• Title/Summary/Keyword: Pneumonectomy

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Clinical study of pulmonary resection for tuberculosis [III] (결핵에 대한 폐절제술의 임상적 고찰)

  • 김병열
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.356-361
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    • 1983
  • Pulmonary tuberculosis is still one of unsolved problems in Korea due to increased number of far-advanced and drug-resistant patients, who have poor pulmonary function. We have analyzed 1332 operated Gases during the period of 1958-1981. Annual incidence of the disease decreased from 110 [1960] to 21 [1980]. The ratio between male and female was 7:3 and the age of peak incidence was in the 3rd and 4th decades. Recently, patients below the age of 20 years were slightly decreased, but above 50 years were slightly increased. The patients consisted of far-advanced case in 60% and moderately-advanced in 39% in 1980, as compared with 40% and 59% correspondingly in 1965. Preoperative sputum positively decreased from 91% [1958-1963] to 43.8% [ 1974-1981 ]. Medically treated patients for more than 3 years increased from 16% [1958-1963] to 51% [1974-1981]. From the view of surgical indication, totally destroyed hung increased from 27% [1958-1963] to 4396 [1974-1981 ]. Therefore, pneumonectomy occupied 53.8% of total surgical management recently. Mode of surgical treatment showed that thoracoplasty [33%], resection [57%] in 1958-1963 and thoracoplasty [2%], resection [98%] in 1974-1981. As Semb`s thoracoplasty was the first choice of treatment until 1960, thereafter resection became the choice. Postoperative mortality increased from 1.6-2.096 to 396 recently as well as morbidity. It was mainly due to increased number of poor pulmonary function and postoperative spread of disease. On the basis of our experience, far-advanced and drug-resistant patients increased in number recently, whose pulmonary function was poor. So postoperative mortality and morbidity increased. Proper surgical intervention should be considered before the appearance of resistance for all chemotherapeutic drugs.

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A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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Cavitary Lung Cancer (공동성 폐암의 외과적 고찰)

  • 박재길
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.800-805
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    • 1989
  • The roentgenologic appearance of carcinoma of the lung may vary considerably from case to case. And when it forms cavitary lesion, it is frequently confused with benign lesions and treated conservatively. Twenty-seven patients with cavitary bronchogenic carcinoma were treated in our St. Marys Hospital during the period 1984-1989. There were 24 males and 3 females. They ranged in age from 43 to 76 years. Symptoms of cough, blood-streaked sputum or pleuritic chest pain were present in all patients one month to 6 months before hospital admission and 7 patients among them were delayed in recognition of the malignancy from z month to 3 months. Of 27 malignancies with cavity, 22[81.5 %] were squamous cell ca., 3[11.1%] were large cell ca., and 2[7.4%] were adenoca. And of 22 squamous cell carcinomas, 5 were well differentiated, 13 were moderately and 4 were poorly. All lobes except Rt. middle lobe were involved [RUL 2 cases, RLL 13 cases, LUL 3 cases and LLL 9 cases]. We explored 16 patients and performed 7 lobectomy, 4 bi-lobectomy, 2 pneumonectomy and 3 08zC. Post-operative follow-up examination of the resected 13 patients indicated one and two year survival rates of 69.1 %[9/13 cases] and 37.5%[3/8 cases] respectively, and now 6 survivors whose post-operative periods were from 4 months to 37 months.

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Metastasizing Pleomorphic Adenoma in Right Lung -A case report - (우측 폐로 전이된 전이성 다형태 선종 -증례 보고-)

  • Chung, Won-Sang;Nam, Seung-Hyuk;Kang, Jeong-Ho;Kim, Young-Hak;Kim, Eung-Soo;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.143-146
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    • 2007
  • A metastasizing pleomorphic adenoma originating from the parotid gland is a rare form of neoplasm. The neoplasm is a histologically benign, but clinically controversial entity. Herein, a case report of a pleuro-pneumonectomy of a metastasizing pleomorphic adenoma in the right lung is described. A 57-year-old man, who underwent resection of parotid gland due to a pleomorphic adenoma, presented with multiple metastases on the right lung, mediastinum, pericardium and intercostal muscle. The metastatic lesions were composed of a benign pleomorphic structure.

Invasive Pulmonary Aspergillosis in a Immunocompetent Patient after Congenital Heart Disease Surgery: A Case Report (면역저하가 없는 환자에서 선천성 심장수술 후 발생한 폐 아스페르길루스증: 증례 보고)

  • So-Hyun Ji;Seung-Jin Yoo;Eun-Ah Park;Seung-Geun Song
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1529-1536
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    • 2020
  • Invasive pulmonary aspergillosis (IPA) has been known to occur in immunocompromised patients, but has been rarely reported in immunocompetent patients. In immunocompetent patients, pulmonary fungal infections are not initially considered. This results in diagnosis and treatment delays, as well as poor prognosis. We report a case and serial CT findings of IPA in an immunocompetent 29-year-old male after congenital heart disease surgery.

A Case of Pleural Aspergillosis (흉막 아스페르길루스증 1예)

  • Choi, Gueng Sungm;Kang, Ji Ho;Lee, Sang Haak;Kim, Jin Dong;Park, Yong Wan;Park, Jae Han;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.364-367
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    • 2004
  • Aspergillus species cause a wide spectrum of diseases in humans and most frequent site of infection is lung. Pleural aspergillosis is a rare disease with only 3 cases having been in Korea. It may occur as a complication of tuberculosis, especially after pneumonectomy for this condition, or rupture of cavitary pulmonary aspergillosis into the pleura. We report a patient with pleural aspergillosis who showed a clinical improvement with antifungal therapy.

