• 제목/요약/키워드: Mediastinal cyst

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종격동 종양과 낭종의 임상 및 조직학적 고찰 (Clinical and Pathological Analysis of Mediastinal Tumors and Cysts)

  • 김재련;최형호
    • Journal of Chest Surgery
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    • 제28권10호
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    • pp.917-923
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    • 1995
  • For the purpose of analysis of clinical and pathological characteristics in mediastinal tumors and cysts, 82 patients with mediastinal tumors and cysts treated in the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January 1978 to December 1994 were reviewed. There were 49 male and 33 female patients in the study. Age ranges from 10 months to 84 years, with the mean 37.2 years. Frequently encountered symptoms and signs were dyspnea[40.2% , abnormal breathing sound[37.8% , chest pain[35.7% , cough[26.8% , and 18.2% of patients were asymptomatic. The most frequent tumor was anterosuperior mediastinum [59.8% followed by middle[24.4% and posterior mediastinum[15.8% . The malignant tumors were found in 35 cases[42.7% . Successful removal of the mass was possible in all the benign mediastinal masses[57.3% . But in the malignant cases, the surgical removal was possible in 18 cases and other inoperable cases were treated by radiation and chemotherapy. The postoperative complications occurred in 9 cases. Usual complications were bleeding[4 cases , wound infection[3 cases , pneumothorax[1 case and vocal cord paralysis[1 case . In the pathologic viewpoint, teratodermoid tumors[22.0% were the most frequent tumor followed by thymomas[19.5 , benign cysts[15.8% , lymphomas[13.4% and neurogenic tumors[8.5% .

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비디오 흉강경을 이용한 종격동 종양 절제술 (Video-Assisted Thoracoscopic Excision of Mediastinal Masses)

  • 박순익;김동관;유양기;김용희;박기성;박창률;박승일
    • Journal of Chest Surgery
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    • 제35권11호
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    • pp.807-811
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    • 2002
  • 종격동 종양의 경우 그 분포가 다양하나 양성질환이 더 많고, 흉강경 수술시 시야가 좋으며, 수술에 필요한 공간을 쉽게 확보할 수 있다는 점에서 비디오 흉강경 절제술이 기존의 개흉술에 못지 않은 수술방법 이라고 생각되어 본원에서 양성 종격동 종양으로 진단 받은 환자들을 대상으로 비디오 흉강경을 이용한 종격동 종양 절제술을 시행하고 고찰하였다. 대상 및 방법 : 1995년 1월부터 2001년 8월까지 근무력증을 제외한 양성 종격동 종양 43례의 환자에서 비디오 흉강경술을 시도하여 이중 개흉술로 전환된 5례를 제외한 38례를 분석하였다. 결과 : 성별은 남자가 13명(34.2%), 여자가 25명(65.8%)이었으며, 평균 연령은 39.2$\pm$35.4세였다 진단은 신경초종(neurilemmoma) 8.11(21.1%), 흉선 낭종(thyrnic cyst) 6례(15.8%), 기형종(teratoma) 5례(13.2%), 신경절신경종(ganglioneuroma) 5례(13.2%), 기관지원성 낭종(bronchogenic cyst) 4례(10.5%), 심막 낭종(pericardial cyst) 3례(7.9%), 흉선종(thymoma) 3례(7.9%), 림프관종(Iymphangioma) 2례(5.3%) 등이었다. 평균 수술 시간은 110.6$\pm$7.0분, 평균 흉관 거치기간은 4.2 $\pm$0.4일, 수술후 평균 재원기간은 5.2$\pm$0.4일, 평균 술후 진통제 근주 횟수는 1.9 $\pm$ 0.4회이었으며, 이상의 측정치들은 개흉술로 전환된 5례와 비교하여 평균값이 적었으나, 통계적으로 유의하지는 않았다. 수술후 합병증으로는 유미흉, 장기간 공기유출 및 일측성 횡격막 마비가 각 1례가 있었으나 퇴원시 소실된 일과성이었으며, 편측안검하수 1례가 있었다. 결론 : 비디오 흉강경을 이용한 종격동 종양 절제술은 안전하게 시행될 수 있으며, 수술 후 통증경감과 빠른 회복 및 미용상의 장점이 있어 계속 발전되고 적극적으로 시도되어야 한다고 사료된다.

