• Title/Summary/Keyword: Pulmonary resection

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Clinical Evaluation of Pulmonary Resection With Arterial Blood Gas Analysis and Pulmonary Function Test in the Pulmonary Tuberculosis (결핵성 폐질환의 폐절제술후 폐기능 및 동맥혈가스 분석에 대한 임상적 고찰)

  • 채성수
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.856-860
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    • 1993
  • We performed serial pulmonary function test and arterial blood gas analysis at preoperative period and postoperative 1st week in 337 patients who underwent pulmonary resection from May 1988 to April 1992 at Dept. of Thoracic and Cardiovascular Surgery, Seoul adventist hospital. Follow-up study for PFT and ABGA were possible in 30 % of the patients at postoperative 3rd or 4th month. In patient who underwent pneumonectomy, VC was decreased from 57.7% to 46.1%, FVC was decreased from 53.5 % to 41.2 % and MBC also decreased from 68.1% to 49.6 % at postoperative 1st week. But ABGA revealed that POa-, was increased from 87.2 mmHg to 92.7 mmHg, and PCO2 was decreased from 43.2 mmHg to 35.9 mmHg at postoperative 1st week. In patients who underwent lobectomy, VC was decreased from 78.1% to 68.30 %, FVC was decreased from 72.5% to 55.3% and MBC was decreased from 73.5% to 68% at postoperative 1st week.But, ABGA revealed that PO2 was increased from 95.2 mmHg to 97.9 mmHg and PCO2 was decreased from 42.3 mmHg to 39.0 mmHg at postoperative 1st week. The pulmonary function recovered at postoperative 3rd or 4th month and its ratio to preoperative value was 90% in lobectomy cases, but in pneumonectomy cases VC and MBC were recovered 20% and 15 % above the preoperative values. We concluded that resection of atelectasis, destructed lung, open negative and open positive cavity in the pulmonary tuberculosis were beni~t to improve ventilation-perfusion ratio,and pulmonary function was recovered nearly to preoperative level at postoperative 3rd or 4th month.

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Clinical evaluation of bronchiectasis (기관지확장증의 임상적 고찰)

  • 김수성
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.41-47
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    • 1984
  • We experienced 48 operations in 46 surgical patients of bronchiectasis admitted to the Department of Thoracic and Cardiovascular Surgery of Jeonbug National University Hospital from January, 1975 to August, 1982. Among 46 patients, 27 patients [59%] was age group between 21 to 30 years. Common symptoms were cough with sputum, hemoptysis, dyspnea, fever and chilliness, and chest pain. The duration of the symptoms was variable between below one year and above 10 years. The most frequent associated disease, probably the cause of the bronchiectasis, was secondary bacterial infection after viral infection. The left lower lobe and lingular segment was involved most frequently, and the most frequent pathologic type was mixed type [40%]. Single lobectomy, and combined lobectomy and segmentectomy were performed in 77% of the patients. Bilateral resection was performed in three patients with good result. In those patients, the isolated pulmonary function test on each side of the lung performed 2 month later primary lung resection could make them be prevented from pulmonary insufficiency after secondary lung resection. The results were good except two patients who developed pulmonary insufficiency and chronic empyema with bronchopleural fistula.

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Robot-Assisted Pulmonary Resection For Lung Cancer (폐암에서 로봇을 이용한 폐절제술)

  • Lee, Hyun-Sung;Jang, Hee-Jin
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.92-97
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    • 2011
  • MMinimally invasive surgery (MIS) for early stage lung cancer has been an important treatment modality. However, the ergonomic discomfort and counterintuitive instruments hindered the application of video-assisted thoracic surgery (VATS) to more advanced procedures. To improve the compliance with MIS, robotic surgery was adopted. This advance aimed to alleviate the shortcomings of VATS by maximizing the comfort of the surgeon while providing instruments that enabled technically demanding operations and three-dimensional views with increased freedom for intrathoracic movement owing to EndoWrist$^{(R)}$. In this session, we introduced the clinical applications and its results of robot-assisted thoracic surgery in the field of lung cancer surgery. In conclusion, robot-assisted pulmonary resection with lymph node dissection for lung cancer is safe as well as feasible, and it results in a satisfying postoperative outcome. Robot-assisted surgery may provide a good alternative to conventional open or thoracoscopic surgery for lung cancer, provided that the cost effectiveness and long-term prognosis are confirmed.

