• 제목/요약/키워드: 폐절제술

검색결과 147건 처리시간 0.017초

남성 유방암 폐전이 환자의 폐절제술 후 한의기반 통합암치료로 증상 호전에 대한 증례보고 (A Case Report of Symptom Improvement after lobectomy in Male Breast Cancer with Lung Metastasis Patient Treated with Korean Medicine based Integrative Cancer Treatment)

  • 고은주;하수정;박지혜;박소정;이연월;조종관;유화승
    • 대한암한의학회지
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    • 제25권1호
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    • pp.1-9
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    • 2020
  • Objective: The purpose of this study is to report improvement of symptoms after lobectomy of male breast cancer lung metastasis treated with Korean Medicine based Integrative Cancer Treatment (ICT). Methods: A male left breast cancer patient diagnosed with metastasis on lung at July 2019. After Video assisted thoracic surgery (VATS) left lower lobe (LLL) lobectomy and En bloc wedge resection the patient visited the Daejeon korean medicine hospital of Daejeon university East West Cancer Center (EWCC) to treat operation-site (op-site) pain, dysphagia, anorexia with Korean Medicine Treatment. The patient was treated with Korean Medicine based ICT for an approximately 20 days. The clinical outcomes were measured by National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Numeral rating scale (NRS) and Eastern Cooperative Oncology Group (ECOG). The safety of treatment was verified by blood tests. Results: After treatment, op-site pain was improved from NRS 9 to 6, dysphagia and anorexia were relieved from NRS 9 to 2. And ECOG score of the patient was improved from grade 2 to 1. Conclusion: This case study suggests that Korean Medicine based ICT may help to improve post operative sequelae in metastatic lung cancer patient.

만성 결핵성 농흉과 동반된 흉벽 악성 육종 - 1예 보고 - (High Grade Sarcoma Arising from the Chest Wall of a Chronic Tuberculous Empyema - A case report -)

  • 정원재;이성호;김광택;강문철;정재호;손호성;손국희;선경
    • Journal of Chest Surgery
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    • 제41권6호
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    • pp.795-798
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    • 2008
  • 50세 남자 환자가 좌상복부 동통 및 발열 증상을 주소로 내원하였다. 환자는 과거력상 28년전에 폐결핵 및 늑막염으로 약물치료를 받았으며 8년전 재생불량성 빈혈로 비장 절제술을 받았다. 내원 후 시행한 CT 검사상에서 만성 좌측 농흉과 연결을 보이는 복강내 농양이 진단되었다. 만성 농흉과 더불어 전흉벽에 농흉에 의한 흉벽 침습이 의심되는 병병도 아울러 관찰되었다. 환자는 복강내 농양 배액술 이후 좌측 늑막전폐절제술 및 흉벽 절제술을 시행 받았고 병리 조직 검사상 육종이 진단되었다.

청색증과 호흡곤란을 동반한 폐동정맥루의 1예 (Pulmonary arteriovenous malformation manifesting with perioral cyanosis and dyspnea on exertion: A case report)

  • 김유경;김진우;이건;한만용
    • Clinical and Experimental Pediatrics
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    • 제52권1호
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    • pp.124-128
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    • 2009
  • 폐동정맥루는 폐동맥과 폐정맥이 모세혈관 없이 바로 연결된 것으로서 우좌 단락을 형성하여 청색증, 호흡곤란과 곤봉지를 일으키는 질환이다. 또한 뇌혈전에 의하여 뇌출혈이나 뇌농양 등의 신경학적인 합병증을 일으킬 수 있다. 대부분의 경우 청소년기 후기까지 증상이 나타나지 않는 경우가 많다. 본 증례는 입주위의 청색증과 곤봉지 및 호흡곤란을 보인 6세된 남아였다. 흉부 엑스레이에서 우측하엽에 국소적인 결절의 음영이 발견되었고 흉부 단층 촬영을 통해 우측 하엽의 큰 폐동정맥루를 확진하였다. 우측 하엽의 폐절제술로 합병증 없이 성공적으로 치료하였다. 영유아시기에 폐동정맥루의 발생 빈도는 드물긴 하지만, 심혈관계 질환 없이 청색증과 호흡곤란을 보이는 드문 원인으로 폐동정맥루의 가능성을 염두에 두고 일찍 진단하고 치료함으로써 신경학적인 합병증의 발생을 예방하여야 한다.

기관지 유암종 2례 (Two Cases Report of Bronchial Carcinoid Tumors)

  • 최교원;서정일;김성숙;정진홍;이관호;이현우;이동협;이정철;한승세
    • Journal of Yeungnam Medical Science
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    • 제10권2호
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    • pp.525-536
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    • 1993
  • 전형 중심성 기관지 유암종과 비전형 기관지유암종을 기관지내시경하 생검 및 전산화 단층 촬영하 생검으로 확진했으며 근치적 치료로 폐절제술을 시행한 치험 2례를 문헌 고찰과 아울러 보고하는 바이다.

