• Title/Summary/Keyword: Pulmonary resection

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Clinical Study of Surgical Resection of Pulmonary Tuberculosis (폐결핵의 외과적 요법에 대한 임상적 고찰)

  • 고재웅
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.648-654
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    • 1989
  • A clinical study was performed on 363 cases of pulmonary tuberculosis treated surgically resection during the period of 3 years from January, 1986 to December, 1988 in the National Kong-Ju Hospital. The results obtained are follows: 1. The ratio of male to female was 1.6:1 in male predominance, age from 20 to 40 occurred 82.6% of the total cases. 2. The moderately advanced cases was the highest incidence with 53.2 % for extent of disease, duration of illness which 1 to 5 years before operation was 40.8 % of the total cases. 3. Preoperative sputum examination for AFB was 53.2 % in negative but in spite of chemotherapy, persistent positive sputum was 46.7%. 4. Indication for surgery were: total destroyed lung was 35.5 %, destroyed lobe or segment with or without cavity was 30.6%, empyema with or without bronchopleural fistula was 8.5%, according to type and site of surgical procedure, pleuropneumonectomy and pneumonectomy was the highest incidence with 53.4 %, left site was slightly more than right with 55.9 % of the total cases. 5. The incidence of postoperative complication was 10.2 % and then the highest incidence was empyema with or without bronchopleural fistula with 4%, according to type of surgical procedure, postpleuropneumonectomy and postpneumonectomy was 6.1 % of the total cases. 6. Postoperative mortality was 1.4 % of the total cases, according to cause of deaths, hypovolemic shock due to bleeding were 2 cases, respiratory failure were 2 cases and hepatic coma due to hepatic failure was 1 case.

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Clinical Study of Pulmonary Resection for Tuberculosis (II) (결핵에 대한 폐절제술의 임상적 고찰 (제 II 보))

  • 유영선;유회성
    • Journal of Chest Surgery
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    • v.7 no.2
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    • pp.139-144
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    • 1974
  • Clinical observations were made on 513 cases of pulmonary resection for tuberculosis, those were treated at the Department of Thoracic Surgery in National Medical Center from January 1964 to December 1973. 1. The ratio of male to female cases of operation was 2.8:1 in male predominence and age from 21 to 30 occurred 74.3% of the total cases. 2. The extent of disease showed 59.3% moderately advanced, 38.4% far advanced and 2.3% minimal cases. Duration of chemotherapy before surgery was more than one year in 92.7% and only 7.3% was treated less than one year. Preoperative sputum examination for AFB was persistent negative in 8.6,% of cases. 3. Different operative procedures were performed in 513 cases, lobectomy in 230, pneumonectomy and Pleuropneumonectomy in 172, segmentectomy in 63, lobectomy and supplemental segmentectomy with conventional thoracoplasty in 32 cases. 4. The postoperative complications occurred in 67 cases [13.0%]. Of these complications, bleeding in 4.6% , dead space problem in 2.5% and empyema with or without bronchopleural fistula occurred in 2.3% of cases. 5. Overall mortality within 5 months postoperative period was 1.5,0/0 and the most common causes of death were due to shock and empyema with bronchopleural fistula. 6. In all our 867 cases of report I and II, complications occurred in 13.9% and mortality rate was 1.8%.

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Pulmonary Resection of Hemoptysis Patients -29 case- (각혈 환자의 폐절제술 -29례 보고-)

