• Journal of Chest Surgery
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• v.20 no.1
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• pp.92-100
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• 1987

On rare occasions, the left atrium may become extremely large in the mitral valvular disease, showing giant left atrium. The giant left atrium frequently produce compressing effects to the adjacent organs, resulting in the postoperative problems with regard to the hemodynamic and respiratory management. We experienced 13 patients with giant left atrium combined with mitral valvular disease from Oct. 1980 through June 1986. Eleven cases underwent mitral valve replacement with left atrial plication and the other 2 cases were underwent mitral valve replacement without left atrial plication. The follow-up period was 19.3 months in average. There were remarkable postoperative improvements in the chest roentgenogram, echocardiogram, lung function test, NYHA functional class in patients who underwent plication procedure. The postoperative mortality was 9% in plication cases and 50% in non-plication cases.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.703-708
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• 1984

Fibrothorax is the end stage of chronic pathologic processes of pleura such as hemothorax, empyema, or tuberculous effusion. The pleural space become adherent and obliterated, and the lung parenchyma is covered by a thick, fibrous, unexpandable "peel", so the lung function is diminished markedly with impaired ventilation and oxygenation. Constrictive pericarditis is often accompanied fibrothorax, also cardiac and hemodynamic function is deteriorated. Surgical relief of these fibrous peels causes remarkable improvement in pulmonary function, cardiac and hemodynamic function, and subjective symptoms. We experienced a case of bilateral fibrothorax combined with constrictive pericarditis which occured 3 years after bilateral tuberculous effusion. Decortication and percardiectomy were done at the same time through bilateral submammary thoracotomy with sternal transection. Comparing postoperative Peripheral venous pressure, Circulation time, Pulmonary function test, Arterial blood gas analysis, Subjective symptoms with preoperative conditions showed noticeable improvement.provement.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.195-201
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• 1988

Sixty patients with proven lung cancer were retrospectively studied to determine whether postoperative radiation therapy improves survival. Patterns of treatment failure and 5 year survival were assessed according to extent of tumor spread, histology, type of operation, positive resection margin and radiation dose. Of the 60 patients, excluding S patients who received incomplete treatment or poor pulmonary function,55 patients received postoperative radiation therapy following curative resection. The overall survival at 5 years was $39\%$. The hilar and mediastinal lymph node involvement had an influence on survival. The authors recommend that patients with resection. lung cancer involving the hilar and mediastinal lymph nodes may require postoperative radiotherapy to reduce the local recurrence and improve survival.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.25-40
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• 1969

Lung homotransplantation was performed in 15 pairs of dog. Methotrexate and R.E.S. blocking were used to prolong the survival time. Details of handling the transplant, operative technique and management of the recipient were discussed and following results were obtained: 1]. 7 dogs out of 15 dogs of homotransplantation of lung were survived beyond 3 days. In the group of dogs treated with methotrexate, the average survival was 8.5 days, and in the group of dogs treated with R.E.S. blocking, the average survial was 9.7 days with longest survival of 17 days. 2]. The causes of immediate postoperative death in homotransplantation of dogs were lung edema and disruption of bronchial anastomosis. 3]. The main causes of death in successful homotransplantation dogs which were survived beyond 3 days were infection of lung parenchyma and bronchial necrosis rather than the occurence of graft rejection. 4]. Graft rejection was not revealed even after 7 days of operation in the group treated with methotrexate as well as in the group treated with R. E.S. blocking. This finding made it suggest that the R. E.S. blocking may be effective to control the rejection reaction. 5]. Even though the pulmonary function of transplanted lung was revealed the evidence of severe impairment immediate after operation by bronchospirometry, it was increased gradually and 10 days after operation the minute ventilation and oxygen uptake were decreased 8%, 13% respectively less than pre-operative one.

• 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.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.509-512
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• 1998

Although posterolateral thoracotomy(PLT) has been a standard thoracic incision in resection surgery of the lung for surgeons to achieve a good surgical field, there remains concern about severing a group of thoracic muscles remains. Muscle-sparing vertical thoracotomy (MVT) is an alternative to PLT, which gives cosmetic result and may preserve motion of the shoulder girdle as well as respiratory function of the patient in the early postoperative period. However, surgeons tend not to perfer it because of limited surgical field from the vertical wound made on the lateral thoracic wall. The purpose of this study is to compare the surgical outcomes of PLT versus MVT. We retrospectively reviewed 29 patients(15 who had PLT and 14 who had MVT, organized into those two groups) who had undergone lung resection surgery in our institute. There were no clinical differences between the two groups in terms of operation time, estimated amount of blood loss during the operation, amount of chest drainage on the first and the second postoperative day, duration of chest tube placement, incidence and amount of transfusion, and postoperative complications. We conclude that, from our limited experience, MVT can be applied to lung resection surgery as safely as PLT and that it may have a beneficial role for the patient with compromised lung function in addition to cosmetic effect.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1232-1236
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• 1997

Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

• Journal of Chest Surgery
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• v.44 no.6
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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.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.620-626
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• 1993

Determination of preoperatibe pulmonary function is crucial in avoiding complications from pulmonary resection, especially pneumonectomy. Postoperative morbidity and mortality were correlated with the preoperative results of five widely used tests of pulmonary function in 40 patients who underwent pneumonectomy for bronchiectasis, pulmonary tuberculosis, and carcinoma of the lung. Factors analyzed following operation included 30-day mortality, the incidence of arrhythmia, the frepuency of respiratory complications, and the number of individuals requiring prolonged mechanical ventilation. There were statistically significant differences[p<0.001]in mean values among FVC, FEV1, FEV1/FVC and MVV. But the difference of the FEF25-75% was not statistically significant.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.250-258
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• 1993

Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.