Extended Sleeve Lobectomy for Tuberculous Bronchial Stenosis - A case report- (결핵성 기관지 협착에 대한 확대 소매 폐엽절제술 - 1예 보고 -)

  • Kim, Dae-Hyun;Kwak, Young-Tae;Choi, Cheon-Woong;Yoo, Ji-Hong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.793-796
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    • 2010
  • Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.

A Case of Pulmonary Arterial Thrombosis in a Patient with Tuberculous-destroyed Lung and Pulmonary Hypertension (결핵성 파괴폐에 의한 폐동맥 고혈압 환자에서 발견된 근위부 폐동맥 혈전증 1예)

  • Lee, Ji Eun;Kim, Jung Hyun;Kang, Min Kyoung;Park, Hyun Jeong;Lee, Ji Hyun;Kim, Eun Kyung;Lee, Young Kyung;Jeong, Hye Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.1
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    • pp.28-32
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    • 2008
  • Pulmonary arterial thrombosis develops during hypercoagulable states, intra-arterial tumorous conditions, and congenital heart disease accompanied by pulmonary hypertension. Thrombosis in the main pulmonary arterial stump after pneumonectomy can also occur. Herein, we report a very rare case of pulmonary arterial thrombosis in a patient with pulmonary hypertension and a lung destroyed by tuberculosis. He presented with aggravated dyspnea without fever or purulent sputum. His chest computerized tomography scan showed left main pulmonary arterial thrombosis as a convex shape, with the ipsilateral distal arteries and arterioles showing parenchymal destruction. After excluding pulmonary thromboembolism and hypercoagulable disorders, we diagnosed pulmonary arterial thrombosis and treated him with an anticoagulant.

Combined Large Cell Neuroendocrine Carcinoma with Component of Adenocarcinoma-A case report- (선암종의 요소를 갖느느 혼압대세포신경내분비암종-1예 보고-)

  • Park Jong Un;Lee Jae Woong;Jo Tae Jun;Kim Kun Il;Lee Weon Yong;Hong Ki Woo;Eom Kwang Seok;Jun Sun-Young
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.579-582
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    • 2005
  • Combined large cell neuroendocrine carcinoma is an uncommon lung cancer that include large cell neuroendocrine carcinoma with components of adenocarcinoma, squamous cell carcinoma, giant cell carcinoma and/or spindle cell carcinoma histologically. We report a case that pathologically diagnosed as combined large cell neuroendocrine carcinoma with component of adenocarcinoma after right pneumonectomy and mediastinal lymph node dissection. A 44-year-old man with intermittent chest pain was referred to our hospital for lung mass on the right mid lung field.

Resection of Pulmonary Tuberculosis An Analysis of 100 Cases (폐결핵 잔류병변에 대한 폐늑막 절제술 100례)

  • Son, Gwang-Hyeon;Lee, Nam-Su
    • Journal of Chest Surgery
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    • v.18 no.1
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    • pp.97-103
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    • 1985
  • During the period of seven years from Jan. 1976 to Jan. 1983, one hundred cases of pulmonary tuberculous residual lesions were resected at the Department of Thoracic Surgery, Paik Hospital in Seoul, Korea. During the period of this study, 1764 patients were admitted with the diagnosis of pulmonary and/or pleural tuberculosis in the medical and surgical department as a primary or associated conditions. Among these 1764 patients, one hundred selective cases were operated. The results were as follows; l. Extents of the disease by the predominant clinical pictures were: totally destroyed lung; 18, destroyed lobe; 6, cavitary lesion with or without positive sputum; 35, bronchiectasis; 7, bronchostenosis with atelectasis; 2, empyema with or without BPF; 20, pleural thickening; 4, tuberculoma; 3, bullous cyst with tuberculosis; 5 cases, or per cent [Table 1]. 2. Male and female ratio was 1.2:1 or 55 and 45 per cent. Age distribution ranged 15 and 55 with average of 33 years [Table 2]. 3. Type of procedures were: pleuropneumonectomy; 15, pneumonectomy; 25, lobectomy; 37, bilobectomy; 6, lobectomy plus segmentectomy; 3, pleurectomy; 14 cases, or percent, Site of resections were: right; 58 and left; 42 cases, or per cent [Table 3]. 4. Incidence of complications were 10 per cent and the mortality was 4 per cent. The causes of morbidity were analyzed. The main causes of death were pulmonary insufficiency; 2, cardiac arrhythmia; 1, and hepatic insufficiency; 1 case or per cent [Table 4]. 5. Pathologic examinations of the resected pulmonary and pleuropulmonary lesions were observed by gross specimen, correlating with the pre-operative indications of the disease [Fig. 1, 2, 3, 4, 5, 6].>br> 6. Anti-tuberculous chemotherapy was done for 6 to 18 months, post-operatively, in 80 patients. Of these 49 cases were need medication for 12 months [Table 5]. Except the four operative mortality and a case of post-operative recurrent buberculosis under medication, all the other 95 cases are well in activity and free from the disease at the moment.

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