• Title/Summary/Keyword: Pulmonary resection

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Clinical Investigation of Surgical Spontaneous Pneumothorax (외과적 자연기흉의 임상적 고찰)

  • 윤윤호
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.19-24
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    • 1968
  • A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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Choriocarcinorma in the Pulmonary Artery Diagnosed and Treated by Emergency Pulmonary Embolectomy (응급 페동맥 색전 제거술로 진단 및 치유된 폐동맥내 융모막 암종)

  • 조봉균;김종인;이해영;박성달;김송명;김영옥
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.531-534
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    • 2003
  • A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.

Correlation of Preoperative Pulmonary Function Testing and with Pulmonary Complication in Patients after Pneumonectomy (술전 폐기능과 전폐적출술후 폐합병증과의 연관성)

  • Bae, Byeong-U;Jeong, Hwang-Gyu
    • 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.

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Extralobar Pulmonary Sequestration Supplied by Pulmonary Artery (폐동맥에서 공급받는 외엽형 폐격리증;1례 보고)

  • Baek, Hyo-Chae;Park, Jae-Hui;Lee, Du-Yeon
    • Journal of Chest Surgery
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    • v.26 no.11
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    • pp.894-898
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    • 1993
  • Pulmonary sequestration is an uncommon congenital pulmonary malformations characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries. We have experienced a 30 year old male patient with a mediastinal mass complaining of intermittent chest pain, and the mass was histologically confirmed as extralobar pulmonary sequestration. The anomalous blood supply origined from the right pulmonary artery but there was no communication with the tracheobronchial tree. He underwent operation through midsternotomy incision for the purpose of concurrent resection of enlarged thymus noted on chest CT.

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Successful Treatment of a Large Pulmonary Arteriovenous Malformation by Repeated Coil Embolization

  • Park, Jimyung;Kim, Hyung-Jun;Kim, Jee min;Park, Young Sik
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.408-411
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    • 2015
  • Pulmonary arteriovenous malformations (AVMs) are caused by abnormal vascular communications between the pulmonary arteries and pulmonary veins, which lead to the blood bypassing the normal pulmonary capillary beds. Pulmonary AVMs result in right-to-left shunts, resulting in hypoxemia, cyanosis, and dyspnea. Clinical signs and symptoms vary depending on the size, number, and flow of the AVMs. Transcatheter embolization is the treatment of choice for pulmonary AVMs. However, this method can fail if the AVM is large or has multiple complex feeding arteries. Surgical resection is necessary in those kind of cases. Here, we report the case of a patient with a 6-cm pulmonary AVM with multiple feeding arteries that was successfully treated by repeated coil embolization without surgery.

The Role of Resectional Surgery for the Treatment of Localized Multi-drug Resistant Pulmonary Tuberculosis (국소 병변의 다제 내성 폐결핵 환자에서 폐절제술의 역할)

  • An, Chang-Hyeok;Ahn, Jong-Woon;Kang, Kyeong-Woo;Kang, Soo-Jung;Lim, Young-Hee;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.676-683
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    • 2000
  • Background : Surgery may have a role when medical treatment alone is not successful in patients with multidrug resistant (MDR) pulmonary tuberculosis (PTB). To document the role of resection in MDR PTB, we analyzed 4 years of our experience. Methods : A retrospective review was performed on thirteen patients that underwent pulmonary resection for MDR PTB between May 1996 and February 2000. All patients had organisms resistant to many of the first-line drugs including isoniazid (INH) and rifampicin (RFP). Results : The thirteen patients were $37.5{\pm}12.4$ years old (mean${\pm}$S.D.)(M : F=5:8), and their sputum was culture positive even with adequate medication for prolonged periods ($109.7{\pm}132.0$ months), resistant to 2-8 drugs including isoniazid and rifampin. All patients had localized lesion(s) and most (92.3%) had cavities. At least 3 sensitive anti-TB medications were started before surgery in all patients according to the drug sensitivity test. The preoperative $FEV_1$ was $2.37{\pm}0.83$ L. Lobectomy was performed in 11 patients and pleuropneumonectomy in two. Postoperative mortality did not occur, but pneumonia occurred as a complication in one (7.7%). After $41.5{\pm}58.9$ days (range 1~150 days) follow up, negative conversion of sputum culture was achieved in all patients within 5 months. Only one patient (7.7%) recurred 32 months after lung resection. Conclusion : When medical treatment alone is not successful, surgical resection can be a good treatment option in patients with localized MDR PTB.

