Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease

간질성 폐질환의 확진을 위한 흉부외과의 역할

  • Kim Sung-Whan (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University) ;
  • Yahang Jun-Ho (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University) ;
  • Kim Jong-Woo (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University) ;
  • Choi Jun-Young (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University) ;
  • Rhie Sang-Ho (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University) ;
  • Jang In-Seok (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Gyeongsang National University and Institute of Health Science, Gyeongsang National University)
  • 김성환 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원) ;
  • 양준호 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원) ;
  • 김종우 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원) ;
  • 최준영 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원) ;
  • 이상호 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원) ;
  • 장인석 (경상대학교 의과대학 흉부외과학교실, 경상대학교병원 흉부외과, 경상대학교 건강과학연구원)
  • Published : 2006.05.01
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Abstract

Background: Pathologic confirmation is needed to diagnose various forms of interstitial lung diseases. We wanted to find out how much the thoracic surgical lung biopsies will be needed for definite diagnosis of interstitial lung diseases. Material and Method: 17 patients underwent surgical lung biopsy in the department of thoracic and cardiovascular surgery, Gyeongsang National University Hospital from June 1995 to November 2002. Chart review and telephone questionnaire were done for retrospective study. Result: Mean age was $49{\pm}22$ years. Age ranged from 1 to 70 years. Dyspnea was the most common complaint. They were referred for definite differential diagnosis from pediatrics and internal medicine. Biopsy methods were thoracotomy in 11 cases, and thoracoscopy in 6 cases. Pathologic confirmation was possible in 11 cases (65%). According to the pathologic reports, treatment plans were changed in 13 cases (76%). Conclusion: Surgical lung biopsy was effective method in differentiating diagnosis of the interstitial lung disease, There was no mortality during operation. It is important that undiagnosed fibrous lung disease should be recommanded the lung biopsy for planning patient's treatment.

배경: 다양한 형태의 간질성 폐질환의 확진을 위해서 조직학적인 진단을 필요로 한다. 흉부외과의 폐생검이 간질성 폐질환의 진단에 얼마나 도움이 되는지 알아보고자 하였다. 대상 및 방법: 1995년 6월부터 2002년 11월까지 경상대학교병원 흉부외과에서 폐생검을 시행한 17명의 환자를 대상으로 병록지, 전화설문을 시행하여 후향적인 조사를 하였다. 결과: 평균 나이는 $49{\pm}22$세였다. 나이의 범위는 1세에서 70세였다. 주소는 대부분 호흡곤란이었으며, 간질성 폐질환의 확진을 위하여 소아과와 내과에서 의뢰된 환자들이었다. 폐생검 접근방법은 흉강경 6예, 개흉술 11예였다. 11예에서(65%) 확진이 가능하였고, 조직학적인 진단이 확인된 후 13예에서(76%) 치료방법을 변경하였다. 결론: 외과적인 폐생검술은 간질성 폐질환의 감별진단에 도움을 줄 수 있다. 폐생검술은 수술 중 사망이 없을 정도로 안전한 방법이다. 진단이 되지 않은 간질성 폐질환의 감별진단을 위하여 폐생검이 권유하는 것은 치료방법의 결정에 중요하다.

Keywords

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