  • 박병률
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1139-1143
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    • 1995
  • We experienced 29 cases of patients with a chief complaint of hemoptysis who were performed pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, Pusan Medical Center Hospital for 3 years from May 1990 to April 1993. The mean age of hemoptysis patients was 34.7 year old, and hemoptysis was most prevalent in third and fourth decades. The underlying lung diseases of hemoptysis patients were tuberculosis in 12[41.4% , bronchiectasis in 9[31.0% , lung cancer in 4[13.8% , aspergyllosis in 3[10.3% and pneumonia in 1[3.5% . Modes of hemoptysis were blood tinged in 7[24.1% , massive in 22[75.9% . Operation times were elective in 7[24.1% of all blood tinged hemoptysis, delayed in 20[69.0% , emergency in 2[6.9% out of massive hemoptysis. The cases of the definite bleeding focus found by bronchoscopy were 19 cases[65.5% . The operative procedures of hemoptysis were single lobectomy in 14[48.3% , pneumonectomy in 6[20.7% , lobectomy with segmentectomy in 5[17.2% , bilobectomy in 3[10.3% and segmentectomy in 1[3.5% . The postoperative results of hemoptysis were complete recovery in 27[93.0% , rehemoptysis in 1[3.5% which was treated by anti-Tbc medication completely, and hospital death in 1[3.5% which was brain metastasis of lung cancer. It was concluded that definitive diagnosis, preoperative control of hemoptysis and operation were important in the management of hemoptysis patients.

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Clinical Analysis of Acquired Tracheoesophageal Fistula (후천성 기관식도루의 임상적 고찰)

  • 백효채;김도형;조현민;이두연
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.61-65
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    • 2002
  • Background : Acquired tracheoesophageal fistula(TEF) results mostly from Prolonged tracheal intubation and insertion of nasogastric tube. Although the incidence has decreased since the usage of low pressure, high volume cuff of endotracheal tube, it is seldom cured spontaneously and needs surgical treatment. Material and Methods : We have retrospectively reviewed five cases of TEF who underwent surgical treatment for cure from March, 1990 to September, 2001 and analyzed the cause, treatment, postoperative complications and prognostic factors. Results : Majority were men(80% : 4 of 5 patients) and the mean age was 29.4 years old(range, 11-58). The most predominant etiology was prolonged intubation or tracheostomy(80% : 4 of 5 patients) and 3 of 5 patients were treated by tracheal resection and end to end anastomosis with primary closure of esophagus. Postoperative complications occurred in 4 patients the most common complications were wound infection(4 cases) and esophageal leakage(2 cases). Extubation was done on postoperative day 11.5(range, 1-33) days, and factors causing delayed extubation were status esophagus. epilepticus, edema, and tracheal stenosis. Conclusion : Spontaneous closure of TEF is seldom possible and the surgical treatment of choice is tracheal resection and end to end anastomosis with primary repair of the esophagus. preoperative pulmonary rehabilitation and early extubation postoperatively are important factors for success.

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Applying Extended Theory of Planned Behavior for Lung Cancer Patients Undergone Pulmonary Resection: Effects on Self-Efficacy for Exercise, Physical Activities, Physical Function, and Quality of Life (폐절제술을 받은 폐암환자에 대한 확장된 계획행동이론의 적용: 운동 자기효능감, 신체활동, 신체기능 및 삶의 질에 미치는 효과)

  • Lim, Yeonjung;Lee, Haejung;Kim, Do Hyung;Kim, Yeong Dae
    • Journal of Korean Academy of Nursing
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    • v.50 no.1
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    • pp.66-80
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    • 2020
  • Purpose: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. Methods: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ2 test, Fisher's exact test, Mann-Whitney U test, t-test, and generalized estimation equations (GEE). Results: There were significant differences between the two groups regarding SEE (χ2=13.53, p=.009), PA (χ2=9.51, p=.049), functional status (χ2=10.55, p=.032), and 6MWD (χ2=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=-2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. Conclusion: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

Carinal Resection and Reconstruction for Carinal Tumor (기관분기부 종양에 대한 기관분기부절제와 재건)

  • Cho, Sung-Kyu;Lee, Ja-Young;Lee, Sang-Cheol;Kim, Hyeong-Ryul;Jheon, Sang-Hoon;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.399-403
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    • 2008
  • Carinal resection is technically demanding and the surgical risk is relatively high. When tumor is confined around the carina, then lung parenchymal sparing surgery is technically feasible in selected cases. We performed carinal resection and reconstruction without pulmonary resection for a patient suffering with squamous cell carcinoma that involved the carina and this patient had undergone right upper lobectomy 19 months previously due to lung cancer.

