• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.236-239
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• 2006

A 32 year-old man was transferred to our hospital due to blood-tinged sputum for 15 days. He had been treated at a private hospital for recurrent pneumonia. The chest X-ray showed an atelectasis on the right middle lobe. Computed tomography of the chest demonstrated a broncholith on right middle lobar bronchus with lobar atelectasis of the right middle lobe. We tried to remove the broncholith through fiberoptic bronchoscopy, but could not remove it. Therefore, we performed surgical removal of broncholith and the right middle lobectomy. The cause of broncholith was identified as actinomycosis by pathologic examination. The broncholith caused by actinomycosis is rare. We report a rare case of broncholithiasis with recurrent obstructive pneumonia caused by actinomycosis, which was treated by surgical operation.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.84-93
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• 1997

The bronchoscopy is usually performed in the patients who present symptoms of wheezing, hemoptysis, signs of airway obstruction, unexplained long-term chronic cough with or without radiologic features of pneumonia, emphysema or atelectasis. The symptoms and signs of cases of suspected airway foreign body are of often cofused with those of asthma pneumonia and other respiratory tract disease. The ventilating bronchoscopy will be helpful for removal of certain foreign bodies as well as alleviating medically-unresponsive bronchopulmonary conditions via removing abnormal secretions or merely improving ventilation. The authors have performed clinical analysis of 59 patients who were suspected of airway foreign bodies and treated by ventilating bronchoscopy from September 1985 to February 1995. The results were as follows: 1) Among the 59 cases of bronchoscopy, 51 cases(97%) were under the age of 3. The ratio of male and female was 2.69:1 2) Most common presenting symptom was coughing(84.7%) followed by dyspnea, fever, wheezing and anterior chest pain. 3) Among 39 cases of identified foreign bodies, abnormal findings in the chest X-ray films were found in 33 cases(84.6%) and most common abnormal radiologic feature was pneumonia in 10 cases(25.6%) followed by combination of pneumonia and emphysema, or emphysema alone. All the 20 cases of absent foreign body presented abnormal radiologic features and common findings were pneumonia and atelectasis. 4) Vegetable foreign bodies were the most common form of removed airway foreign bodies(69.2%) followed by metallic foreign bodies(12.8%) and plastic foreign bodies(7.7%). 5) By distribution of the location of foreign bodies, 29 cases(74.4%) were located in the main bronchus( 16 cases of right side and 13 cases of left side), 8 cases were in the trachea and 2 cases were found at the cordal level. 6) By duration of foreign body lodgement in the airway, 9 cases(23.1%) were removed within 7 to 30 days, 10 cases(5.6%) within 3 days and 5 cases(12.8%) were enlodged over 30 days. 7) In the cases of absent foreign bodies, common bronchoscopic findings were mucopurulent or thick mucoid discharge in the main bronchi, erythema or edema of bronchial mucosa and all the cases were improved after ventilating bronchoscopy with concomitant medical management.

• Journal of Chest Surgery
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• v.55 no.1
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• pp.30-36
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• 2022

Background: No consensus exists regarding whether volatile anesthetics are superior to intravenous anesthetics for reducing postoperative pulmonary complications (PPCs) in patients undergoing general anesthesia for surgery. Studies of this issue focused on anatomic pulmonary resection are lacking. This study compared the effects of total intravenous anesthesia (TIVA) versus volatile anesthesia on PPCs after anatomic pulmonary resection in patients with lung cancer. Methods: This retrospective study examined the medical records of patients with lung cancer who underwent lung resection at our center between January 2018 and October 2020. The primary outcome was the incidence of PPCs, which included prolonged air leak, pneumonia, acute respiratory distress syndrome, empyema, atelectasis requiring bronchofiberscopy (BFS), acute lung injury (ALI), bronchopleural fistula (BPF), pulmonary embolism, and pulmonary edema. Propensity score matching (PSM) was used to balance the 2 groups. In total, 579 anatomic pulmonary resection cases were included in the final analysis. Results: The analysis showed no statistically significant difference between the volatile anesthesia and TIVA groups in terms of PPCs, except for prolonged air leak. Neither of the groups showed atelectasis requiring BFS, ALI, BPF, pulmonary embolism, or pulmonary edema after PSM. However, the length of hospitalization, intensive care unit stay, and duration of chest tube indwelling were shorter in the TIVA group. Conclusion: Volatile anesthetics showed no superiority compared to TIVA in terms of PPCs after anatomical pulmonary resection in patients with lung cancer. Considering the advantages of each anesthetic modality, appropriate anesthetic modalities should be used in patients with different risk factors and situations.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.148-154
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• 1982