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Surgical Treatment of Bronchiectasis (기관지확장증의 외과적 치료)

  • 권영무
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.683-690
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    • 1990
  • This study is based on an analysis of 76 cases of bronchiectasis treated by pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University from September, 1978, to February, 1989. There were 37 males and 39 females, and their age raged from 7 to 75 years, with 66 cases (87.7%) between 10 and 39 years. The past history included mealses(36/8%), frequent URI (26.3%), pulmonary tuberculosis(23.7%), and pneumonia or bronchitis (21.1%). The main clinical symptoms were cough(90.8%), purulent sputum(88.2%), hemoptysis(64.5%). The preperative diagnosis was made by bronchography. Thirty-five cylindrical, 16 cystic, 1 varicose and 20 mixed types of bronchiectasis were noted. The majority of the cases had disease in the dependent portion of the lung. Various types of pulmonary resection were performed. Early complications developed in 10 cases(13.2%), but no operative death. THe follow-up ranged from 10 months to 137 months. In 57 cases having resection of all bronchiectatic lesion, 48(84.2%) had excellent or improved conditions, but 5(8.8%), unchanged. In 19 cases whom not all demonstrable disease removed, 14(73.7%) had excellent or improved conditions, but 3(15.8%0, unchanged.

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Median Sterontomy for Bilateral Resection of Emphysematous Bullae (정중 흉골 절개술을 통한 양측의 기종성 폐포의 절제)

  • 이성윤
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.720-730
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    • 1990
  • The complicated pulmonary emphysema including “Giant bullae” and spontaneous pneumothorax often involve both lungs, and controversy exists concerning which is the more rational means of surgical treatment-bilateral simultaneous operation or two staged operation. We report three cases of the complicated bilateral bullous emphysema and two cases of bilateral spontaneous pneumothorax treated through median sternotomy. We performed the ligation of bullae, bullectomy, cystectomy, wedge resection, and left lower lobectomy through median sternotomy. No technical problems were encountered through this approach, which provided maximum benefit with one operation In conclusions, median sternotomy may be appropriate for resection of emphysematous bullae, specially in a severe COPD patient who may be poorly tolerated the superimposed loss of respiratory function due to incisional pain, because median sternotomy permit bilateral exploration, minimal impairment of pulmonary function, simultaneous restoration of pulmonary function, less incisional pain than routine lateral thoracotomy.

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Surgical Treatment of Pulmonary Aspergillosis; 11 Cases Report (폐국균증에 대한 외과적치료;11례 보고)

  • 조재호
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.380-383
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    • 1993
  • Aspergillosis is not only the problem increasing the freguency for recent decades but also a serious one. Coexistent pulmonary diseases are frequent and the most common antecedent disease is Tuberculosis with healed cavitary lesion. Interest of the surgeons is aroused because of it`s predilection to sudden life-threatening, exsanguinating pulmonary hemorrhage. 11 patients with pulmonary aspergillosis evaluated at this hospital in a 7-year period, and the results were as follows: 1.male to female ratio was 1:1.75. 2.The most common symptom was gross or microscopic hemoptysis[72.7%]and other symptoms were chest pain[9.1%] and chronic productive coughing[9.1%]. 3.The right upper lobe was most common involving site[81.8%] 4.Surgical interventions were 8 cases of lobectomy, 1 case of lobectomy with wedge resection, 2 cases of wedge resection. 5.Post-operative complications developed in 5 patients and were 4 cases of wound infections, 2 cases of empyemas, 1 case of bleeding, 1 case of atelectasis.

