폐절제술후 발생한 합병증 및 사망률에 대한 후향적 고찰

Retrospective Study for Morbidity and Mortality after Major Lung Resection

  • 문광덕 (아주대학교 의과대학 흉부외과학 교실) ;
  • 이철주 (아주대학교 의과대학 흉부외과학 교실) ;
  • 김영진 (아주대학교 의과대학 흉부외과학 교실) ;
  • 최호 (아주대학교 의과대학 흉부외과학 교실) ;
  • 김정태 (아주대학교 의과대학 흉부외과학 교실) ;
  • 강준규 (아주대학교 의과대학 흉부외과학 교실) ;
  • 홍준화 (아주대학교 의과대학 흉부외과학 교실)
  • Moon, Kwang-Deok (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Lee, Cheol-Joo (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Kim, Young-Jin (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Choi, Ho (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Kim, Jung-Tae (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Kang, Joon-Kyu (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Hong, Joon-Hwa (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine)
  • 발행 : 2000.04.01

초록

Background: A retrospectiye study was done for understanding morbidity and mortality after major lung resection. Material and Method: From June 1994 to August 1998, 203 patients received major lung resections for various causes. There were 142 males and 62 females with a mean age of 47.5 years. Initial complains were cough in 47.8%, sputum in 33.0%, hemoptysis or blood-tinged sputum in 23.2%, dyspnea in 18.2%, chest pain in 15.3%, weight loss in 10.8%, fever and chill in 4.9%. There were no complaints in 5.9% of the total patients. The underlying diseases were lung tumor(102 cases/50.2%), bronchectasis(28 cases/13.8%), aspergillosis(24 cases/1.8%), tuberculosis(20 cases/9.9%) and others (29 cases/66.5%) and pneumonectomy(68 cases/33.5%). The postoperative complications were classified as : empyema, BPF, respiratory problem, persistent air leakage over 7 days, arrhythmia, ventilator applied over 24 hours, bleeding, wound infection and chylothorax. The postlobectomy complications were revealed as follow: empyema(3.7%), BPF(2.2%), respiratory problem(5.2%), persistent air leakage over 7days(8.9%), arrhythmia(2.2%), ventilator applied over 24 hours(2.2%), bleeding(1.5%), wound infection(2.9%), chylothorax(0.7%). The postpneumonectomy complications were revealed as follow : empyema(5.9%), BPF (5.9%), respiratory problem(17.6%), persistent air leakage over 7days(0%), arrhythmia(5.4%), ventialtor apply over 24 hours(7.4%), bleeding (7.4%), wound infection(2.9%) and chylothorax(1.5%). Reoperation was done in 8 cases (4.0%). There were 5.8% operative mortalities in pneumonectomy and 0.7% in lobectomy.

키워드

참고문헌

  1. J Thorac Surg v.10 Individual ligation technique for lower lobectomy Blades B.;Kent EM
  2. JAMA v.101 Successful removal of an entire lung for carcinoma of the bronchus. Graham EA;Singer JJ
  3. J Thorac Cardiovac Surg v.86 Modern thirty-day operative mortality for surgical resection in lung cancer. Ginsberg RJ;Lucius DH;Eagan RT(et al)
  4. Arch Surg v.108 Minimal pulmonary resection in treatment of cancer of the lung Shields TW;Higgins GA Jr.
  5. Ann Thorac Surg. v.48 Determinants of perioperative morbidity and mortality after pneumonectomy Waki R.(et al)
  6. Scand J Thorac Cardiovasc Surg v.17 A Haemorrhagic complications during pulmonary resection. A retrospective review of 1428 resections with 113 haemorrhagic episodes Pelerfty A, Henze
  7. International Trends in General Thoracic Surgery v.2 Role of mechanical ventilation in the genesis of empyema and bronchopleural fistula. Gaud C.;Grillo HC(ed.);Eschappasse H(ed.)
  8. Ann Thorac Surg v.52 Bronchopleural fistula after stapled closure of the bronchus. Vester SR;Faber LP;Kittle CF;Warren WH;Jensik RJ
  9. Chest v.82 Complications of surgery in the treatment of carcimoma of the lung. Nagasaki F.;Flehinger BJ;Martini N.
  10. Ann Thotac Surg v.40 Elective pulmonary lobectomy : Factoors associated with morbiduty and operative mortality. Keagy BA Lores ME;Starek PJ;Murray GF;Lucas CL;Wilcor BR
  11. Thoracic Surgery : Surgical Management of pleural diseases. Chylothorax in adults : Pathophysiology and management. Simpson L.;Desluauriers J(ed.);Lacquet LK(ed.)
  12. Thoracic Surgery : Surgical Management of pleural diseases Chylothorax complicating pulmonary resection. Brie M(et al);Desluauriers J(ed.);Lacquet LK(ed.)
  13. Ann Thorac Surg v.54 Elective pneumonectomy : Factors associated with morbidity and operative mortality. Patel RL;Townsend ER;Fountain SW
  14. Current Controversies in Thoracic Surgery Malignant pleural mesothelioma : Operative treatment by extrapleural pneumonectomy. Faber LP;Kittle CF(ed)
  15. 대흉외지 v.28 전폐 절제술에 있어서 수술위험인자의 평가 정경영;김길동