• Title/Summary/Keyword: 완전 절제

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Risk factors of Pneumonectomy in Non-Small Cell Lung Cancer (비소세포폐암에시 전폐절제술의 위험 인자)

  • Hwang Eun-Gu;Baek Heejong;Lee Hae-Won;Park Jong-Ho;Zo Jae-Ill
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.616-621
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    • 2005
  • Background: In the resection of lung cancer, pneumonectomy occupied $20 {\~}35\%$ of all resections, and significantly high operative mortality is reported in right pneumonectomy ($10{\~}25\%$). The aim of this study is to identify the characteristics of morbidity, operative mortality and factors affecting operative mortality after pneumonectomy. Material and Method: This study recruited the database which performed pneumonectomy for lung cancer in Korea Cancer Center Hospital from Aug 1987 to Apr 2002. Result: Total of 386 pneumonectomies were peformed in that period. Sidedness were left in 238, right in 148; and the procedures were standard resection in 207, and extended resection in 179. Morbidity occurred in 115 cases ($29.8\%$, 115/386). Mortality occurred in 12 cases ($3.1\%$, 12 in 386). This mortality rate was similar to that of lobectomy ($2.1\%$, 13 in 613) during the same period. Morbidity consisted of 42 hoarseness, 17 (9) pneumonia and ARDS, 8 empyema, 5 (1) broncho-pleural fistula, 5 reoperation for bleeding, 5 (1) arrhythmia, 1 (1) pulmonary edema, and 25 others (The number in the parenthesis is the number of mortality case for that morbidity). Several factors affecting the operative mortality were evaluated. At first, extended procedure ($3.3\%$, 6 in 179) affected the operative mortality similar to the standard procedure ($2.9\%$, 6 in 207)(p=0.812). Second, the rate of operative mortality in an elderly group over 60 years ($5.5\%$, 10 in 182) was significantly higher than the younger group under 60 years ($1\%$, 2 in 204)(p=0.016). Third, sidedness of resection affects to operative mortality. Right pneumonectomy ($6.8\%$, 10 in 148) showed higher operative mortality than that of left pneumonectomy ($0.8\%$, 2 in 238)(p=0.002). The group over 60 years showed higher incidence of respiratory morbidity ($11.0\%$, 20 in 182) than that of the group under 60 years ($3.4\%$, 7 in 204)(p=0.005). Right pneumonectomy also showed significantly higher incidence ($11.5\%$, 17 in 148) than that of left pneumonectomy ($4.2\%$, 10 in 238)(p=0.008). Conclusion: Age and sidedness of pneumonectomy were the risk factors of operative mortality and respiratory complications, Therefore, careful selection of patients and more attention perioperatively were demanded in right pneumonectomy. However, because the operative mortality is acceptable, pneumonectomy could be done safely if the pneumonectomy is necessary for curative resection of lung cancer.

Recurrent Plasmacytoid Myoepithelioma of the Lung - A case Report - (재발성 형질세포양 세포성 폐 근상피종 -1례 보고-)

  • 박충규;심영목
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.638-641
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    • 1998
  • A recurrent myoepithelioma of the lung in a 36-year-old man is reported. The neoplasm showed histologic features identical to those described in myoepitheliomas of major and minor salivary glands on the basis of Dardick's morphological classification of Myoepitheliomas. He was treated totally with surgical en-bloc resection including the chest wall. The tumor was found to be well encapsulated, and it appeared to be mainly composed of plasmacytoid cells and clear cells with occasional microcystic spaces in a solid growth form by light microscopy. Immunocytochemical, ultrastructural and flow-cytometrical studies supported myoepithelioma differentiation.

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Small Cell Carcinoma of the Esophagus A Case Report (식도에 발생한 소세포암 -1례보고-)

  • Mun, Hyeon-Jong;Kim, Yeong-Tae;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.241-245
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    • 1997
  • Primary small cell carcinoma of the esophagus is a very rare cell type in esophageal cancer and an extremely aggresive tumor with grave prognosis. Because of the highly malignant potency, chemotherapy for the primary therapy of small cell carcinoma is accepted generally. We experienced a case of small cell carcinoma of the lower esophagus. The patient was a 53 year-old male with regional Iymph node metastasis and managed with complete resection and chemotherapy.

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Capillary Hemangioma of the Right Ventricle- A case Report- (우심실에 발생한 모세 혈관종 1례 보고)

  • Song, Hyun;Je, Hyoung-Gon;Matsuda, Naruto;Lee, Jae-Won;Song, Meung-Gun
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.410-413
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    • 2001
  • 심장에서 발생하는 모셀혈관종은 극히 드문 양성 종양이다. 본원에서는 호흡곤란을 주소로 내원한 13세 남자 환자에서,심포음파상 중등도의 혈류 폐쇄를 초래하는 우심실내 종괴를 확인한 후, 우심방을 통해 완전 절제하여 조직검사상 모세 혈관종을 발견하였기에 문헌고찰과 더불어 증례보고하는 바이다.