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Solitary Pulmonary Nodule (고립성 폐결절)

  • 채성수
    • Journal of Chest Surgery
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    • v.15 no.2
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    • pp.148-154
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    • 1982
  • The experience with operative treatment for peripheral situated solitary circumscribed lesions of the lung at the Department of Thorac. & Cardiovasc. Surg., Korea University Hospital during 8 years from March 1974, through April, 1982 was reviewed. Our criteria for Solitary pulmonary nodule were 1. Round or Ovoid shape 2. Surrounded by normal lung Parenchyme 3. Well circumscribed peripheral location 4. No other visible pulmonary diseases on chest X-ray except minimal atelectasis or pneumonitis 5. Largest diameter less than 8 cm Of the 55 patients reviewed, there were 69% of malignancy and 31% of benign pulmonary diseases. In malignancy 38 patients, there were 18 patients with squamous cell carcinoma, 8 patients with undifferentiated large cell carcinoma, 2 patients with undifferentiated small cell carcinoma, 10 patients with adenocarcinoma and patient with metastatic carcinoma. In benign pulmonary nodule 17 patients, here were 5 patients with tuberculoma, 5 patients with aspergilloma, 2 patients with A-V fistula, 1 patient with pulmonary blastoma, 1 patient with paragonimiasis, and 1 patient with lung abscess. Overall male to female occurrence ratio was 39:16, and most prevalent age incidence was 7th decades. Most frequent size distribution was 4-6 cm in diameter. All of benign diseases were cured by resection and 66% of malignancy performed operation and has 75% resectability.

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Pulmonary Aspergillosis Combined with Pulmonary Tuberculosis (폐결핵에 병발한 폐 Aspergillosis의 1치험례)

  • Jo, Kuen Hyon;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.193-197
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    • 1976
  • Pulmonary aspergillosis is a rather uncommon disease as a saprophytic infection, mostly producing significant repeated hemoptysis and frequently combined with chronic debilitating disease or cavitary lung disease such as pulmonary tuberculosis, lung abscess and bronchiectasis. Evaluation of the characteristic symptom, X-ray finding composing intracavitary fungus ball with crescent air patch and immunologic test constitute essential part of diagnosis. Surgical resection is a successful treatment combined with administration of anti-fungal agent to eradicate completely. We present one case of surgically removed pulmonary aspergillosis showing fungus ball, superimposed on underlying pulmonary tuberculosis, with review of the related literatures.

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Result of Surgical Resection for Pulmonary Metastasis from Urothelial Carcinoma

  • Han, Woo-Sik;Kim, Kwhan-Mien;Park, Joon-Suk
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.242-245
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    • 2012
  • Background: Treatment of pulmonary metastasis from urothelial cell carcinoma has been mostly palliative chemotherapy and the role of pulmonary metastasectomy has not been investigated much. Materials and Methods: This study is a retrospective interim review of pulmonary metastasectomy from urothelial carcinoma at single institution between 1998 and 2010. Overall 16 patients underwent pulmonary metastasectomies. Results: There was no postoperative complication or hospital mortality. Mean hospital stay was 6 days. Overall and disease-free 5-year survival were 65.3% and 37.5%, respectively. Conclusion: In selected patients with pulmonary metastasis from urothelial carcinoma, surgical treatment is feasible and could contribute to long-term survival in selected patients.