Effects of a Progressive Walking Program on Physical Activity, Exercise Tolerance, Recovery, and Post-Operative Complications in Patients with a Lung Resection (점진적 걷기프로그램이 폐절제술 환자의 신체활동량, 운동능력, 회복력 및 합병증 발생에 미치는 효과)

  • Kim, Inah;Lee, Haejung
    • Journal of Korean Academy of Nursing
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    • v.44 no.4
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    • pp.381-390
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of a Progressive Walking program (PW) on physical activity, exercise tolerance, recovery, and post-operative complications for patients with a lung resection. Methods: A nonequivalent control group non-synchronized design was utilized and 37 participants with a lung resection (22 for control group, 15 for experimental group) were recruited at A university hospital from December 2012 to August 2013. The PW consisted of preoperative education, goal setting, and feedback, provided to the experimental group, and usual care to the control group. Data were analyzed using the SPSS WIN 18.0. Results: A higher proportion of patients in the experimental group showed adequate levels of physical activity (p=.001), shorter period of chest tube retention (${\leq}7$ days; p=.011), and shorter stay in the hospital (${\leq}10$ days; p=.036) than patients in the control group. Patients in the experimental group reported longer 6-minute walking distance (p=.032) and lower levels of dyspnea (p=.049) than patients in the control group. The PW did not influence the occurrence of pulmonary complications. Conclusion: The findings of this study suggest that the PW could be a useful strategy for improving patients' post-operative health and reducing cost after lung resection.

Clinical Study of the Relation between Bronchial Submucosal Granuloma and Post-resectional Bronchopleural Fistula (기관절단면의 결핵성 육아종의 존재여부에 따른 기관지늑막루 발생한 관한 연구)

  • 서정욱;정일영
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.524-529
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    • 1996
  • 200 cases of pulmonary tuberculosis patients treated by surgical resection were anlized Bronchial resection margin was examined by microscopic study to detect submucosal tuberculosis granuloma. 6 cases of bronchopleural fistula that occurred after resection were also asnalized to fond any relation with submucosal granuloma. Among 200 cases, 19 cases (9.5%) showed submucosal granu- loma. Of the 19 cases, 2 cases (10.5%) developed ea ly and late bronchopleural fistula On the con- trary, only 2.2% developed in granuloma negative cases. Granuloma positive cases were mote fre- quently seen in preoperative sputum positive cases and showed incidence of residual pleural dead space resection.

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Surgical Treatment of Pulmonary Tuberculosis (폐결핵의 절제술에 대한 임상적 고찰)

  • Kim, Ae-Jung;Gu, Ja-Hong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.397-402
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    • 1996
  • A clinical study of 36 cases of pulmonary tuberculosis that had had a surgical resection during the period of 13 years from January 1979 to December 1992 was performed in the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital The ratio between male and female was 3.5 1 and the age of peak incidence was in the 2nd and 3rd decades. The common prodromal symptoms were chest pain (38.9 %) and hemoptysis or blood tinged sputum (36.1 %). Preoperative diagnostic examination of sputum positivity for AFB stain despite antituberculosis chemotherapy was noticed in 22.8 oyo . Surgical indications were destroyed lobe or segment with or without cavity (58.3 oyo), mass unable to differentiate from lung cancer (16.7 %), total destroyed lung (13.9 %), bronchostenosis with atelectasis and distal bronchiectasis (11.1 %). Types of resection were pneumonectomy in 16.7%, lobec omy and segmentectomy 2.7%, lobectomy 50 %, segmentectomy 27.8%, and wedge resection 2.7%. Postoperatively, pulmonary function Improved compared to the preoperative examination, although these changes were not statistically significant. One patient died of ulcerative colitis due to drug hypersensitivity, and the postoperative complications were remnant dead space in 11.1 %, spreading of tuberculosis in 5.5%, and empyema with BPF in 5.5%.

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Bronchoplastic Procedures in Patients with Benign Bronchial Stenosis ann'Obstruction -Review of 13 cases- (양성 기관지 협착 및 폐쇄환자에서의 기관지 성형술 -13례 보고-)

  • 조건현;조민섭
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1366-1372
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    • 1996
  • Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

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