• Title/Summary/Keyword: Surgical Resection

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Surgical Resection of Solitary Fibrous Tumors of the Pleura (고립성 섬유성 흉막 종양의 수술적 절제)

  • 장지원;김관민;심영목;한정호;이경수;김진국
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.432-437
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    • 2004
  • Background : Solitary fibrous tumors of the pleura (SFTP) is one of rare neoplasms that originated from submesothelial mesenchyme. Clinical course or extent of surgical resection is not well known. Material and Method: We retrospectively reviewed all the clinical records of the patients who had undergone surgical resection of benign and malignant SFTP, Result: Twenty two (male female 14 : 8) patients were enrolled and mean age was 50.2(range 25∼83). Number of symptomatic patients at the time of diagnosis was 13 (59%) and the most common symptom was dyspnea. Operative approach was carried out through thoracotomy (n=14) or video-assisted thoracic surgery (n=8). Mass excision was performed in 12 cases and en bloc resection including adjacent structure in 10 cases. In all cases complete resection was performed. There was no operative mortality. Malignant SFTP were 11 cases and benign SFTP 11 cases. Local recurrences (n=2) or distant metastasis (n=6) occurred only in malignant SFTP. Conclusion: Number of symptomatic patients, on bloc resection, and recurrence was more in malignant SFTP. Although complete surgical resection is known as treatment of choice for SFTP, further study should be performed about systemic therapeutic modalities pre- or postoperatively to control recurrence and metastasis.

Appropriate Timing of Surgery after Neoadjuvant Chemo-Radiation Therapy for Locally Advanced Rectal Cancer

  • Garrer, Waheed Yousry;Hossieny, Hisham Abd El Kader El;Gad, Zeiad Samir;Namour, Alfred Elias;Amer, Sameh Mohammed Ahmed Abo
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4381-4389
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    • 2016
  • Background: Surgery is the corner stone for the management of rectal cancer. The purpose of this study was to demonstrate the optimal time of surgical resection after the completion of neoadjuvant chemo-radiotherapy (CRT) in treatment of locally advanced rectal cancer. Materials and Methods: This study compared 2 groups of patients with locally advanced rectal cancer, treated with neoadjuvant CRT followed by surgical resection either 6-8 weeks or 9-14 weeks after the completion of chemo-radiotherapy. The impact of delaying surgery was tested in comparison to early surgical resection after completion of chemo-radiotherapy. Results: The total significant response rate that could result in functional preservation was estimated to be 3.85% in group I and 15.4% in group II. Some 9.62% of our patients had residual malignant cells at one cm surgical margin. All those patients with positive margins at one cm were in group I (19.23%). There was less operative time in group II, but the difference between both groups was statistically insignificant (P=0.845). The difference between both groups regarding operative blood loss and intra operative blood transfusion was significantly less in group II (P=0.044). There was no statistically significant difference between both groups regarding the intra operative complications (P=0.609). The current study showed significantly less post-operative hospital stay period, and less post-operative wound infection in group II (P=0.012 and 0.017). The current study showed more tumor regression and necrosis in group II with a highly significant main effect of time F=61.7 (P<0.001). Pathological TN stage indicated better pathological tumor response in group II (P=0.04). The current study showed recurrence free survival for all cases at 18 months of 84.2%. In group I, survival rate at the same duration was 73.8%, however none of group II cases had local recurrence (censored) (P=0.031). Disease free survival (DFS) during the same duration (18 months) was 69.4 % for patients in group I and 82.3% for group II (P=0.429). Conclusions: Surgical resection delay up to 9-14 weeks after chemo-radiation was associated with better outcome and better recurrence free survival.

Surgical Treatment of Emphysematous Bullae (기낭성 폐기종의 외과적 치료)

  • 김형묵
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.165-170
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    • 1973
  • The selection and treatment with resection and drainage for patients with emphysematous bullae is discussed with reference to two patients recently. One case with bilateral multiple bullous emphysema resulting tension pneumothorax due to rupture of the bullae on right, 47 year old man with pulmonary tuberculosis history for 16 years, was treated with resection of the bullae on right including upper lobectomy and c!osed rhoracostomy drainage on left for another spontaneous pneumothorax, and result was excellent for 6 month after discharge. Another 53 year old man with giant tension air cysts occupying right whole lung field and shifting mediastinum to the left was treated with right under water sealed closed thoracostomy drainage for 7 days in vain, and resection was not performed for his poor respiratory function and general condition. The most useful preoperarive information was obtained from a study of the plain chest radiogram and the surgical procedure of choice was obliteration of the bullae at thoracotomy.

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Surgical Treatment of Metastatic Lung Cancer (전이성 폐암의 외과적 치료)

  • 박재길
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.815-820
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    • 1987
  • Excision of the metastatic pulmonary sarcoma or carcinoma in the selected cases is now the accepted and the most effective method of treatment. From January 1978 to July 1987, 14 patients with metastatic lung cancer were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. Ages ranged from 26 years to 68 years [mean=38.0 years]. Primary sites were uterus in 6 patients, colorectum in 2, sarcoma of extremities in 2, and 1 case of pancreas, kidney, skin and melanoma of hand. Fourteen posterolateral thoracotomies were done and resected the 36 metastatic masses in 14 patients. Surgical mortality was none. The performed procedures of resection were as follows; lobectomy with wedge resection in 2, lobectomy in 3, segmentectomy in 1 and wedge resection in 8. Eleven patients were received radiotherapy or chemotherapy, or both postoperatively. Among the 14 patients, there were 5 survivors. They are 6, 7, 21, 35, and 63 months postoperatively. Among them, 9 patients were dead. Within one year in 2, two years in 6, and three years in l.

