• Journal of Chest Surgery
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• 제54권4호
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• pp.253-257
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• 2021

Video-assisted thoracic surgery (VATS) for lobectomy or segmentectomy is considered a favorable alternative to thoracotomy because of its usefulness and safety; it reduces postoperative pain, lowers morbidity, and shortens the hospital stay. However, despite these advantages of VATS, it has been difficult to perform VATS pneumonectomy due to the high morbidity and mortality rate of pneumonectomy. Recently, as VATS techniques have been developed and the usefulness of VATS pneumonectomy has continued to be reported, the frequency of VATS pneumonectomy is gradually increasing at large-volume centers. This article describes VATS pneumonectomy with a focus on the surgical technique.

• Journal of Chest Surgery
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• 제33권1호
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• pp.73-78
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• 2000

Background: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inf-lammatory lung disease. Material and Method: Eighty-five patients underwent pneumon-ectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergio- losis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, Result: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneu-monectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pl- eural spillage due to cavity or lesion perforation(p=.003) which is as the same results as gen-eral complication rate. Conclusion: The postoperative complication rate of pneumone-ctomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra- pleural spillage.

• Journal of Chest Surgery
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• 제16권4호
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• pp.539-546
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• 1983

Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.

• 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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• 제26권11호
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• pp.845-850
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• 1993

Post-Pneumonectomy Empyema[PPE] is a relatively uncommon but serious complication. And the management of it remains a disturbing and controversial area in the field of general thoracic surgery. Many methods have described and have had varying degrees of success. For the purpose of providing the guideline for management of post-pneumonectomy empyema, we reviewed our experiences of treatment of PPE from January 1985. to December 1992. There were 17 cases, which consist 7.9% of all pneumonectomy cases for that period. There were 13 male and 4 female patients with mean age of 47.1$\pm$ 16.2 yrs old. Both chest has the same incidence. The most common disease for prior pneumonectomy was tuberculosis, but the PPE was the most frequently occurred in empyema. The duration between pneumonectomy and PPE was 44.7 $\pm$81.1 months, where 58.8% of patients occurred within 1 month. Fever was the most frequent complaint and wound dischrge was detected in less than half of patients. There were 2 in-hospital mortalities.Mostly, in 13 cases, we did Eloesser operation. Five of them could finish second Clagett procedure, but one had recurrence. Four bronchopleural fistular patients underwent 3 single stage muscle flap closure and 1 direct closure with modified Clagett procedure. None had recurrence. Mean follow-up duration is 30.9\ulcorner22.3 months. There was 1 late death which was not related to PPE but to Malignancy recurrence.

• Journal of Chest Surgery
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• 제28권5호
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• pp.504-506
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• 1995

Postpneumonectomy empyema is an infrequent but dreaded complication. The seriousness of this complication is impossible to eliminate the space containing the infection, and consequently, it is difficult to sterilize the space. The time from pneumonectomy to the development of an empyema ranges from several days to several years, with most evident with 4 weeks. We experienced a case of postpneumonectomy empyema that occurred 27 1/2 years after initial pneumonectomy. She was treated with intrapleural antiseptic irrigation and open-tube drainage following partial decortication. The patient had an uneventful recovery and was discharged from hospital with improved condition.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1218-1220
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• 1992

Pneumonectomy on a patient with documented poor pulmonary function indicating a contraindication to surgery can be associated with a high risk of serious postoperative morbidity or mortality. However the usual criterias, on the performance of a pneumonectomy on a high risk patient based on the preoperative assessment of the pulmonary function may not sometimes predict with accuracy the operative outcome in the postoperative period. We recently performed pneumonectomy with good results on a patient with poor pulmonary function that would otherwise have been an absolute contraindication to surgery by usual criteria.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1132-1136
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• 1992

We report a successful right,sleeve pneumonectomy using femoro-femoral bypass on a 26-year-old woman with severe carinal and lower tracheal stenosis of tuberculous origin. Omental graft on the anastomotic site was added, There was no specific postoperative complication and postoperative bleeding was minimal.

• Journal of Chest Surgery
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• 제36권9호
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• pp.703-706
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• 2003

전폐절제술 후 증후군은 우전폐절제술 후 혹은 우동맥궁을 가진 환자의 좌전폐절제술 후 심한 종격동의 이동과 회전에 의하여 기도가 폐쇄되어 심한 호흡곤란을 일으키는 질환이다. 그러나, 전폐절제술이 아니더라도 종격동의 이동과 회전에 의해 기도가 폐쇄될 수 있다. 삼성서울병원 흉부외과에서는 폐결핵성 파괴폐에 의해 유발된 전폐절제술후양(postpeumonectomy-like syndrome) 증후군을 전폐절제술과 함께 조직확장기(tissue expander)를 삽입하여 종격동 정복(mediastinal repositionng)을 시행한 예를 경험하였기에 보고하는 바이다.

• The Korean Journal of Physiology
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• 제25권1호
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• pp.81-85
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• 1991

At the fifth day after right lung pneumonectomy in New-Zealand white rabbits $(0.8{\sim}1.1\;kg\;B.W.)$, phospholipid and protein concentration in the left lung lavage fluid were measured for clarification of the effect of unilateral pneumonectomy on the secretory function of the type II pneumocytes in growing rabbits. In an attempt to evaluate the effect of unilateral pneumonectomy on the compensatory growth of the residual lung, left lung weight and left lung weight-body weight ratio and DNA concentration, RNA/DNA and total DNA content in the left lung tissue were measured in pneumonectomized and in sham operated control rabbits. The lung weight of pneumonectomized rabbit was approximately two times heavier than that of the control rabbits. DNA concentration and RNA/DNA of the lung tissue were not changed but total DNA content was increased significantly. Phospholipid concentration in the lung lavage fluid of the pneumonectomized rabbits was over two times higher than that of control rabbits. from these experimental results, It is concluded that unilateral pneumonectomy in growing rabbits might cause to increase the secretion of pulmonary surfactant from type II pneumocyte of the residual lung. The cellular hyperplasia seems to be the primary response of the compensatory growing lung in unilateral pneumonectomized growing rabbits.