종격동 질환의 비디오 흉강경 수술 (Video-assisted Thoracoscopic Surgery for Mediastinal Lesions)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • 제31권1호
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    • pp.40-45
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    • 1998
  • 종격동은 기관, 식도, 심장 및 주요혈관 등 주장기와 조직으로 이루어진 곳으로 다양한 병변이 발생하며, 종격동 질환의 진단과 치료에서 외과적 접근방법은 중요한 부분을 차지해왔다. 최근 흉강경수술 개발은 종격동질환 진단 및 치료에서 새로운 효과적인 수기로 평가받고있다. 고려대학교 안암병원 흉부외과에서는 1992년 3월부터 1997년 4월까지 종격동의 병변에 33명의 환자에서 비디오 흉강경술을 시행하였다. 환자는 남자가 16명 여자가 17명이었으며 연령은 14세부터 69세였고 평균 42세였다. 대상이된 종격동 질환의 해부학적 위치는 전종격동 14례, 중종격동 5례, 후종격동 11례, 상종격동 3례였다. 종격동 질환은 신경초종 9례, 낭성기형종이 5례, 심막 낭종 4례, 신경절신경종 2례,흉선 2례, 흉선낭종 2례, 흉선종 1례, 식도평활근종 2례, 유피종 1례, 지방종 1례, 악성 림프종 1례, 기관지 원성 낭종 1례, 심막 삼출 1례, Boerhaave's병 1례였다. 수술중 작업 창이 필요했던 경우가 6례였다. 개흉수술로 전환한 경우는 6례(24%)로 종양이 커서 개흉수술 전환이 필요했던 경우가 1례, 심한유착으로 인한 개흉수술 전환이 3례, 흉강경으로 접근이 어려웠던 경우가 2례있었다. 평균 수술 시간은 116분($\pm$56분)이었다. 수술후 흉강 드레인 거치기간은 평균 4.7일이었다. 수술후 평균 입원일수는 8.7일이었다. 종격동 각부위의 종양 및 염증성 질환의 진단과 치료에 비디오 흉강경의 적용이 가능하였으며, 비디오 흉강경을 이용한 종격동 종양 절제술은 안전성, 수술후 통증경감 및 빠른회복 등의 장점이 있는 것으로 나타났다.

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Clinical Characteristics and Management of Intrathoracic Bronchogenic Cysts: A Single Center Experience

  • Lee, Deok-Heon;Park, Chang-Kwon;Kum, Dong-Yoon;Kim, Jae-Bum;Hwang, Il-Seon
    • Journal of Chest Surgery
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    • 제44권4호
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    • pp.279-284
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    • 2011
  • Background: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. Materials and Methods: Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records. Results: There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected. Conclusion: Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.

종격내시경을 이용한 기관지성 낭종절제술 치험 1례 (A Bronchogenic Cyst Treated by Mediastinoscopy -A case report-)

  • 변정욱;김정철
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.789-791
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    • 1996
  • 환자는 19세 남자로 1주일 전부터 갑자기 발생한 우측 흉통과 어깨에 동통, 연하곤란을 호소하여 기관지성 낭종으로진단되었다. 종격동내시경을 이용하여 기관지성 낭종을 절제하고낭종의 하부는 기관과 유착이 심하여 완전히 절제하지 못하여 세포의 파괴를 위해 전기소작을 하여 좋은 결과를 얻었기에 보고하는 바이다.

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Epicardial Cyst Originating from Right Ventricle

  • Kim, Joo Yeon;Koo, Hyun Jung;Lee, Miji;Kim, Gwan Sic;Jung, Sung-Ho
    • Journal of Chest Surgery
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    • 제46권2호
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    • pp.138-141
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    • 2013
  • Pericardial cysts are reported by some authors, but epicardial cysts are extremely rare. We report one case of epicardial cyst that was detected incidentally and was removed successfully. Furthermore, unusually, pathological examinations confirmed that the cyst wall was looked like a vessel wall.

