• Title/Summary/Keyword: Lung surgery

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Bilateral Sequential Lung Transplantation for a case with Respiratory Failure due to Lymphagioleiomyomatosis (림프관평활근종증에 의한 호흡부전 환자에서의 순차적양측 폐이식 치험)

  • 성숙환;김주현;김영태;서정욱;유철규;김영환;한성구;심영수;오용석
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.88-95
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    • 2000
  • Pulmonary lymphangioleiomyomatosis is a chronic destruct8ive disease of the lung affecting women of childbearing ages which eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic measure because this disease responds poorly to other therapies, To date only a few reports in the literature describes the clinical experience of the bilateral sequential lung transplantation of this rare condition. We performed a bilateral sequential lung transplantation on a 32-year-old woman suffering from lymphangioleiomyo-matosisw. The heart-lung block was harvested from a 51-year-old donor. We transplanted the left lung first through the clam-shell incision. As the hemodynamics deteriorated suddenly during the dissection of the right lung the right lung was transplanted under the cardio-pulmonary bypass. Although the patient's lung function was initially satisfactory the patient died of sepsis and subsequent cardiogenic shock at the postoperative 18th day. Autopsy findings showed infection of Candida albicans on the pericardium and the left lung which had been initiated possibly from the left bronchial anastomosis site,. Through detailed review of the clinical course we concluded that lung transplantation could have been performed safely on this disease provided that early diagnosis and proper management or the oppor-tunistic infection have been carried out.

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Lack of Association of Glutathione S-transferase M3 Gene Polymorphism with the Susceptibility of Lung Cancer

  • Feng, Xu;Dong, Chun-Qiang;Shi, Jun-Jie;Zhou, Hua-Fu;He, Wei;Zheng, Bao-Shi
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4465-4468
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    • 2012
  • Objective: The conclusions of published reports on the relationship between the glutathione S-transferase M3 (GSTM3) A/B gene polymorphism and the risk of lung cancer are still debated. This meta-analysis was performed to evaluate the association between GSTM3 and the risk of lung cancer. Methods: Association investigations were identified from PubMed, Embase, and Cochrane Library, and eligible studies were included and synthesized using a meta-analysis method. Results: Eight reports were included into this meta-analysis for the association of GSTM3 A/B gene polymorphism and lung cancer susceptibility, covering 1,854 patients with lung cancer and 1,926 controls. No association between the GSTM3 A/B gene polymorphism and lung cancer was found in this meta-analysis (B allele: OR = 1.25, 95% CI: 0.89-1.76, P = 0.20; BB genotype: OR = 1.53, 95% CI: 0.71-3.32, P = 0.28; AA genotype: OR = 0.85, 95% CI: 0.59-1.23, P = 0.39). Conclusions: The GSTM3 A/B gene polymorphism is not associated with lung cancer susceptibility. However, more studies on the relationship between GSTM3 A/B gene polymorphism and the risk of lung cancer should be performed in the future.

Plasma Cell Granuloma of the Lung - Report of 2 Cases - (형질세포 육아종 2례 보고)

  • 형질세
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.487-491
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    • 1985
  • Two cases of plasma cell granuloma of the lung, whose incidence is 0.7% in the tumor of the lung and bronchus, are managed at department of thoracic and cardiovascular surgery, College of Medicine, Choong Nam national University Hospital from March, 1983 to July, 1984. The plasma cell granuloma of the lung, which is usually asymptomatic, is most commonly detected in routine chest films. The prognosis of the plasma cell granuloma is good after surgical resection. One case [female] was undertaken right pneumonectomy, the other, left lower lobectomy. Both cases had uneventful postoperative courses and are well being now.

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Vaniching Lung: Report of One Case (거대기종성 폐낭포증 1례 보고)

  • Lee, Dong-Jun;Kim, Sang-Hyung
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.253-259
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    • 1978
  • A case of Vanishing lung of right entire lung field in a man of 36 years of age was encountered at Dept. of Chest Surgery of Chonnam University Hospital. His chief complaints were cough, severe dyspnea and chest pain for about 14 years. Right pneumonectomy was done and gross finding was multiple chambered cysts of the right lung with thin epithelium. The review of the literatures was also done.

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Technical Aspects of Lung Transplantation: Adverse Events and Circumstances

  • Kim, Do Hyung
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.307-312
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    • 2022
  • Adverse events or emergency situations that are unacceptable in the context of lung transplantation may occur during the procedure. These adverse events and circumstances are not problems that are caused by insufficient experience or can be solved by increasing surgical experience. The purpose of this review is to describe the adverse events and circumstances that occur during lung transplantation and to identify an appropriate surgical approach through an analysis of case reports in the global literature.