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Primary Intrathoracic Goiter - A case report - (일차성 가슴안 갑상샘종 - 1예 보고 -)

  • Park, Ki Sung
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.131-133
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    • 2009
  • Intrathoracic goiters consist of two types: the primary and secondary type. Primary intrathoracic goiters are very rare. We report here on a case that was resected with using the thoracoscopic assist technique. The transthoracic or transsternal approach is necessary for primary goiters to remove them completely without complications.

Sacrococcvgeal Chordomas with Wide-spread Metastases - Report of Two Cases and Review of Literature - (원격전이를 보인 천미골 척삭종 2례)

  • Suh Hyun Suk;Shin Young Ju;Joo Mee;Kim Byung Jik
    • Radiation Oncology Journal
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    • v.17 no.1
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    • pp.52-56
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    • 1999
  • Chordomas are rare tumors arising from the primitive notochord. The commonest affected segment is the sacrum and these chordomas frequently follow a progressive course with multiple recurrences and metastases and eventual death due to tumor. This report describes two cases of sacrococcygeal chordomas with widespread metastases treated by surgery and adjuvant radiation therapy.

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Primary Malignant Melanoma Presenting as an Anterior Mediastinal Mass (전종격동에 원발한 악성 흑색종)

  • 김형렬;이정상;김영태;김주현;김지은
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.697-700
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    • 2002
  • Primary malignant melanoma of the mediastinum is extremely rare : To date, there have been only 8 cases reported in the literature. We report a case of a 50-year-old woman presented with an anterior mediastinal mass. The mass invaded the lung parenchyme of right upper lobe, which was wedge-resected with the mass. Microscopically, spindle or polygonal tumor cells with prominent nucleoli and intracytoplasmic melanin pigments are characterized and Fontana stain confirmed the presence of melanin pigment. Immunohistochemical studies showed diffuse positive staining for HMB45, S100 protein and vimentin, which further suggested melanoma.

A Pedunculated Cavernous Hemangioma located beneath the Inferomedial Scapular Area -A Case Report- (견갑골 내측부 하방에 발생한 자루를 동반한 해면 혈관종 -증례 보고-)

  • Park, Tae Soo;Kim, Sung Jae;Ryu, Jeong Ah
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.2
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    • pp.93-96
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    • 2011
  • We reported a patient with a large pedunculated cavernous hemangioma located beneath inferomedial border of the scapular bone and the trapezius muscle checked by ultrasonography before and after the operation. In ultrasonographic finding, the peduncle was difficult to be visualized preoperatively due to acoustic shadowing.

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Lymphangioma of the Chest Wall (흉벽의 임파관종)

  • 김영진;이철주;소동문;김정태;강준규;홍준화
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.855-857
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    • 1999
  • Lymphangioma(or cystic hygroma) of the chest wall is rare case. We experienced one such case in a 16-year-old girl who complained of a large recurrent mass on her right upper post erolateral chest wall which had developed several years ago. The diagnosis was made following a physical examination, chest magnetic resonance imaging(MRI), and radio isotope (RI) lymphangiogrphy and was confirmed by a histopathological examination. We performed total excision of the lesion followed by a repeated sclerosing therapy with intralesional injection of Vibramycin.

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Prognostic Factors of Thymic Carcinoma (흉선암의 예후인자)

  • Park, In-Kyu;Kim, Dae-Joon;Kim, Kil-Dong;Bae, Mi-Kyung;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.564-569
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    • 2005
  • Background: Thymic carcinoma is a rare malignant disease with sparse data for treatment and prognosis. We intended to investigate the prognostic factors of thymic carcinoma. Material and Method: Data of 42 patients, who were diagnosed and treated for thymic carcinoma from January of 1986 to August of 2003 were reviewed retrospectively. Influences of characteristics of patients, Masaoka stage, histologic grade, completeness of resection and adjuvant treatment on survival were evaluated. Result: There were 30 male and 12 female patients and their mean age was $52.0\pm15.7$ years old. There were 28 patients with low-grade histology and 13 patients with high-grade histology. Clinical stage according to Masaoka stage were I in 2, II in 2, III in 15 $(35.7\%)$, IVa in 10 $(23.8\%),\;and\;IVb\;in\;13\;(31\%)$ patients. Surgical resection was done in 22 patients, Complete resection was possible in 13 patients and incomplete resection was done in 9 patients. Among 20 patients without resection, 8 patients received chemotherapy, 7 patients received radiotherapy and 5 patients received combined therapy. Median survival time was $31.7\pm6.1$ months and 5 year survival rate was $28.5\%$. High grade histology (hazard ratio=3.009, $95\%\;confidence\;interval=1.178\sim7.685,$ p=0.021) and incompleteness of resection (hazard ratio=3.605, $95\%$ confidence interval= $1.1541\sim1.580$, p=0.023) were the prognostic factors of thymic carcinoma. Conclusion: In thymic carcinoma, low grade histology is a good prognostic factor and complete resection can prolong the survival of patients.