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Surgical Treatment of Pulmonary Aspergillosis (폐국균증의 외과적 치료)

  • 여승동
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.611-615
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    • 1992
  • Between July 1988 and August 1991, 8 cases of pulmonary resection for pulmonary asp-ergilloma had been performed in the department of thoracic surgery, Korea Cancer Center Hospital. The patients were consisted of 4 males and 4 females and were evenly distributed from fourth decade to sixth decade. Hemoptysis was the most common chief compla int. In chest roentgenogram, patch infiltration was noted in 4 cases[50%] and intracavi-tary fungus ball was noted in only 2 cases[25%]. A. fumigatus was identified pre-operatively in 2 cases by bronchoscopic washing and in 1 case by culture of pleural effusion, Eight pulmonary resections were done by 5 lobectomies, 1 segmentectomy, 1 wedge resection and 1 pneumonectomy, Postoperative pathologic findings showed that 6 cases [75%] were combined with bronchiectasis, 1 case with tuberculosis and 1 case with pneumonia. We experinced 1 case of postoperative pulmonary edema but there was no mortality case.

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Accumulation of Ga-67 in Metastatic Pulmonary Nodules from a Moderately Differentiated Adenocarcinoma of the Rectum (직장의 중등도 분화성 선암으로부터 전이된 폐결절에서의 Ga-67 섭취)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.2
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    • pp.140-142
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    • 2002
  • A 67-year-old woman who had undergone anterior resection for a moderately differentiated adenocarcinoma of the rectum and wedge resection for liver metastasis presented with hematogenous lung metastasis. Metastatic pulmonary nodules in both lung fields were shown on plain chest radiograph and CT. Ga-67 SPECT images revealed accumulation of radioactivity corresponding to the pulmonary nodules. The authors present an unusual case of accumulation of Ga-67 in metastatic pulmonary nodules in a patient with a moderately differentiated adenocarcinoma of the rectum.

Surgical treatment of pulmonary aspergilloma (폐 국균증의 수술적 치료)

  • Park, Seung-Il;Son, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.26 no.10
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    • pp.775-780
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    • 1993
  • Pulmonary aspergilloma resulting from colonization of Aspergillus fumigatus is potentially life-threatening disease due to massive hemoptysis. Between August 1990 and November 1993, twelve patients were operated for the treatment of pulmonary aspergilloma. The mean age was 38.8 years. All patients had underlying cavitary lung disease, and the tuberculosis is the most common cause. Ten patients have experienced hemoptysis, but the clinical presentation of hemoptysis at the time of operation was mostly intermittent and scanty. Operative procedures were segmentectomy in 1 patient, lobectomy in 8, pneumonectomy in 2, and pleuropneumonectomy in 1. There were three complications, bronchopleural fistula in one patient and prolonged air leak in 2. There was no postoperative death. Conclusively, our results suggest that established aspergilloma associated with tuberculosis or other cavitary lesions should undergo early elective pulmonary resection, even though it has only minimal hemoptysis.

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Change of Pulmonary Function after Pulmonary Resection (폐절제술후 폐기능 변화에 관한 연구)

  • 김용진
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.517-528
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    • 1985
  • Pulmonary function studies today are generally accepted as an integral part of the evaluation of poor-risk patients who are to have pulmonary surgery. The effect of various pulmonary surgery on lung function was investigated in 54 patients in whom comprehensive lung function test were performed before and between 2 months and 14 months after operation at the Department of Thoracic Surgery, Seoul National University Hospital. According to the result of analysis, the effect of pulmonary resection on forced flow rate was keeping with the change of lung volume, and the preoperative level of ventilatory function plays a major role in determining postoperative loss of functioning lung. Although all measures of expiratory flow [FVC, FEV1, FEFO.2-1.2, MEF50, FEF25-75] have the same percentage of reproducibility, but FEV1 shows most sensitive, reliable linear correlation with the functioning pulmonary tissue loss than other parameters. The linear regression lines derived from the correlation between preoperative [X] and postoperative [Y] FEV1 on various surgical procedures were as follows: 1. Y = 0.57X 0.03. in pneumonectomy group of lung cancer[r=0.84]. 2. Y = 0.56X + 0.33. in lobectomy group of lung cancer[r=0.79]. 3. Y = 0.69X + 0.25. in lobectomy group of pulmonary infection[r=0.91].

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