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폐절제술후의 폐기능 예측에 대한 나선식 정량적 CT의 유용성 (나선식 정량적 CT와 폐관류스캔과의 비교) (Use of Quantitative CT to Predict Postoperative Lung Function (Comparison of Quantitative CT and Perfusion Lung Scan))

  • 이조한
    • Journal of Chest Surgery
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    • 제33권10호
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    • pp.798-805
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    • 2000
  • Background : the prediction on changes in the lung function after lung surgery would be an important indicator in terms of the operability and postoperative complications. In order to predict the postoperative FEV1 - the commonly used method for measuring changes in lung function- a comparison between the quantitative CT and the perfusion lung scan was made and proved its usefulness. Material and Method : The subjects included 22 patients who received perfusion lung scan and quantitative CT preoperatively and with whom the follow-up of PFT were possibles out of the pool of patients who underwent right lobectomy or right pneumonectomy between June of 1997 and December of 1999. The FEV1 and FVC were calibrated by performing the PFT on each patient and then the predicted FEV1 and FVC were calculated after performing perfusion lung scan and quantitative CT postoperatively. The FEV1 and FVC were calibrated by performing the PFT after 1 week and after 3 momths following the surgery. Results : There was a significant mutual scan and the actual postoperative FEV1 and FVC at 1 week and 3 months. The predicted FEV1 and FVC(pneumonectomy group : r=0.962 and r=0.938 lobectomy group ; r=0.921 and r=913) using quantitative CT at 1 week postoperatively showed a higher mutual relationship than that predicted by perfusion lung scan(pneumonectomy group : r=0.927 and r=0.890 lobectomy group : r=0.910 and r=0.905) The result was likewise at 3 months postoperatively(CT -pneumonectomy group : r=0.799 and r=0.882 lobectomy group : r=0.934 and r=0.932) Conclusion ; In comparison to perfusion lung scan quantitative CT is more accurate in predicting lung function postoperatively and is cost-effective as well. Therefore it can be concluded that the quantitative CT is an effective method of replacing the perfusion lung scan in predicting lung function post-operatively. However it is noted that further comparative analysis using more data and follow-up studies of the patients is required.

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원발성 폐 악성 흑색종 -1예 보고- (Primary Malignant Melanoma of Lung -A case report-)

  • 정영균;이응배;박재용
    • Journal of Chest Surgery
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    • 제39권1호
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    • pp.76-79
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    • 2006
  • 폐에 발생하는 원발성 악성 흑색종은 극히 드물다. 46세 여자가 2개월간의 마른기침과 혈담을 주소로 내원하였다. 컴퓨터단층촬영 상 우측 폐하엽에 4.5$\times$5.0 cm 크기의 종괴가 관찰되어 기관지내시경 하 및 경피적 폐생검술을 반복 시행하였으나 정확한 진단이 되지 않았다. 악성 종양을 의심하고 시행한 술 전 검사에서는 전이 소견이 없어 수술적 접근을 하였다. 우하엽 폐절제술과 임파절 박리를 시행하였으며 종양과 임파절 모두 원발성 악성 흑색종으로 진단되었다. 술 후 40일째 우측 반부전마비가 있어 촬영한 뇌자기공명 영상상 좌측 두정부에 전이 소견이 있어 종양제거술을 시행하였으나 술 후 8개월째 사망하였다.

누두흉과 선천성 낭종성 선종양 기형의 최소 침습적인 동시수술 -1예 보고- (Minimally Invasive Simultaneous Treatment for Congenital Cystic Adenomatoid Malformation associated with Pectus Excavatum - A case report -)

  • 조덕곤;조민섭;김경수;왕영필;조규도
    • Journal of Chest Surgery
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    • 제39권2호
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    • pp.171-175
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    • 2006
  • 최소 침습성 흉부수술은 최근에 가장 발전되어온 중요한 수술의 한 분야이다. 선천성 낭종성 선종양 기형은 비교적 드물게 발생하는 폐질환으로 누두흉, 선천성 심장 및 폐혈관 질환 같은 여러 가지 선천성 기형 등이 동반될 수 있다. 저자들은 우하엽 폐에 선천성 낭종성 선종양 기형이 있으며 누두흉이 동반된 5세 된 남아 환자를 최소 침습적인 방법으로 치료 경험하였다. 저자들은 흉강경을 이용하여 우하엽 폐절제술을 실시하였고, 동시에 누두흉에 대해서는 흉골 하 금속막대를 이용한 너스 술식으로 교정하였다. 이와 같이 이러한 질환에 대한 최소 침습적인 수술방법은 유용하고 미용적으로 우수하다.

