• Journal of Chest Surgery
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• 제44권6호
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• pp.413-417
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• 2011

Background: Sleeve lobectomy for lung cancer in close proximity to or involving the carina is widely accepted. Operative morbidity and mortality rates, recurrence, and survival rates have varied considerably across studies. Materials and Methods: From March of 2005 to July of 2010, sleeve lobectomy was performed in 19 patients and pneumonectomy was performed in 20 patients. In this paper, the results of sleeve lobectomy and pneumonectomy for patients with lung cancer will be compared and evaluated. Results: There were no postoperative complications in either group, but there was one mortality in the pneumonectomy group. There was better preservation of pulmonary function in the sleeve lobectomy group than the pneumonectomy group (p=0.066 in FVC, p=0.019 in FEV1). The 3-year survival rates were 46.7% in the sleeve lobectomy group and 54.5% in the pneumonectomy group (p=0.505). The 3-year disease-free survival rates were 38% in the sleeve lobectomy group and 45.8% in the pneumonectomy group (p=0.200). Conclusion: Sleeve lobectomy for lung cancer showed low mortality, low bronchial anastomotic complication rates, and good preservation of pulmonary function.

• The Korean Journal of Physiology
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• 제17권2호
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• pp.177-182
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• 1983

In order to clarify the effect of the unilateral pneumonectomy on the compensatory growth of the residual lung, liver and kidney, and serum electrophoresis pattern, right lung pneumonectomy was performed on rabbits under general anesthesia with pentobarbital sodium. On the fifth day after the surgery, the weight of the residual lung, liver and bilateral kidneys was measured and organ weight-body weight ratio was calculated. And in an attempt to know whether the cells in the liver and the kidney were proliferated by unilateral pneumonectomy, DNA content was determined. The quantity(g/100 ml) of serum protein was determined also and serum electrophoresis was performed on cellulose acetate membrane. The results obtained are summarized as following. The weight of the residual lung and lung weight-body weight ratio was significantly increased respectively. The weight of the liver and organ weight-body weight ratio were not changed but the DNA content of the liver and kidney tissue increased significantly, illustrating that unilateral pneumonectomy caused cellular hyperplasia in the liver and in the kidney as well as in the residual lung. The quantity(g/100 ml) of serum protein was significantly increased and in the analysis of the electrophoregram, there was significant difference between the normal and pneumonectomy group. Taken together, these results indicate that unilateral pneumonectomy caused the compensatory hyperplasia of the liver, the kidney and the residual lung as well as the change of electro-phoretic pattern. And it also suggests that a humoral factor, which proliferates the cells in the residual lung, the liver and the kidney, existed in the pneumonectomized rabbits.

• Journal of Chest Surgery
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• 제38권9호
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• pp.616-621
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• 2005

배경: 비소세포폐암에서 전폐절제술은 총 시행 술식 중 $20 {\~}35\%$를 차지하고 있으며 특히 우측 전폐 절제술의 경우 $10{\~}25\%$의 높은 사망률이 보고되고 있다. 이에 저자들은 전폐 절제술 후 일어날 수 있는 합병증의 양상을 알아보고 술식에 따른 합병증의 양상과 원인, 그리고 사망률에 미치는 원인을 알아보고자 하였다. 대상 및 방법: 1987년 8월부터 2002년 4월까지 원자력병원 흥부외과에서 비소세포폐암으로 전폐절제술을 시행 받은 환자들의 의무기록을 후향적으로 조사하였다. 결과: 총 386예의 전폐 절제술을 시행하였으며 좌측 238예, 우측 148예였으며 표준술식 207예, 확장술식 179예였다. 이중 115예의 합병증($28.5\%$)이 발생하였고, 12예에서 사망하여 $3.1\%$의 수술 사망률을 보였다. 이는 같은 기간에 시행된 폐엽 절제술의 수술사망률($2.1\%$)과 비슷하였다. 사망 예를 좌우로 구분해보면 좌측2예($0.5\%$), 우측 10예($2.6\%$)였다. 합병증을 증상별로 분류하면 애성 42예, 폐렴 및 급성호흡부전 17예(9예), 농흉 8예, 기관지-늑막루 5예(1예), 재수술을 요하는 출혈 5예(1예), 부정맥 5예, 폐 부종 1예(1예), 기타 25예이었다(괄호 안은 그 합병증에 의한 사망예). 수술사망에 영향을 미치는 요인으로는 먼저 확장 술식 6예($3.3\%$), 표준 술식 6예($2.9\%$)의 수술 사망을 보여 두 군간의 유의 있는 차이는 보이지 않았다(p=0.812). 그리고 60세 미만군(n=204)에서 2예($1.0\%$), 60세 이상 군(n=182)에서 10예($5.5\%$)가 사망하여 의미 있는 차이를 보였으며(p=0.016), 좌우를 비교했을 때 우측의 사망률이 5배정도 높았으며 통계적으로도 의미 있는 차이를 보였다(p=0.002). 호흡기계 합병증에 영향을 미치는 요인을 보면 60세 이상 군에서 20예($11.0\%$)와 60세 미만 군에서 7예($3.4\%$)로 60세 이상 군에서 의미 있는 차이를 보였으며(p=0.005), 좌측 전폐 절제술 군에서 10예($4.2\%$)와 우측 전폐 절제술 군에서 17예($11.5\%$)로 우측에서 의미 있는 차이를 보였다(p=0.008). 결론: 본 연구에서 전폐절제술의 수술사망과 호흡기계합병증은 60세 이상의 고령과 우측 전폐절제술 시 높아진다. 따라서 고 위험군의 수술 시에 수술대상환자의 선별과 수슬전 후 환자관리가 중요할 것으로 생각한다. 그러나 전폐절제술의 수술 사망률은 폐엽 절제술과 비슷하므로 폐암의 완전절제를 위해서는 전폐절제술은 안전하게 시행될 수 있는 술식으로 생각한다.

