• Journal of Chest Surgery
• /
• 제55권1호
• /
• pp.37-43
• /
• 2022

Background: The surgical strategy for single-stage resection of primary colorectal cancer (CRC) and synchronous pulmonary metastases remains a matter of debate. Methods: Perioperative data of patients who underwent single-stage resection of primary CRC and synchronous pulmonary metastases were compared to those of patients who underwent 2-stage resections. The demographic data, number of metastases, type of pulmonary and colorectal resections, operation time, blood loss, postoperative complications, morbidities, mortality, medical costs, and length of hospital stay were analyzed. Results: Twenty-two patients underwent single-stage resection of primary CRC and pulmonary metastases, while 27 patients underwent 2-stage resection. Tumor size and the number of pulmonary metastases were not significantly different between the 2 groups. The extent of pulmonary metastasectomy and abdominal procedures were similar in both groups, as was the thoracic surgical approach (video-assisted thoracic surgery vs. thoracotomy). However, open laparotomy was performed more frequently in the 2-stage group than in the single-stage group (p=0.045), which also had a longer total anesthetic time (p=0.013). The operation time, medical costs, estimated blood loss, complication rates, and severity were similar in both groups, but the length of hospital stay was shorter in the single-stage group (p<0.001). Conclusion: Single-stage colorectal and pulmonary resection shortened the overall hospital stay, with no significant changes in operation time, medical costs, hospital mortality, and morbidity. Therefore, single-stage resection could be a good surgical strategy in selected patients.

• Journal of Chest Surgery
• /
• 제25권9호
• /
• pp.962-967
• /
• 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.

• Tuberculosis and Respiratory Diseases
• /
• 제51권4호
• /
• pp.386-389
• /
• 2001

An endobronchial metastasis is defined as a subsegmental or a more proximal central bronchial metastasis of a nonpulmonary neoplasm in the bronchoscopically visible range. However, the frequencies of endobronchial metastasis range from 2 to 50% of pulmonary metastases from extrathoracic neoplasms by a different definition of an endobronchial metastasis. Primary neoplasms of an endobronchial metastasis including breast cancer, colon cancer, renal cell carcinoma, and ovarian cancer are relatively common. However, an endobronchial metastasis arising from thyroid cancer, parotid gland tumor, bone tumor, bladder cancer, and stomach cancer has only rarely been reported in the literature. Here we report a case of an endobrochial metastases from a hepatocellular carcinoma.

• Journal of Chest Surgery
• /
• 제25권8호
• /
• pp.806-811
• /
• 1992

The primary neuroendocrine carcinomas[NEC] of the lung are relatively rare. There are classified histologically into the following groups. 1] bronchial carcinoid, 2] well differentiated neuroendocrine carcinoma[WDNC], 3] intermediate cell neuroendocrine carci-noma[ICNC], 4] small cell neuroendocrie carcinoma[SCNC]. The NE cells can be found throughout the mucosa of the bronchial tree by the electron microscopy. By the immunocytochemistry, Neuron-specific enolase[NSE], serotonin, born-csin, and calcitonin are found in normal solitary NE cells and neuroepithelial bodies. The immunohistochemistry has the advantage that it can be applied on routine pathology specimens. The NSE was localized in all of the NE granule bearing tumors but also present in 57 per cent of the non NE carcinomas. Together the combination of chromogranin A, bombesin and NSE should provide an exellent signature for tumor cells expressing NE features, such as carcinoids and other NE carcinomas. We have experienced two cases of primary pulmonary NEC in 59 and 29 years old men. The former was admitted due to exertional dyspnea and left chest pain, the latter, newly developed mass on chest X-ray. They were treated by Lt pneumonectomy with LN dissection and RLL resection with LN dissection The postoperative diagnoses were could be confirmed by NSE study as NEC which were SCNEC and INEC in subgroups. The postoperative courses were uneventful.

• Tuberculosis and Respiratory Diseases
• /
• 제50권2호
• /
• pp.252-257
• /
• 2001

저자들은 Swyer-James 증후군에 침범되지 않은 정상 폐측에 병발한 기관지원성 편평 상피세포암의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제25권7호
• /
• pp.711-715
• /
• 1992

Massive hemoptysis is defined as pulmonary hemorrhage of more than 600ml to 800ml within 24hours. Among the many causes, the most common include pulmonary tuberculosis, abscess, bronchiectasis, cystic fibrosis bronchial carcinoma. Most acute episodes of hemoptysis last less than 24 hours and gradually subside. However, when the hem-optysis is massive, it carries a mortality rate of 50% to 100%. It is generally agreed that surgery is the treatment of choice for patients with massive hemoptysis. We had the one case of 39 year-old male with recurrent massive hemoptysis. In the past history, he had pulmonary tuberculosis 20 years ago but no chest trauma, Previous chest CT showed well defined cavitary lesion with calcification on RUL Under the bronchoscope finding, we indentified active bleeding from right upper lobe bronchus without end-obronchial lesion. Therefore, emergency thoracotomy was done with impression of hem-optysis due to pulmonary tuberculosis. But operative findings were as follows ; the 4th fractured rib was impacted into the lung parenchyme with severe adhesion and middle lobe was not inflated. So, Upper and middle lobectomy were performed. He was diagnosed finally by operative and pathological findings as massive hemoptysis due to impaction of fractured rib into the lung parenchyme and discharged without complication.