원발성 종격동 종양에 관한 임상적고찰 (Clinical Study of the Primary Mediastinal Tumor)

  • 최필조;이종수;이성광
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.141-145
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    • 1990
  • Author made a clinical study of 48 cases of primary mediastinal tumors experienced in the dept. of the thoracic and cardiovascular surgery of Pusan National University Hospital during the 12 years period from march 1978 to march 1989. There were 34 males and 14 females. Their age distribution was from 4 months to 70 years, with the mean age of 34.4 years. 8.3 % of the patients were younger than 15 years old. There were teratoma 14 cases[29%], thymoma 11 cases[23%], neurogenic tumor 10 cases[21 %], lymphoma 6 cases[13 %], benign cyst 6 cases[13 %], and one case of fibrous histiocytoma in the histological distribution. The malignant tumors were 12 cases[25 %]. The common symptoms were chest pain and discomfort[35.4], coughing[18.8], general weakness and dyspnea. 16.7% of the patients were asymptomatic at admission. The successful removal was done in all cases of benign mediastinal tumors. In malignant cases, the surgical removal could be done in 5 cases. There was not postop. mortality. The frequent complications were atelectasis, infection, bleeding.

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중 전상부 종격동의 중피낭종 -수술 치험 1례- (Mesothelial Cyst of the Middle and Anterior-Superior Mediastinum -One Case Report-)

  • 전순호;강정호;지행옥;김영학;정원상;김혁;박문향;서정국;진석철
    • Journal of Chest Surgery
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    • 제31권10호
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    • pp.1017-1021
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    • 1998
  • 중피낭종은 심막체벽낭종, 스프링워터낭종, 장막낭종 등 여러 가지 이름으로 명명되고 있다. 대부분의 중피낭종은 심낭의 기형으로 부터 발생 된다고 하나, 본 증례는 늑막기형에서 발생된 아주 희귀한 중피낭종이므로 조직학적으로 특수 염색을 통하여 확진하게 되었다. 본 증례는 64세 여자 환자로서 입원 당시 우측 목 부위에 통증 없는 낭성 종괴가 만져져 외래를 통하여 내원케 되었다. 컴퓨터 단층촬영상 종격동 림프관종이라는 진단하에 수술을 시행하여 낭성종괴를 완전 절 제 하였다. 수술후 절제된 조직소견 결과 종격동 중피낭종이 확진 되었으며 수술후 환자는 큰 후유증 없이 완치되어 퇴원 하였다.

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흉강 내시경을 이용한 식도 중봉 낭종 수술 치험 -1례- (Excision of Esophageal Duplication Cyst with VATS - One case report -)

  • 박성용;김태훈;이두연;김은영;전세은;조상호
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.39-42
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    • 2007
  • Esophageal duplication cyst is very rare mediastinal tumor which is congenital lesion of the esophagus. Esophageal duplication cyst could be excised with video assisted thoracoscopic surgery(VATS) if it is relatively small, cystic lesion and not adhered severely to the surrounding tissues such as lung, trachea, bronchus, esophagus and pleura. We report a case of an esophageal duplication cyst which was located in the right thoracic cavity below carina and could be excised completely and repaired by interrupted suture with 3.0 black silk. The patient was discharged at 10 days after operation with good condition and has been in uneventful condition 2 months after operation.

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Spontaneous Disappearance of a Pericardial Cyst: Case Report and Literature Review

  • Moffa, Angelo Pio;Stoppino, Luca Pio;Loizzi, Domenico;Milillo, Paola
    • Journal of Chest Surgery
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    • 제51권1호
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    • pp.72-75
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    • 2018
  • Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared. Although the spontaneous resolution of these lesions is rare, this article highlights the possibility of conservative management in select cases.