경피적 폐생검술에 의한 폐암의 흉벽 전이 -1례 보고- (Chest Wall Implantation of Lung Cancer After Percutaneous Fine Needle Biopsy -A Case Report)

  • 심성보;이성호
    • Journal of Chest Surgery
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    • 제30권4호
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    • pp.445-448
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    • 1997
  • 폐암의 진단에 유용한 방법인 경피적 폐생검술에 미세바늘이 도입된 1970년대 이후 경피적 폐생검술 에 의한 폐암의 흉벽 전이는 아주 희귀하게 보고되고 있으며, 치명적 인 합병증으로 인식되고 있다. 저자들은 65세 남자로 폐암(편평상피세포암, T2N0M0)진단으로 우상엽과 우중엽의 양폐엽 절제술을 시행한 환자에서, 수술전 시행한 경피적 폐생검술 60일(폐절제술 48일)만에 흉벽에 촉지된 직경 1mm 의 돌기를 발견하였라.이 돌기는 20일 만에 직경 1.5cm의 화농성 종괴로급속히 성장하여 폐암의 흉벽 전이로 진단하고 ni생검술 80일째 종괴를 포함한 광범위 절제술과 피부 이식술을 시행하였다. 병리 조직 검사상 피부와 피하 지방 조직의 흉벽에 전이된 암으로 훤발성 폐암과 같은 편평상피세포암으로 확 인하였다.

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결핵성 폐질환의 폐절제술후 폐기능 및 동맥혈가스 분석에 대한 임상적 고찰 (Clinical Evaluation of Pulmonary Resection With Arterial Blood Gas Analysis and Pulmonary Function Test in the Pulmonary Tuberculosis)

  • 채성수
    • Journal of Chest Surgery
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    • 제26권11호
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    • pp.856-860
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    • 1993
  • We performed serial pulmonary function test and arterial blood gas analysis at preoperative period and postoperative 1st week in 337 patients who underwent pulmonary resection from May 1988 to April 1992 at Dept. of Thoracic and Cardiovascular Surgery, Seoul adventist hospital. Follow-up study for PFT and ABGA were possible in 30 % of the patients at postoperative 3rd or 4th month. In patient who underwent pneumonectomy, VC was decreased from 57.7% to 46.1%, FVC was decreased from 53.5 % to 41.2 % and MBC also decreased from 68.1% to 49.6 % at postoperative 1st week. But ABGA revealed that POa-, was increased from 87.2 mmHg to 92.7 mmHg, and PCO2 was decreased from 43.2 mmHg to 35.9 mmHg at postoperative 1st week. In patients who underwent lobectomy, VC was decreased from 78.1% to 68.30 %, FVC was decreased from 72.5% to 55.3% and MBC was decreased from 73.5% to 68% at postoperative 1st week.But, ABGA revealed that PO2 was increased from 95.2 mmHg to 97.9 mmHg and PCO2 was decreased from 42.3 mmHg to 39.0 mmHg at postoperative 1st week. The pulmonary function recovered at postoperative 3rd or 4th month and its ratio to preoperative value was 90% in lobectomy cases, but in pneumonectomy cases VC and MBC were recovered 20% and 15 % above the preoperative values. We concluded that resection of atelectasis, destructed lung, open negative and open positive cavity in the pulmonary tuberculosis were beni~t to improve ventilation-perfusion ratio,and pulmonary function was recovered nearly to preoperative level at postoperative 3rd or 4th month.

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일측 폐절제술후 폐기능의 추적관 (Follow up study of pulmonary function after pneumonectomy)

  • 박재길;김세화;이홍균
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.539-546
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    • 1983
  • Maximal expiratory flow-volume [MEFV] curves were studied in 22 patients who underwent pneumonectomy with various pulmonary lesions, such as lung cancer, bronchiectasis and tuberculosis etc, at the preoperative stage and 3 week, 4 month and 12 month after pneumonectomy for the analysis of the reduction and progressive improvement of postoperative ventilatory function. And the factors affecting them like as age difference and the site of pneumonectomy were also analyzed. From these curves peak flow rate [PF R], maximal expiratory flows at 25% and 50% of expired forced vital capacity [V25, V50] and forced vital capacity [FVC] were obtained. In addition, partial pressure of oxygen and carbon dioxide in arterial blood were measured. The results were as follows; 1. The mixed type, especially obstructive type of ventilatory impairment was observed at 3 week after operation. For 1 year of postpneumonectomy FVC was increased by 12.3% of predicted compared to 2.6% of predicted V50. 2. The improvement of FVC during 1 year of postpneumonectomy showed decreasing tendency with the increase of age but the changes of V25 and V50 were unremarkable. 3. The differences of immediate postoperative reduction and progressive improvement of ventilatory capacity after right and left pneumonectomy were analyzed. The reduction of V50, V25 and FVC at 3 week of postoperation were greater in patients with right pneumonectomy [20.9%, 18.2% and 26.2% of predicted] than in patients with left pneumonectomy 16.5%, 18.2% and 18.1%]. But there was no significant difference of these values at 12 month after pneumonectomy. 4. The partial pressure of oxygen in arterial blood [$PaO_2$] was decreased by 13.6 mmHg at 3 week after pneumonectomy compared to the preoperative stage but returned to the normal range within 4 month after pneumonectomy. However, TEX>$PaCO_2$ was within the normal range during 1 year of postoperation.

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