• Journal of Chest Surgery
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• v.24 no.9
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• pp.918-925
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• 1991

The technique of sleeve lobectomy has emerged as a relatively recent mode of excisional therapy. Acceptance of the technique has been slow because initially it has believed to be more difficult technically, to be associated with more complications, and be an inadequate operation for cancer. Sleeve lobectomy for bronchogenic carcinoma is an alternative to pneumonectomy. Four patients with bronchogenic carcinoma were treated by lobectomy with sleeve resection of the bronchus from 1986 to 1990. Three patients were male and one patient was female. Ages ranged from 43 years to 68 years. Symptoms were cough, sputum, blood tinged sputum, and dyspnea. Histopathologically, 3 cases were squamous cell carcinoma, 1 case was adenocarcinoma. Preoperative stage was stage I in 3 cases and stage II in 1 case. All of them were alive after operation.

• Korean Journal of Adult Nursing
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• v.21 no.5
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• pp.519-528
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• 2009

Purpose: This study was designed to evaluate the effect of TENS on pain and pulmonary function of post-lobectomy patients with lung cancer. Methods: The study data collection was done from February 4, 2008 to February 7, 2009. The subjects were assigned at random to the experimental group and control group with 20 subjects in each group. The experimental group was measured for pain and pulmonary function after surgery and then again after applying TENS 100 Hz frequency and 40 mA output for 20 minutes. The control group was measured the same as the experimental group except applying sham TENS. Results: The pain score of the experimental group which had TENS applied revealed that there were more significant reductions than the control group which had sham TENS applied. There was no significant difference with the number of times of receiving analgesics between the experimental and control group. The effect of TENS on pulmonary function was significantly different between the experimental group and the control group on VC 2 hours after surgery. There was no significant difference between FVC and FEV1. Conclusion: The findings of the study indicate that the TENS is effective in easing the pain of patients after a lobectomy.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.356-361
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• 2007

Background: Recent progress in the surgical therapy for lung cancer is one of the best examples of the successful evolution of clinical medicine. We reviewed our experience to evaluate the surgical outcomes in patients with non-small cell lung cancer. Material and Method: We reviewed clinical records of 432 consecutive patients with proven non-small cell lung cancer who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes from 1995 to 2005. The clinical characteristics, surgical methods, and recurrence patterns were analyzed. Result: Lobectomy was the most common procedure (66.7%) performed and sleeve lobectomy was the least (5.6%). In 179 patients (42.6%) the recurrence was noted and the regional recurrence (67 cases, 16.0%) was less than systemic recurrence (112 cases, 26.7%). The main sites of regional recurrence were hilum (25 cases, 37.3%) and ipsilateral mediastinum (54/432 cases, 25.4%). The hospital mortality rate was 2.8% (12/432 cases) and resection-morbidity rate was 12.5% (54/432 cases). Conclusion: The low recurrence rate, especially regional recurrence rate indicated that our surgical procedures with preoperative measures were considered useful and effective.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.116-118
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• 1997

Endobronchial lipomas Are rare lesions that usually obstruct a major bronchus and cause irreversible pulmonAry damage distally. They are histologically benign tumors. But they can produce pulmonary damage or irreversible bronchiectasis if dignoses or tr atments are delayed. Whenever possible, the treatment of choice is resection by means of bronchoscopy. If endoscopic removal is not possible or lf the nature of the tumor is unclear, surgery is necessary. with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma . We present a case of endobronchial lipoma causing bronchial obstruction and peripheral organizing pneumonia with its clinical features. diagnosis find treatment methods.

• 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.37 no.8
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• pp.672-683
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• 2004

Background: The treatment results of the advanced lung carcinoma is not satisfactory with the present therapeutic modalities: surgical resection, anti-cancer chemotherapy, and radiotherapy or combination therapy. To predict the prognosis of the non-small-cell lung carcinoma, TNM classification has been was as the basic categorization; however, it has been not satisfactory. It is necessary to consider the causes and the prognosis of the lung carcinoma from another points of view rather the conventional methods. We intended to find out the relationship between the major apoptotic factor, p53 gene and the prognosis of the patient with lung carcinoma. Material and Method: Three hundreds and fifty-nine patients with lung carcinoma who underwent surgery were analysed. We observed p53 protein accumulated in the cellular nuclei. The p53 protein was detected by immuno-histo-chemical method. We collected information of the patient retrospectively. Result: p53 protein densities were observed in 40% in average as a whole. The protein density was 44 percent in man, 25 percent in woman, 49 percent in the squamous cell carcinoma, and 38 percent in the adenocarcinoma. There were significant correlations between the p53 protein density and the mortality in the squamous cell carcinoma (p=0.025), follow-up duration in TNM stage I group (p=0.010), and follow-up duration in the lobectomy patient group (p=0.043), and tumor cell differentiation (p=0.009). p53 protein densities were significantly different between the lobectomy and the pneumonectomy group (p=0.044). Conclusion: The authors found that p53 protein had some correlations with the prognosis of the lung cancer partially in some factors. We suggest the p53 protein density could be used as a marker of prognosis in the non-small-cell lung carcinoma.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.26-35
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• 1994