The experience with operative treatment for peripheral situated solitary circumscribed lesions of the lung at the Department of Thorac. & Cardiovasc. Surg., Korea University Hospital during 8 years from March 1974, through April, 1982 was reviewed. Our criteria for Solitary pulmonary nodule were 1. Round or Ovoid shape 2. Surrounded by normal lung Parenchyme 3. Well circumscribed peripheral location 4. No other visible pulmonary diseases on chest X-ray except minimal atelectasis or pneumonitis 5. Largest diameter less than 8 cm Of the 55 patients reviewed, there were 69% of malignancy and 31% of benign pulmonary diseases. In malignancy 38 patients, there were 18 patients with squamous cell carcinoma, 8 patients with undifferentiated large cell carcinoma, 2 patients with undifferentiated small cell carcinoma, 10 patients with adenocarcinoma and patient with metastatic carcinoma. In benign pulmonary nodule 17 patients, here were 5 patients with tuberculoma, 5 patients with aspergilloma, 2 patients with A-V fistula, 1 patient with pulmonary blastoma, 1 patient with paragonimiasis, and 1 patient with lung abscess. Overall male to female occurrence ratio was 39:16, and most prevalent age incidence was 7th decades. Most frequent size distribution was 4-6 cm in diameter. All of benign diseases were cured by resection and 66% of malignancy performed operation and has 75% resectability.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.169-173
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• 1982

We have experienced two cases of complicated teratoma in anterior mediastinum. One case, 1-year-old female, has a huge anterior mediastinal teratoma involving almost all of the left pleural cavity with atelectasis of the left lung. The other case, 12-year-old female, has a anterior mediastinal teratoma with fistula between the teratoma and the bronchus of anteromedial basal segment of left lung. The bronchus has a bronchiectatic change with cell infiltration. We performed exploratory thoracotomy with complete excision of tumor mass in both cases and with additional resection of anteromedial basal segment of the left lung due to inflammation and necrosis in latter case. The patients had uneventful postoperative courses and were discharged in good condition. Histopathologic diagnosis of these were benign teratoma consist of skin, skin appendages, cartilage, connective tissue, and gut.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.141-145
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• 1990

Author made a clinical study of 48 cases of primary mediastinal tumors experienced in the dept. of the thoracic and cardiovascular surgery of Pusan National University Hospital during the 12 years period from march 1978 to march 1989. There were 34 males and 14 females. Their age distribution was from 4 months to 70 years, with the mean age of 34.4 years. 8.3 % of the patients were younger than 15 years old. There were teratoma 14 cases[29%], thymoma 11 cases[23%], neurogenic tumor 10 cases[21 %], lymphoma 6 cases[13 %], benign cyst 6 cases[13 %], and one case of fibrous histiocytoma in the histological distribution. The malignant tumors were 12 cases[25 %]. The common symptoms were chest pain and discomfort[35.4], coughing[18.8], general weakness and dyspnea. 16.7% of the patients were asymptomatic at admission. The successful removal was done in all cases of benign mediastinal tumors. In malignant cases, the surgical removal could be done in 5 cases. There was not postop. mortality. The frequent complications were atelectasis, infection, bleeding.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.579-584
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• 1991

The records of 25 patients with traumatic diaphragmatic injuries seen at Chosun University Hospital from February 1977 to May 1991 were reviewed. We treated 20 male and 5 female patients ranging in age from 6 to 72 years. The diaphragmatic injuries were due to blunt trauma in 19 cases[traffic accident 13, fall down 4, compression injury 2] and penetrating trauma in 6 cases[stab wound 5, gun shot 1]. Most common symptoms were dyspnea[72%], chest pain[56%] and abdominal pain [40%], Chest X-ray were normal in 7 cases[28%] and 22 cases[88%] were diagnosed or suspected as diaphragmatic injuries preoperatively. The repair of 25 cases were performed with thoracic approach in 16 cases, thoracoabdominal approach in 6 cases and abdominal approach in 3 cases. Postoperative complications included atelectasis, wound infection and empyema. there was no postoperative death.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.294-297
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• 1993

This study based on the clinical analysis of 42 cases of bronchiectasis treated by surgical resection at the Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital, during 6 years period from 1986 to 1991. The 42 patients with bronchiectasis were composed of 33 males and 9 females, and the peak incidence of age was in the 3rd decade. The clinical symptoms were cough, purulent sputum, hemoptysis and dyspnea. Based on the morphological classification by bronchograpgy, the common type was present in 19 cases[45%] of cylindrical type. The frequently involved site was left lower lobe, and so left lower lobectomy was the most frequently performed method of surgical resection. Postoperative complications were occurred in 8 cases[18%], such as wound infection, atelectasis, pleural effusion, hemothorax, but there were no fatal cases.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.842-846
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• 1995

Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.