이다. 폐엽절제 후 아무런 합병증 없이 회복 중이던 환자에서 갑자기 발생한 급성폐동맥색전증으로 보존적 치료에도 악화되어 응급 색전제거술로 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 발표하는 바이다.

Primary Pulmonary Chordoid Meningioma

  • Bae, So Young;Kim, Hye-seon;Jang, Hyo-Jun;Chung, Won-Sang;Kim, Hyuck;Kim, Young Hak;Lee, Jun Ho;Bang, Seong Sik
    • Journal of Chest Surgery
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    • 제51권6호
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    • pp.410-414
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    • 2018
  • Primary pulmonary meningioma is a rare disease, and chordoid meningioma is an uncommon variant of meningioma in the central nervous system (CNS) with a high recurrence rate. We report a case of primary pulmonary chordoid meningioma that presented as a solitary pulmonary nodule (SPN). The SPN was resected by thoracoscopic wedge resection and was revealed to have characteristics of chordoid meningioma. After confirming the absence of a meningioma in the CNS by brain imaging, the nodule was diagnosed as a primary pulmonary chordoid meningioma. The patient remained disease-free after 26 months postoperatively. To our knowledge, this is the third case of primary pulmonary chordoid meningioma to be reported.

기관지확장증의 외과적 요법 (Surgical Treatment of Bronchiectasis)

  • 이영욱
    • Journal of Chest Surgery
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    • 제15권1호
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    • pp.15-20
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    • 1982
  • During the past ten years from 1972 to 1981, a total of 100 cases of bronchiectasis were treated by pulmonary resection at C.A.F.G.H. Pulmonary tuberculosis and frequent U.R.I. were the most frequent associated disease and encountered in 54% in this series. Various types of pulmonary resection were performed on 100 patients; left lower lobectomy in 40 cases, left lower lobectomy and lingular segmentectomy In 29 cases, right lower lobectomy in 12 cases, right middle and lower lobectomy in 12 cases, lingular segmentectomy in 3 cases, left pneumonectomy in 3 cases and both lower lobectomy in 1 case. Complications developed in 9 cases and 1 case among them died of sepsis following secondary opera-tion. Among complications of 9 cases, postoperative atelectasis showed in 4 cases, hemorrhage in 2 cases, bronchopleural fistula in 2 cases, pulmonary edema in 1 case. Complications were treated by conservative and secondary operative management with satisfactory result except one death. Remainders without complication showed good result without symptom in postoperative and follow-up periods.

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원발성폐지방육종(Primary Pulmonary Liposarcoma)에 관한 수술치험 1예 (Surgery for Primary Pulmonary Liposarcoma)

  • 김수완;김진국;김관민;최용수;안긍환;심영목
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.942-945
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    • 2004
  • 원발성폐지방육종은 극히 드문 질환일 뿐만 아니라, 국소재발이 빈번하고 발병 초기에 원격전이가 발생하여 예후가 불량한 질환이다. 지방육종의 치료를 위해서는 수술적인 절제가 우선적이나, 완전히 절제를 못하였을 경우 지방육종이 국소적으로 재발하게 되고 상당히 빠른 속도로 자라게 된다. 저자들은 원발성폐지방육종을 완전 절제하여 10개월 간 재발 및 전이가 없는 예를 경험하였기에 보고하는 바이다.