• 고신대학교 의과대학 학술지
• /
• 제33권2호
• /
• pp.240-244
• /
• 2018

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.

• 대한두경부종양학회지
• /
• 제8권2호
• /
• pp.72-81
• /
• 1992

Thyroid cancer, the most common cancer of endocrine neoplasms, has tremendous variation in tumor biologic behavior. There is no consensus about treatment mode to prevent recurrences despite of recent advance in understanding characteristics of thyroid cancer. So, we have made a clinical analysis and follow-up study of recurred 27 cases among 189 cases treated under the diagnosis of thyroid carcinoma in the department of surgery, Chonnam University Hospital from February, 1982 to February, 1992 to clarify our experience about the characteristics of recurred thyroid cancer. The results were as follow: According to the pathological classification of recurred thyroid cancer, recurrence rate was 11.6% in papillary carcinoma, 15.6% in follicular carcinoma, 37.5% in medullary carcinoma, 66.7% in undifferentiated carcinoma, respectively, and the mean recurrence rate of thyroid cancer was 14.3%. The recurrence rate according to age was 28.6% in 8th decade and 17.9% in 4th decade. The recurrence rate according to sex was not singificant(15.6% in male: 14% in female). The mean period to relapse was 4 years 6 months in papillary carcinoma, 2 years 5 months in follicular carcinoma, 2 years 1 months in medullary carcinoma, 2 years 6 months in undifferentiated carcinoma. The recurrence rate according to previous operating methods, such as performing lymph node dissection or not, mode of thyridectomy, type of lymph node dissection was statisfically non-specific. Common recurrent sites of papillary and follicular carcinoma was cervical lymph node and remained thyroid tissue. Medullary and undifferentiated carcinoma was noted in multiregional or systemic involvement Reoperation was performed with complete resection of recurred or metastatic mass, such as radical neck dissection or mass extirpation from involved organs as possible. The postoperative complications were 2 cases of horseness, and 1 case with hematoma, transient hypocalcemia, wound infection, and pulmonary insufficency, respectively. 5-year survival rate was 85.5% in papillary carcinoma, 66.7% in follicular carcinoma. 50% in medullary carcinoma, and 50% in undifferentiated carcinoma. We concluded that recurrence in thyroid cancer give a reconsideration to previous conservative therapy and more extensive surgical procedures for thyroid cancer including lymphatic dissection are recommanded to prevent recurrences in selected cases if possible.

• Tuberculosis and Respiratory Diseases
• /
• 제40권1호
• /
• pp.58-66
• /
• 1993

본 인제대학교 의과대학 서울 백병원 내과학 교실에서는 우연히 발견된 단순흉부 X 선에서의 종괴를 주소로 내원한 16세 남자에서 기관지내시경 및 조직검사를 통하여 우측 상엽기관지에서 발생한 점액표피양 암종을 확인한뒤 우상엽폐절제술을 실시하여 저등급의 조직소견을 보였던 점액표피양 암종 1예와 객혈을 주소로 내원한 41세 남자에서 흉부 전산화단층촬영, 자기공명영상, 기관지내시경검사 및 생검으로 고등급의 점액표피양 암종을 확인한 후 기관지내시경을 통한 에탄올 주입후 좌전폐절제술을 실시하여 재발없이 병의 경과를 관찰중인 다른 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한정형외과학회지
• /
• 제54권3호
• /
• pp.276-280
• /
• 2019

간세포암은 전 세계적으로 가장 흔한 악성 종양 중의 하나로, 간세포암의 간 외 전이는 주로 폐, 림프절, 뼈, 부신 등에 발생한다. 하지만 간세포암의 골격근 전이는 매우 드물고, 보고된 문헌도 흔치 않다. 42세 여성 환자가 우측 대퇴부에 압통이 동반된 연부조직 종괴를 주소로 내원하였다. 7년 전 간세포암과 폐전이가 진단되어 치료를 받은 기록이 있었으며 영상학적 검사 및 혈액 검사 결과 등에서 간세포암의 반막양근 내 전이가 의심되어 절개 생검술을 시행하였고 전이성 간세포암으로 밝혀져 광범위 절제술을 시행하여 치료하였다. 이를 문헌고찰과 함께 보고하고자 한다.