• Journal of Chest Surgery
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• v.34 no.5
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• pp.418-421
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• 2001

53세 남자 환자가 객혈을 주소로 입워하여 우축 상엽 편평상피세로 폐암으로 진단 받았다. 캄퓨터 단층촬영상 하부 기관에 종양의 침윤이 의심되었다. 우측 하엽과 중엽을 보존하기 위해서 우측상엽과 하부 기관외측을 포함하여 절제하는 기관기관지 성형술 시행하였고, 수술후 우측 폐의 팽창은 완전하였다. 수술 후 1주일째 시행한 기관지 내시경 검사상 우측 중엽과 하엽의 기관지는 뒤틀림 없이 잘 유지되어 있었다. 수술 후 항암치료와 방사선 치료를 받고 현재 환자는 수술 후 1년 7개월 동안 외래 추적관찰 중이다. 저자들은 우측 상엽의 폐암이 기관 하부를 침범한 경우에 우측 기관 소매 전폐절제술의 합병증을 피하고 환자의 폐기능을 보조하면서 침윤된 우측상엽을 포함하여 절제하는 기관기관지 성형술을 시행하여 이에 보고하는 바이다.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.179-186
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• 1997

The frequency of primary lung cancer is increasing compared to other cancer. Complete surgical resection is the most effective method of treatment, but it is limited to only 25 to 30 percent of patients after initial clinical presentation. The survival rate is different by the subtypes of carcinoma, stages, and general condition of patients. The author investigated the survival rate of 87 patients with squamous cell carcinoma of the lung after surgery. Age ranged from 31 to 73 years, with Lean 57.1) $\pm$ 7.15 and 80.5% (70 cases) was initially diagnosed at sixth and seventh decades. Male to female ratio was 8.9'1. Initial complaints were cough with sputum in 78.1%, weight loss in 31.0%, chest pain and discomfort in 29.9%, and hemoptysis in 24.1%. The location of the tumor was right side in 44.8% and left slde in 55.2% ; LUL in 39.1%, RLL in 20.7%, LLL in'16. 1%, RUL in 14.9% and RML in 9.2%. Stage I was 19.5%, stage II 25.3%, stage olla 54.1% and stage lIIb 1.1%. Operative procedures were as follow : pneumonectomy in 52.9%, lobectomy in 47.1%, sleeve upper lobectomy in 4 cases. Single mediastinal Iymph node involvement was observed in 17 cases, and multi-level mediastinal Iymph node involvement in 23 cases. Lower paratracheal Iymph node and subcarinal Lymph node were more frequently involved in right side lung cancer, with 8 and 10 cases, respectively and subaortic Iymph node was most frequently involved in left side lung cancer with 9 cases. Operative complications were hoarseness, wound infection and chylothorax in 7, 5 and 4 cases, respectively. The operative mortality was 2.2% and the cause of death was pulmonary edema. Postoperative follow-up period ranged from 1 month to 99 months with a mean of 29.95 $\pm$ 17.21 months. Overall one-year survival rate was 75.1 % and five-year survival rate was 29.8%. One-year and five-year survival rates were 93.7% and 52.4% for stage 1, 92.2% and 30.5% for st ge ll, and 61.2% and 17.4% for stage llla, respectively. These findings correlate survival rate with tumor size, mediastinal Iymph node metastasis and surgical resectability, and long-term survival can be expected with small sized tumor, absent mediastinal Iymph node metastasis and complete surgical resection.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.835-838
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• 2002

A 68-year-old man with Guillain-Barre syndrome after the resection of right upper lobe for squamous cell lung cancer is presented. He developed a sudden, symmetric, extremity weakness, respiratory insufficiency, and sensory ataxia on postoperative day 6. He was intubated emergently and placed on a ventilator. Electrodiagnostic studies were performed on days 2, 20, and 40 following the onset of weakness. Motor nerve conduction abnormalities were the predominant findings. Prolonged motor distal latencies, temporal dispersion, and partial motor conduction blocks were present and formed the diagnostic features of Guillain-Barre syndrome. With supportive care and additive use of intravenous immunoglobulin, the illness resolved 6 weeks later after the onset of weakness.