• Journal of Chest Surgery
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• v.28 no.10
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• pp.911-916
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• 1995

Thirteen patients with lung cancer have undergone bronchoplastic procedures from January 1991 to July 1994 in Kyung Hee univ. Hospital.Among them,twelve patients were male and one patient was female from 33 to 76 years of age.[ mean 56.6 11.5 years of age The pathologic diagnoses were squamous cell carcinoma in twelve patients and adenoid cystic carcinoma in one patient.The bronchoplastic procedures consisted of seven right upper sleeve lobectomies, one right middle sleeve lobectomy, one left lower sleeve lobectomy and four sleeve pneumonectomies. In these sleeve pneumonectomies, right sleeve pneumonectomy was done in three patients and the other was left sleeve pneumonectomy. Including the four sleeve pneumonectomies, carinoplasty was performed in seven patients. Postoperatively, we carried out bronchoscopic suction of intrabronchial secretions in necessary for the prevention of postoperative complication. All except one were discharged without any complication and have been in good condition. Postoperative mortality was in one patient who expired 25days after right middle sleeve lobectomy with respiratory failure.

• Journal of Chest Surgery
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• v.26 no.6
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• pp.463-469
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• 1993

From May 1986 to May 1992, 72 patients were diagnosed and operated for primary lung cancer, among them 65 patients were clinically evaluated at the department of Thoracic & Cardiovascular Surgery, Masan Koryo General Hospital. 1. There were 52 males 13 females[M:F=4:1], and 5th, 6th decade of life[72%] was peak incidence. 2. The preoperative diagnosis and its positive rate were sputum cytology 35%, bronchoscopy 47%, pleural effusion cytology 80%, and pleural biopsy 50%. 3. The classification histologic types were squamous cell cancer 71%, adenocarcinoma 17%, undifferentiated cell carcinoma 4.6%, and staging classification were Stage I 31%, Stage II 22%, Stage IIIa 26%, and Stage IIIb 20%. 4. The operative methods were lobectomy 52%, pneumonectomy 36%, and open biopsy 12%, and operability was 89%, resectability was 88%. 5. The postoperative complications developed 13 patients[22%], and operative mortality was 5%. 6. The overall actuarial survival rate was 1year 70%, 2year 42%, 3year 32%, 4year 26%, and 5year 22%, according to Stage 5year survival rate was Stage I 37%, Stage II 22%, Stage IIIa 3year 12%, Stage IIIb 2year 23%. And according to operative method lobectomy 23%, pneumonectomy 19%.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.368-374
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• 1983

Combined type of primary lung cancer is a very rare form in clinical experience, which is 3 histologically different variants of bronchogenic carcinoma. These type had a well differentiated squamous carcinoma forming keratin pearls, well differentiated adenocarcinoma and pleomorphic undifferentiated cell carcinoma, usually small cell carcinoma. The patient, a male, 49-Y-0, was complaint coughing, mild dyspnea, blood tinged sputum and chest pain. Under diagnosis of lung cancer preoperatively, the right total pneumonectomy was performed with very difficulty such as arrhythmia, ventilation impairment during post operation course. The histology of specimen was disclose as 3 different histological type, combined lung cancer as squamoadenoundifferentiated carcinoma. The mediastinal nodes were freed from metastasis but the parietal pleural metastatic loci was found. The radio & chemotherapy were performed post-operatively. The patient had been experienced empyema at post-pneumonectomy space and then open drainage procedure and thoracoplasty had been added for treatment course. The patient is alive recently.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.566-571
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• 1990

The Bronchial stump disruption in bronchopleural fistula with empyema thoracis after pneumonectomy has remained one of the most dreaded complications of thoracic surgery. Management of chronic bronchopleural fistula still poses a therapeutic dilemma in spite of various surgical techniques that have been attempted to control this complication. Only recently, transsternal transpericardial approach for repair of the postpneumonectomy bronchopleural fistula has been utilized in some cases. The patient was a 31 year-old woman who was admitted to our hospital on August 18th, 1989 due to right postpneumonectomy bronchopleural fistula with empyema thoracis for 5 years since she had undergone right pneumonectomy due to pulmonary tuberculosis at E-hospital in 1984. Transsternal transpericardial closure of the fistula was employed and then the thoracic catheter was removed two months later, after the empyema cavity was sterilized by the Clagett method. So, we think this surgical technique is a relatively simple and effective method to the control of chronic postpneumonectomy bronchopleural fistula with empyema thoracis.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.851-856
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• 1989

Initial successful treatment of postpneumonectomy empyema depends to a large extent on adequate dependent drainage of the empyema sac and the use of antibiotics. But definite control of the infected space remains a disturbing and controversial area in the field of thoracic surgery. A 55-year-old man had a right pneumonectomy for tuberculosis with the development of postoperative thoracic empyema and in October 1973. Postoperatively, an empyema developed and the condition was managed with closed drainage and an open window thoracostomy. He was transferred to our institution in October 1988, and underwent thoracoplasty for the obliteration of the empyema space, resulting in a remaining space. The remaining space after thoracoplasty was obliterated by myoplasty using a rotation flap of splitted pectoralis major muscle three months later. He was discharged with uneventful course 12 days after operation, and continues to do well 3 months following operation. Our experience shows that thoracoplasty and myoplasty offer an effective alternative method of management of post-pneumonectomy empyema.