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A Study on Surgical Treatment of Thymoma -Analysis of 18 Cases- (흉선종의 외과적 치료에 대한 연구 -18례 분석-)

  • 이형렬
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.303-309
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    • 1994
  • Eighteen patients with thymoma have undergone surgical treatment at Pusan National university Hospital from 1983 to 1993. The mean age of the patients was 47.3$\pm$13.3 years old and male to female ratio was 1.6 : 1. Eleven of the patients[61.1%] with thymoma had myasthenia gravis; 12 cases[66.7%] were encapsulated and 6[33.3%] invasive. Operation was complete resection in 14[77.8%] of the patients, partial resection with residual tumor in 3[16.7%], and simple biopsy in one[5.5%]. Adjuvant radiotherapy was administered in 5 of 6 invasive thymoma. Postoperatively one patient died for excessive bleeding and sepsis. A tumor relapse was observed in one patient who had invasive thymoma and underwent partial resection followed by postoperative radiotherapy. The overall 5-year survival rate was 88.2$\pm$ 7. 9%.The presence of myasthenia gravis is not considered as an adverse factor for survival but it contributes to early discovery of associated thymoma.

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Cardiac Angiosarcoma on the Right Atrium: Two Cases

  • Park, Won-Kyoun;Jung, Sung-Ho;Lim, Ju-Yong
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.120-123
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    • 2012
  • We detected two cases of right atrial angiosarcoma that had a similar appearance on imaging studies. Although the surgical findings were similar for the two patients, one had a clear resection margin, while the other had tumor cells in the resection margin on frozen biopsy. We suggest that preoperative data on magnetic resonance imaging and computed tomography in patients with angiosarcomas may not predict the exact extent of surgical resection or prognostic outcomes.

Long-Term Survival after Wide Resection of Malignant Fibrous Histiocytoma of the Chest Wall

  • Shin, Jin Won;Chang, Yong Jin;Cho, Deog Gon;Choi, Si Young
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.36-39
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    • 2019
  • Primary malignant fibrous histiocytoma (MFH) of the chest wall is extremely rare and is characterized by aggressive features, including a high incidence of local recurrence and distant metastasis. Surgical resection of the chest wall is the primary modality of management. However, surgical treatment is not generally recommended in patients with evidence of distant metastasis. Here, we present a case of chest wall MFH along with a schwannoma mimicking distant metastasis in the right upper arm. The patient was treated by radical en bloc resection and survived for more than 9 years without recurrence.

Endoscopic Resection for Early Gastric Cancer beyond Absolute Indication with Emphasis on Controversial Issues

  • Min, Yang Won;Lee, Jun Haeng
    • Journal of Gastric Cancer
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    • v.14 no.1
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    • pp.7-14
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    • 2014
  • Endoscopic resection is the established treatment for early gastric cancer in selected patients with negligible risk of lymph node metastasis ('absolute indication'). Based on clinical observations and large pathological databases, expanding indications for endoscopic resection beyond absolute indication has been tried in Japan and Korea. However, controversies exist regarding the safety of treating early gastric cancer beyond absolute indication in terms of pathological evaluation of the resected specimen, definition of expanded indication, discrepancy between pre-endoscopic resection and post-endoscopic resection diagnoses of gastric neoplasm, and the best strategy for cases with non-curative resection. In this brief review, current evidence and clinical experience regarding issues of endoscopic resection beyond absolute indication will be summarized.

Surgical Treatment of Stage III Carcinoma of the Lung after Preoperative Chemotherapy and Radiation Therapy - 8 case report - (폐암의 항암약물및 방사선치료후 절제수술;8례 보고)

  • 이두연
    • Journal of Chest Surgery
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    • v.25 no.9
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    • pp.962-967
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    • 1992
  • Eight patients with proven clinical stage Ill lung carcinoma of which six were epidermoid cell carcinoma and two were small cell carcinoma underwent concomitant radiation therapy and chemotherapy before surgical resection from March 1990 to February 1992 at the thoracic surgical department, Yongdong Severance Hospital, Yonsei University College Medicine The therapy consisted of more than one cycle of chemotherapy every 4 weeks and concomitant irradiation. Three to four weeks after chemotherapy and radiation therapy, the patient were reevaluated for thoracotomy and pulmonary resection. Two patients were found to have unresectable lesions and, radiosotopes were implanted to the remaining tumors. Three patients had complete pneumonectomies and two patients had pericardial penumonectomyo. Only one patient had complete pneumonectomy & concomitant resection of ribs attached to tumors with reconstruction of chest wall with Marlex mesh. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 2 patients, without operative mortality. The median survival of all patients was eight months, but the median survival of survivors which lung tumor were completely resected completely and whose pathologic reports showed stage I or 0, was about 18 months to now. The overall result indicates some benefit from this preoperative chemotherapy and radiation therapeutic regimen in patients with advanced unresectable lung cancer.

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Surgical analysis of pulmonary aspergilloma (폐국균종의 외과적 임상분석)

  • 이종국;박승일;서재정;원준호
    • Journal of Chest Surgery
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    • v.33 no.3
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    • pp.245-251
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    • 2000
  • Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

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