Outcome of Limited Resection for Lung Cancer

  • Cho, Jeong-Su;Jheon, Sang-Hoon;Park, Sung-Joon;Sung, Sook-Whan;Lee, Choon-Taek
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.51-57
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    • 2011
  • Background: Up to now, lobectomy, bilobectomy and pneumonectomy combined with extensive lymph node dissection have been regarded as the standard procedures for non-small cell lung cancer (NSCLC). In high-risk patients, however, limited resection (LR) has been attempted as a salvage procedure, and, recently, indication for LR has been extended to selected cases with early-stage NSCLC. Material and Methods: Among the 773 patients who underwent surgical procedures for NSCLC in Seoul National University Bundang Hospital from May 2003 to December 2008, 43 patients received LR. Medical records of these patients were retrospectively reviewed. Results: Mean age at operation was $66.0{\pm}12.4$ years, and there were 30 males. Twenty-five patients underwent conservative limited resection (CLR) and 18 underwent intentional limited resection (ILR). Indications for CLR were multiple primary lung cancer in 9 (9/25, 36%) and severe concomitant diseases in 5 (5/25, 20%). Of these, 6 patients underwent segmentectomy and 19 received wedge resection. During the follow-up period of $28.0{\pm}17.8$ months, 15 patient developed recurrent lung cancer. ILR was selectively performed in lesions almost purely composed of ground glass opacity (${\geq}$95%), or in small solid lesions (${\leq}$2 cm). Of these, 11 patients underwent segmentectomy and 7 underwent wedge resection. During the follow-up period of $31.7{\pm}11.6$ months, no patient developed recurrence. Conclusion: Intermediate-term outcome of LR for early-stage lung cancer is comparable to that of standard operation. For the delineation of the indications and appropriate surgical techniques for LR, prospective randomized multi-institutional study may be expedient.

Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease (간질성 폐질환의 확진을 위한 흉부외과의 역할)

  • Kim Sung-Whan;Yahang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho;Jang In-Seok
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.382-386
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    • 2006
  • 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.

Changes of Serum Levels of Alpha 1-Proteinase Inhibitor in Pre-and Post Open Heart Surgery (개심술 전후의 Alpha 1-Proteinase Inhibitor 의 추이)

  • Jeong, Jong-Hwa;Kim, Song-Myeong
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.402-415
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    • 1989
  • Extracorporeal circulation leads to functional disorder and structural damage of organs, especially hematologic and pulmonary system, mainly by sequestration of neutrophils and deposition of macrophages at lung. Then, proteases are secreted, which insult vascular basement membrane of pulmonary capillary and alveolar septa of the lung. Among these, the most important protease at lung is elastase, because major component of lung is elastin. For prevention of lung injury, inactivators or antidotes to elastase should be necessary and Alpha 1-Proteinase Inhibitor is the elastase inactivator. Clinical experimental study was carried out to investigate the immediate postoperative change of serum Alpha 1-PI level following cardiopulmonary bypass for 20 heart cases [congenital 16 cases, acquired 4 cases] and 10 control [subtotal gastrectomy] cases. Also preliminary study was performed for 31 cases of open heart patients. The results were as follows: l. Immediate postoperative serum levels of Alpha 1-PI was significantly decreased at open heart surgery group [P< 0.005], but not decreased at control group. 2. There were no significant difference in change of serum Alpha 1-PI level between and membrane and bubble oxygenator group.Z 3. There were no significant difference in changes of serum Alpha 1-PI level between CHD and AHD. Alpha 1-PI is consumed at lung during cardiopulmonary bypass and increase after operation compensatedly and protect multiple organic damage especially lung. Therefore, Alpha 1-PI can be indicator for evaluation of prevention and treatment of pump-lung syndrome.

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Combined Surgery of Pulmonary Resection and Coronary Artery Bypass Grafting (CABG) (폐절제와 관상동맥 우회술의 동반 수술 치험 3예)

  • Kim Jin Sun;Lee Young Tak;Kim Jhingook;Kim Kwhanmien;Choi Yong Soo;Sung Kiick;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.253-257
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    • 2005
  • The patients with primary lung cancer who have symptoms of angina pectoris commonly have underwent coronary artery bypass grafting (CABG) prior to lung resection. Recently, there are attempts to conduct simultaneous operation of CABG and lung resection to reduce disadvantages of staged operation, such as repeated general anesthesia, two wound incisions and delay of lung operation. These attempts generally report good results. Three patients underwent lung resection and CABG simultaneously, and had good post operative status without recurrence of cancer and angina pectoris. We conceive these as worthy cases to report.

Early Detection of the Acute Exacerbation of Interstitial Pneumonia after the Surgical Resection of Lung Cancer by Planned Chest Computed Tomography

  • Oyama, Kunihiro;Kanzaki, Masato;Kondo, Mitsuko;Maeda, Hideyuki;Sakamoto, Kei;Isaka, Tamami;Tamaoki, Jun;Onuki, Takamasa
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.177-183
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    • 2017
  • Background: To improve postoperative outcomes associated with interstitial pneumonia (IP) in patients with lung cancer, the management of the postoperative acute exacerbation of IP (PAEIP) was investigated. Methods: Patients with primary lung cancer were considered to be at risk for PAEIP (possible PAEIP) based on a preoperative evaluation. The early phase of this study was from January 2001 to December 2008, and the late phase was from January 2009 to December 2014. In the early phase, chest computed tomography (CT) was performed for patients for whom PAEIP was suspected based on their symptoms, whereas in the late phase, chest CT was routinely performed within a few days postoperatively. The numbers of possible PAEIP cases, actual PAEIP cases, and deaths within 90 days due to PAEIP were compared between both phases. Results: In the early and late phases, surgery was performed in 712 and 617 patients, 31 and 72 possible PAEIP cases were observed, nine and 12 actual PAEIP cases occurred, and the mean interval from the detection of PAEIP to starting treatment was $7.3{\pm}2.3$ and $5.0{\pm}1.8$ days, respectively. Five patients died in the early phase, and one patient died in the late phase. Significantly fewer PAEIP-related deaths were observed in the late phase (p<0.05). Conclusion: Identifying patients at risk for PAEIP by routine postoperative CT examinations led to the early diagnosis and treatment of PAEIP, resulting in the reduction of PAEIP-related mortality.