Background: Bronchioloalveolar cell carcinoma today needs further studies as an early diagnosis will drastically improve the chances of cure. Methods: Twenty-four cases of bronchioloalveolar cell carcinoma for the period of 5 years were studied in terms of incidence, age, sex, underlying diseases, symptoms, radiographic findings, methods of diagnosis, clinical and pathologic staging, methods of treatment, and survival retrospectively. Results: No correlation was found between patients' age, sex and underlying diseases. Most common symptoms were cough(62.5%), chest pain(29.2%), and sputum(29.2%). Of the 24 cases, 13 patients(54.2%) had solitary nodule, 6 patients(25%) had multiple nodules. At the time of diagnosis, 3 patients(12.5%) had the stage I diseases, 3 patients(12.5%) had the stage II diseases, 4 patients(16.7%) had the stage IIIa diseases, 3 patients(12.5%) had the stage IIIb diseases, and 11 patients(45.8%) had the stage IV diseases. 14 cases(58.3%) were found inoperable at the time of admission; they all died within 17 months. In 7 cases with stage I, II, IIIa diseases curative resection were attempted, in 1 case with stage IV disease wedge resection for palliative management was performed, and in 4 cases patients were still alive at the time of conclusion of this study. Conclusion: We conclude that early diagnosis of disease will increase operability and improve chances of survival and that aggressive diagnostic workup for suspicious pulmonary infiltrate is essential as early operation offers the best chances of cure.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.349-355
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• 2004

Non-small cell lung cancer (NSCLC) with invasion of mediastinal structures is classified as stage IIIB, and has been considered surgically unresectable However, in a selected group of these patients, better results after surgical resection compared to non-surgical group have been reported. The aim of this study is to evaluate the role of surgical resection in treatment of mediastinal T4 NSCLC. Material and Method: Among 1067 patients who underwent surgical intervention for non-small cell lung cancer from Aug 1987 to Dec 2001 in Korea cancer center hospital, 82 patients had an invasion of T4 mediastinal structures (7.7%). Resection was possible in 63patients (63/82 resectability 76.8%). Their medical records in Data Base were reviewed, and they were followed up completely until Jun 2002. Surgical results and prognostic factors of NSCLC invading mediastinal structures were evaluated retrospectively. Result Lung cancer was resected completely in 52 patients (63.4%, 52/82). Lung resection was lobectomy (or more) in 14, pneumonectomy in 49. The mediastinal structures invaded by primary tumor were great vessel (61.9%), heart (19%), vagus nerve (9.5%), esophagus (7.9%), and vertebral body (7.9%). Nodal status was N0 in 11, N1 in 24, and N2 in 28 (44.4%). Neoadjuvant therapy was done in 6 (9.5%, 5 chemotherapy, 1 radiotherapy), and adjuvant therapy was added in 44 (69.8%, 15 chemotherapy, 29 radiotherapy) in resection group (n=63). Complication was occurred in 23 (31.7%), and operative mortality was 9.5% in resection group. Median and 5 year overall survival including operative mortality was 18.1 months and 21.7% in resection group (n=63), 6.2months and 0% in exploration only group (n=19, p=.001), 39 months and 32.9% in N2 (-) resection group (n=35), and 8.8 months and 8.6% in N2 (+) resection group (n=28, p=.007). The difference of overall survival by mediastinal structure was not significant. Conclusion: The operative risk of NSCLC invading mediastinal structures was high but acceptable, and long-term result of resection was favorable in selected group. Aggressive resection is recommended in well selected pateints with good performace and especially N2 (-) NSCLC with mediastinal invasion.

• Tuberculosis and Respiratory Diseases
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• v.39 no.2
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• pp.176-179
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• 1992

Bronchial webs are rare lesions which often go unrecognized. A 36-year-old female was admitted to our hospital for recurrent cough and dyspnea. A diagnosis of bronchial asthma was made and she was treated with conventional therapy. She did not respond to drug therapy. On the physical examination, there was localized wheezing on the left lung field. By the bronchogram, we found a membrane-like structure in the left main bronchus. A bronchoplasty was performed and now the patient leads her normal life without any medications for asthma.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.616-620
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• 1992

A sleeve lobectomy is an appropriate operative procedure in patients with endobronchial neoplasms of low-grade malignancies in the proximal airways and for a small but significant number of patients with carcinoma. Here, we present eleven cases of sleeve lobectomy which were performed from 1984 to the August of 1991 in the Department of Thoracic Surgery of Seoul National University Hospital. The sex distribution was 6 males and 5 females in the age range from twenty to sixty seven, with an average of 44.9 years. The pathologic diagnoses were 7 cases of pulmonary malignancies: carcinoid in two, mucoepidermoid carcinoma in two, adenoid cystic carcinoma in one, adenocarcinoma in one, and squamous carcinoma in one. Other diagnoses were two cases of tuberculous bronchial strictures and two cases of benign tumors: one case of pesudolymphoma and one case of neurilemmoma. The procedures consisted of five right upper sleeve lobectomies [Fig. 1], four left upper sleeve lovectomies [Fig. 2], one left lower sleeve lobectomy[Fig. 3], and one right middle and lower lobetomy [Fig. 4]. All except one had a normal preoperative pulmonary function. The case which had a poor pulmonary function was a 66-year-old female adenocarcinoma patient. She seemed to be very intolerable to pneumonectomy [predicted FEV1=0.60L]. Therefore, she had a right sleeve upper lobectomy and experienced smooth postoperative course without any pulmonary problems. All cases had good postoperative results and no postoperative complications.