• Journal of Chest Surgery
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• v.33 no.12
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• pp.982-987
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• 2000

미만성 악성 중피세포종은 예후가 불량한 드문 암종으로, 아직까지 적절한 병기 분류가 없고, 병리 조직학적인 진단이 쉽지 않다. 치료에 대해서 논쟁이 많지만 선택된 환자에서 늑막 폐절제술을 시행하고 보조적인항 화학요법과 방사선 요법이 생존 기간을 연장시킬 수 잇다. 저자들은 1992년 6월부터 7년간 미만성 악성 중피세포종 환자 4례에서 늑막 폐절제술을 시행하였으며 수술후 조기 사망은 없었다. 3례의 환자에서 수술후 보조요법을 시행할 수 있었다(보조 화학요법 2례, 보조 화학요법 및 방사선 치료 1례). 그러나 한 예에서는 수술후 발생한 심장염전에 의한 저산소성 뇌손상 및 농흉으로 인하여 보조용법을 시행할 수 없었다. 저자들은 저자들의 늑막 폐 절제술의 경험 및 미만성 악성 중피세포종에 대한 논란이 되는 점을 문헌고찰과 함께 보고하는 바이다.

• Proceedings of the KTCVS Conference
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• 1993.06a
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• pp.114-114
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• 1993

• Journal of Chest Surgery
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• v.27 no.11
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• pp.922-929
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• 1994

This research represents an attempt to study the postoperative results among 32 patients who underwent complete resections of primary lung and involved mediastinal lymph nodes between January 1988 and June 1993. Ages ranged from 34 to 73 years with a mean age of 51.31 $\pm$ 8.17 years. There were 29 male patients[90.6%]. Left lung cancers were more frequent than right lung cancers. There were 19 cases of left lung cancers accounting for 59.4% of the total lung cancers. The difference, however, was insignificant. There was no T1 lesion. T2 and T3 lesions were 21[65.6%] and 11 cases[34.4%], respectively. As for cell type, squamous cell carcinomas were reported in 25 cases making up 78.1% of the cell types. Pneumonectomy was conducted on 20[62.5%] cases. Lobectomy and sleeve lobectomy were conducted on 12[37.5%] cases respectively. Mediastinal lymph node involvemednts were most frequent in subcarinal lymph node[9/13] among right lung cancers, while subaortic lymph noce[12/19] was most frequent among left lung cancers. Postoperative complications were reported in 18.9% of the total cases, including 2 cases each of paralysis of the recurrent laryngeal nerve and 1 case each of chylothorax and pyothorax. They were more frequent among patients who underwent pneumonectomy. The operative mortality stood at 3.1% with 1 patient who underwent pneumonectomy dying of pulmonary edema. The 1-year and 5-year survival rates were 50.8% and 30.1%, respectively. Patients treated with squamous cell carcinoma, involvement of single level mediastinal lymph node and lobectomy showed a higher level of survival. These fidings suggest that a long-term survival can be expected of a considerable number of N2 non-small cell lung cancer patients with a selective complete surgical resection of primary lung cancers involved mediastinal lymph nodes.

• Tuberculosis and Respiratory Diseases
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• v.53 no.3
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• pp.325-331
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• 2002

Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.192-195
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• 2000

Pulmonary function test is used as a guideline for safe pulmonary resection without complications. Usually FEVl lower than 1 liter is considered as a contraindication of lobectomy. Therefore, the curative operation of resectable lung cancer can not be performed in the case of poor pulmonary functions. Nowadays, there are some arguing points about the value of preoperative PFTs before the pulmonary resection. We performed a right pneumonectomy for stage H lung cancer in a patient with poor lung function test; FVC 2.17L, FEVl 0.97L, FEVl/FVC 44%, FEF 25-75％ 0.42L/sec, MVV 28L/min, TLC 5.18L, RV 2.99. During 4 months follow up, the patient had been tolerable. The follow up PFTs at postoperative 3 months 18 days showed up as follows; FVC 1.20L, FEVI 0.63L, FEVl/FVC 53%, FEF 25-75% 0.31L/sec, MVV 25L/min, TLC 3.80L, RV 2.33L.