• Tuberculosis and Respiratory Diseases
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• v.45 no.3
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• pp.630-635
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• 1998

Lung volume reduction surgery, resecting the most severely affected regions of emphysema, was designed to improve quality of life for selected patients with severe emphysema We report a case of a 72 year old severe emphysema patient who received bilateral lung volume reduction surgery and showed marked improvement of quality of life and lung function.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.827-832
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• 1997

Lung volume reduction surgery(LVRS) has recently been advocated as an alternative or a bridge to lung transplantation for patients with evere dibbling emphysema. This procedure is a palliative treatment performed to alleviate the dyspnea of patients with emphysema and improve performance in the activities of daily living. The rationale of lung volume reduction for generalized emphysema is that the removing of the diseased and functionless lung may improve the function of remaining, less diseased lung. The factors critical to the success of LVRS are careful patient selection, accurate localization of target areas, meticulous anesthetic and operative technique, and intensive postoperative support. We have experienced a case of severe emphysema in a 59-year-old male patient. After selection process and pulmonary rehabilitation, the patient was treated with video-assisted thoracoscopic LVRS and the post-operative course was uneventful.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.543-548
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• 1999

Background: These days, lung volume reduction surgery (LVRS) is used as an alternative or a bridge operation to lung transplantation in treating patients with severe emphysema. The procedure can be used in patients with pulmonary nodules combined with severe emphysema. We report the results of 21 months follow up after lung volume reduction surgery in 7 cases including 2 cases of concurrent resection of pulmonary nodules. Material and Method: Seven patients with emphysema, including 2 cases of preoperatively suspected lung cancer were operated with LVRS technique between July 1996 and June 1997. Result: Postoperative mortality was observed in a case of squamous cell carcinoma in LUL with brain metastasis, detected at postoperative 13months. Average of 21months(19-25months) follow up was done for other cases without specific events. Conclusion: LVRS is a useful operation in the treatment of patients with severe emphysema, but further evaluation should be done about the long term results and precise criteria for patient selection. Simultaneous LVRS and tumor resection could be done in patients with emphysema with marginal reserve in the hope of maximizing postoperative lung functions.

• Proceedings of the KTCVS Conference
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• 1996.04a
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• pp.20-23
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• 1996

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.21-32
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• 1997

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.323-327
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• 2006

Lymphangioleiomyomatosis (LAM) is a rare disease in women of childbearing ages that eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic modality in end-stage LAM. While single-lung transplantation is the preferred operation, the graft failure or recurrence of LAM was reported. We performed a single lung transplantation on a 36-year-old woman suffering from respiratory failure due to lymphangioleiomyomatosis. After a 1-year follow up, the patient was readmitted because of graft failure with collapsed transplanted lung. The lung volume reduction surgery (LVRS), tracheostomy and ventilator care were performed. However, neither the medical nor surgical treatment had any effect. Subsequently, we performed a contralateral single lung re-transplantation and had a good postoperative results.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.1005-1011
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• 1991

Eighty-four patients with pulmonary metastases from gestational choriocarcinoma were treated at the Catholic Medical Center between August, 1985 and August, 1991. Among these 13 patients underwent thoracotomy with resection of pulmonary lesions and the results obtained were follows. 1] The ages of the patients ranged from 26 to 47 years, with a mean age of 31 years. 2] The frequency of chemotherapy before operation ranged from zero to 46, with a mean frequency of 13.6. 3] Four patients were operated upon for a solitary metastasis of the lung; 6 patients, for unilateral multiple metastases and 3 patients, for bilateral pulmonary metastases. 4] Eight patients underwent wedge resection; 1 patient, segmentectomy; 2 patients, lobectomy; 3 patients, open lung biopsy. The lung lesions of eleven patients showed hemorrhagic necrosis[among these, 2 patients combined with pulmonary tuberculosis]; one was non-necrotic choriocarcinoma; another one was metastatic lung carcinoma from endocrine cancer of unknown origin. 5] Among twelve patients who had managed with chemotherapy before thoracotomy three patients were in remission; among 13 patients who had undergone thoracotomy 6 patients were in remission. 6] The median survival time of these patients was 25.8 months with 3 postoperative deaths. Subsequently, in the patients with pulmonary metastases from choriocarcinoma, if the primary tumor is under control, there are no other metastases, and the patients should be able to tolerate the planned operation, it is necessary to undergo aggressive thoracotomy for diagnostic purposes; for therapeutic purposes only when the pulmonary lesion is the only remaining source of increased hCG excretion; for reduction of tumor volume to shorten hospitalization or to reduce the quantity of drugs.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.184-190
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• 2020

Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC.

• Journal of Chest Surgery
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• v.16 no.4
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3257-3265
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• 2015

Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.