• Journal of Chest Surgery
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• 제3권1호
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• pp.3-12
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• 1970

During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital. This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage. The results were obtained as follows. 1.Left pneumonectomy was done in sixty-six of 100 patients [66 %] and the right one was done in the rest thirty-four[34 %]. The ratio between left and right was nearly 2:1. 2.Of all oostoperative complications, the intrapleural infection was most common, and these were 53 % in empyema thoracis and 12.7 % in pulmonary tuberculosis respectively. 3.More postoperative complications could be seen after right pneumonectomy than the left one. 4.It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy,postoperatlve tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver. 5.The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window. 6.Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy. 7.The mortality rate was 10 % in our cases and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.

• Journal of Chest Surgery
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• 제28권5호
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• pp.464-470
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• 1995

From Jan 1988 to Dec 1993, 196 consecutive patients with various pulmonary diseases underwent pneumonectomy. Mean age was 54.0 years[range:7-74 . The underlying diseases were lung cancer[154 cases , destroyed lung[29 cases with pulmonary tuberculosis or empyema thoracis and others[13 cases . The overall mortality and complication rate were 5.6% and 14.8%. In the groups of more than and less than 60 years of age, there was significant differences in mortality rate[P=0.004 . In the group of pneumonectomy and pleuropneumonectomy, there was no significant differences in mortality[P=0.164 and complication rate[P=0.052 . In the group of normal and abnormal EKG, there was no significant differences in mortality[P=0.560 and complication rate[P=0.693 . In the preoperative FEV1, preoperative FVC and predicted postoperative FEV1, prognostic cut-off points were 1800cc, 2600cc and 1300cc, and at points, positive predicted value were 12.3%, 10.5%.and 7.7% and negative predicted value were 97.8%, 98.3% and 96.2% respectively. The preoperative FEV1 is the most reliable indicator in assessment of prognosis of pneumonectomy.

• Journal of Chest Surgery
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• 제27권9호
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• pp.808-811
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• 1994

We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

• Journal of Chest Surgery
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• 제26권8호
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• pp.609-612
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• 1993

Studies of pulmonary function using spirometry were performed before and after pneumonectomy for inflammatory lung diseases from 1985 to 1990 at the Pusan Paik Hospital, Inje Medical College. Fifty-two patients were evaluated ; 33 tuberculosis, 17 bronchiectasis, 2 abscess, and 1 actinomycosis. All patients had preoperative and postoperative FVC, FVC[% predicted], FEV1, %FEV1, MVV and MVV[%predicted] determinations. And above datas were compared each other statistically with applying of the paired t-test. The results were obtained as follows : there were significant decreased after surgery in the values of FVC, FVC[% predicted], MVV, and MVV[% predicted], but the values of FEV1, and %FEV1 were no significant changes after surgery.

• Journal of Chest Surgery
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• 제27권1호
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• pp.60-62
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• 1994

Pulmonary edema and respiratory failure is uncommon but fatal complications associated with major operations of the lung, especially after pneumonectomy. The extracorporeal membrane oxygenation[ECMO] is quite often used in infants with severe respiratory failure and congenital heart disease which is well documented in the literature. In adults, the results of ECMO is comparatively poor to those found in neonates. We have experienced a case of ECMO applied on a 48 year old male who had respiratory failure after pneumonectomy, and the patient was successfully weaned from bypass. Unfortunately however, the patient expired on postoperative 15 day due to multiorgan failure.

• Journal of Chest Surgery
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• 제24권6호
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• pp.555-559
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• 1991

Post-pneumonectomy empyema thoracis is an uncommon, but very serious problem. Early diagnosis & adequate drainage followed by thoracoplasty and or myoplasty are very important principles for the management of the empyema thoracis & will enable patient to recover from the toxic effects. During the period of January, 1985 to December, 1990, 13 patients with post-pneumonectomy empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. There were 10 males % 3 females ranging from 31 years to 79 years of age. The occurrence ratio of left to right side was 8: 5. The underlying pathologic lesions of empyema thoracis were pulmonary tuberculosis[7], lung ca. [2] pneumothorax[2], lung abscess[1] pneumonia[1]. We treatment procedure for post-pneumonectomy empyema thoracis were open window thoracostomy in 10 cases, Clagett procedures in 2 cases, one thoracoplasty, and two cases of Clagett procedures followed by open window thoracostomy in one cases.

• Journal of Chest Surgery
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• 제50권2호
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• pp.123-125
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• 2017

Malignant tumors associated with chronic empyema have been reported in the literature, and a majority of these tumors are lymphomas. Epithelial tumors originating from the post-pneumonectomy space in patients with chronic empyema are extremely rare. Here, we present the cases of 2 patients with squamous cell carcinoma arising from the pleural cavity after pneumonectomy for chronic empyema.