• Journal of Chest Surgery
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• v.25 no.6
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• pp.616-620
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• 1992

A sleeve lobectomy is an appropriate operative procedure in patients with endobronchial neoplasms of low-grade malignancies in the proximal airways and for a small but significant number of patients with carcinoma. Here, we present eleven cases of sleeve lobectomy which were performed from 1984 to the August of 1991 in the Department of Thoracic Surgery of Seoul National University Hospital. The sex distribution was 6 males and 5 females in the age range from twenty to sixty seven, with an average of 44.9 years. The pathologic diagnoses were 7 cases of pulmonary malignancies: carcinoid in two, mucoepidermoid carcinoma in two, adenoid cystic carcinoma in one, adenocarcinoma in one, and squamous carcinoma in one. Other diagnoses were two cases of tuberculous bronchial strictures and two cases of benign tumors: one case of pesudolymphoma and one case of neurilemmoma. The procedures consisted of five right upper sleeve lobectomies [Fig. 1], four left upper sleeve lovectomies [Fig. 2], one left lower sleeve lobectomy[Fig. 3], and one right middle and lower lobetomy [Fig. 4]. All except one had a normal preoperative pulmonary function. The case which had a poor pulmonary function was a 66-year-old female adenocarcinoma patient. She seemed to be very intolerable to pneumonectomy [predicted FEV1=0.60L]. Therefore, she had a right sleeve upper lobectomy and experienced smooth postoperative course without any pulmonary problems. All cases had good postoperative results and no postoperative complications.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.170-175
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• 1989

Eleven cases of pulmonary resection had been performed for pulmonary aspergilloma in the department of thoracic and cardiovascular surgery, School of Medicine, Kyungpook National University from August 1984 to July 1988. The patients were consisted of six males and five females and were evenly distributed from third decade to sixth decade. Hemoptysis was usually presenting symptom [72.2%] and the variable was the interval between symptom onset to surgical resection, which was ranged from few months to several years In the plane chest films, intracavitary fungus balls were noted in five cases [5/11] and upper lobe involvements were seven cases [7/11]. Aspergillus fumigatus was identified preoperatively in three cases among the eight cases of sputum culture. Mean preoperative FVC and FEV 1.0 values were in normal range. Eleven pulmonary resections were done by eight lobectomies, two segmentectomies and one pneumonectomy. The lesion was superimposed upon old tuberculosis in eight patients, in one upon bronchiectasis and in two upon tuberculous bronchiectasis. Five complications appeared postoperatively which included ARDS [1 case] bleeding [2 cases], persistent air leak[1 case], and dead space [1 case].

• Journal of Chest Surgery
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• v.6 no.1
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• pp.41-46
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• 1973

This is a report on four cases of atelectasis which were implicated as one case of mucoid impaction and three cases of blood clots in main bronchus. The 1st case was found to be massive atelectasis on Lt. entire lung due to mucoid impaction with pulmonary tuberculosis. This case was performed the Lt. pneumonectomy. There are contain-ing impacted yellowish-gray jelly like thick materials on the Lt. whole bronchial trees and pathologic findings were consistent with tuberculosis including caseation necrosis and multinucleated giant cell on whole left lung thoroughly in microscopic findings. The 2nd and 3rd case [25 years old female and 30 years old female] were diagnosed as one sided entire lung ateletasis which were led by accumulation of old blood clots on bronchus following incomplete expectoration of sudden massive hemoptysis from pulmonary tuberculosis lesion. These two cases were recovered by removal of blood clots and bronchial irrigation under bronchoscopy. Follow up chest film revealed well aeration. The 4th case [45 years old] was taken the removal of old blood clots and tissue debris under the bronchoscopy as bronchial obstruction following massive hemoptysis. The cytologic findings revealed the class III in fresh sputum and class 1V in bronchial irrigation which may suggest of malignancy. However, we could not found the causative lesions suggestive malignancy by the bronchography and other diagnostic measurements.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.574-577
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• 2001

A 54-year-old homosexual man was diagnosed as human immunodeficiency virus-1-positive in 1992. He was admitted to a tertiary hospital in March, 2000 because of right flank pain, fever and intermittent cough. A chest roentgenogram showed right-sided pleural effusion, and closed thoracostomy was performed for drainage Salmonella species and Escherichia coli were isolated from the pleural fluid. In spite of 6 weeks of antibiotic treatment, fever did not subside and the general condition gradually deteriorated, and under the diagnosis of lung abscess with empyema thoracis, right pleuropneumonectomy was performed. The general condition improved postoperatively until day 10 when he showed sudden change in mental status to stuporous and developed focal seizure. Brain CT showed multiple abscesses in right frontal and left frontotemporal lobes and he expired on postoperative day 14.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.245-251
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• 2000

Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.590-593
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• 2000

The incidence of pulmonary leiomyosarcoma as primary lung tumor is very rare. Most of the primary leiomyosarcomas originate in the hilar region in relation to the main bronchus or pulmonary vessels and only a few originate more peripherally. This rare tumor can mimic bronchial carcinoma and present with local or systemic symptoms, or it may be discovered as an incidental finding on a routine chest X-ray. We report with review of literature, a case of incidental primary pulmonary leiomyosarcoma which originated peripherally. Huge mass was found on the left lung of a 61-year-old man on the chest X-ray peripherally. He underwent the surgical resection of the left pneumonectomy and the postoperative course was uneventful.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1299-1304
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• 1992

We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

• Journal of Chest Surgery
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• v.26 no.12
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• pp.934-939
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• 1993

Mediastinal lymph node involvement [N2 disease] is generally accepted as an important factor influencing the outcome of patients with lung cancer.The long-term survival rates of completely resected patients with N2 disease are frequently reported from 15% to 30%.To improve the management and the outcome of patients with resectable N2 disease, we analyzed the survival rates and the prognostic factors for resected N2 lung cancer. Between August 1989 and September 1993, we experienced 27 patients with N2 disease of 115 surgically treated lung cancer at the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University Medical School. Of these 27 N2 disease 4 had only an exploratory thoracotomy, and 23 underwent pulmonary resection by pneumonectomy[15], bilobectomy[3], lobectomy[4] and sleeve lobectomy[1].All of resected 23 patients received postoperative adjuvant chemotherapy[3], radiotherapy[2] or combined chemo-radiotherapy[18].Complete follow-up was obtained in 23 patients and median survival was 22 months and overall 1-year and 2-year survival rates by Kaplan-Meir method were 65 % and 45 %, respectively. Survival differences according to histology, tumor location, number of positive nodal station and operative method were not significant, statistically. Conclusively, we think that in resectable N2 lung cancer, complete tumor resection and mediastinal lymph node dissection, and postoperative adjuvant therapy should be done to improve the survival.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.98-105
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• 1991

There have been reports concerning the association of laryngeal carcinoma and lung cancer. Second primary respiratory tract malignancies occur frequently in patients who have undergone the treatment of laryngeal cancer probably because they are exposed to the same carcinogen. Recently, we have experienced two patients who developed second primary lung cancer 30 and 41 months after the first diagnosis of laryngeal cancer at the Department of Thoracic & Cardiovascular Surgery, Yonsei University College of Medicine. Relative long interval between the two carcinomas indicated metastasis unlikely. From a therapeutic standpoint, it is of great importance that they should be regarded as separate primaries and not as metastasis. Longevity will depends on a presumption that the lesions are separate primaries and the status of stage at the time of detection of second primary lesion. The follow-up of patients who are seen with carcinomas of the head and neck should be done at regular interval and include a chest roentgenogram and cytologic examination of sputum to detect early changes before the tumors becomes incurable. The first 76 year old patient with left upper lobectomy due to the T2N0M0 lung cancer has been in good condition to present. But the second 55 year old patient with right pneumonectomy due to the T2N0M0 lung cancer died of respiratory failure and septic pneumonia 3 months after operation and chemotherapy.

• Journal of Chest Surgery
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• v.24 no.12
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• pp.1185-1191
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• 1991

The clinical and pathological analysis of solitary pulmonary nodules were estimated in 35 patients with nodules who were surgically resected at the Dept. of Thoracic and Cardiovascular Surgery of Chonnam National University Hospital from July 1978 to Aug. 1989. The results were as follows: 1. Mean age of patients was 43.5 years extending from 11 years to fi7 years old and male to female ratio was 6: l. 2. Preoperative symptoms were complained of dull pain in the chest, cough, hemoptysis and general weakness in 69% of patients. 3. The histopathologic findings of surgically resected nodules showed benign nodule in 51% and malignancy 49%. The most frequent diseases were granuloma[67%] in benign nodules and squamous cell carcinoma[76%] in malignancy. In topographical region of nodules in the lung, benign granuloma was more prevalent in upper lobes, while malignancy was slightly more frequent in lower lobes. 4. The incidence of malignancy by age was extremely rare in patients with less than 35 years old, but in greater than 35 years of age, malignancy comprised up to 67% of patients. 5. Complications of thoracotomy were minor bleedings, wound infections and chest pain not to be required any reoperation except one patient died of sudden onset of arrhythmia after pneumonectomy.