• Journal of Chest Surgery
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• v.54 no.4
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• pp.263-265
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• 2021

Intraoperative events can occur during video-assisted thoracoscopic surgery (VATS) lobectomy due to unfavorable surgical anatomy, such as dense adhesions or calcifications around the pulmonary arteries. Troubleshooting intraoperative complications is essential for performing safe and successful VATS pulmonary resection and lymph node dissection. If continuous bleeding occurs or VATS does not proceed despite all measures, conversion to open thoracotomy should not be delayed.

• Journal of Chest Surgery
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• v.33 no.2
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• pp.195-198
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• 2000

Primary sarcomas of the pulmonary arteries are and the clinical presentation closely resembles several more common conditions, Therefore they are seldomly diagnosed preoperatively without a pathologic esxamination of sufficient surgical specimen. Treatment of these tumors remains primarily surgical as possible and the role of the adjuvant chemotherapy and radiotherapy is not yet evident We report a case of primary sarcoma of pulmonary artery clinically suspected of carcinoid partially involving the pulmonary parechyme and the bronchus mainly in the left main pulmonary artery and the vein with left intrapericardial pneumonectomy.

• Journal of Chest Surgery
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• v.24 no.10
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• pp.1005-1011
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• 1991

Eighty-four patients with pulmonary metastases from gestational choriocarcinoma were treated at the Catholic Medical Center between August, 1985 and August, 1991. Among these 13 patients underwent thoracotomy with resection of pulmonary lesions and the results obtained were follows. 1] The ages of the patients ranged from 26 to 47 years, with a mean age of 31 years. 2] The frequency of chemotherapy before operation ranged from zero to 46, with a mean frequency of 13.6. 3] Four patients were operated upon for a solitary metastasis of the lung; 6 patients, for unilateral multiple metastases and 3 patients, for bilateral pulmonary metastases. 4] Eight patients underwent wedge resection; 1 patient, segmentectomy; 2 patients, lobectomy; 3 patients, open lung biopsy. The lung lesions of eleven patients showed hemorrhagic necrosis[among these, 2 patients combined with pulmonary tuberculosis]; one was non-necrotic choriocarcinoma; another one was metastatic lung carcinoma from endocrine cancer of unknown origin. 5] Among twelve patients who had managed with chemotherapy before thoracotomy three patients were in remission; among 13 patients who had undergone thoracotomy 6 patients were in remission. 6] The median survival time of these patients was 25.8 months with 3 postoperative deaths. Subsequently, in the patients with pulmonary metastases from choriocarcinoma, if the primary tumor is under control, there are no other metastases, and the patients should be able to tolerate the planned operation, it is necessary to undergo aggressive thoracotomy for diagnostic purposes; for therapeutic purposes only when the pulmonary lesion is the only remaining source of increased hCG excretion; for reduction of tumor volume to shorten hospitalization or to reduce the quantity of drugs.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.154-161
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• 2010

Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.171-174
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• 1973

A case of pulmonary aspergillosis, strongly suspected before operation and confirmed after surgical intervention, was reviewed with related literatures. It has become to be a well recognized fact that pulmonary mycosis generally results from sapro-phytic colonization of previous lung cavities usually due to pulmonary tbc, lung abscess, cyst of bronchiectasis. Recently, the author experienced one case of pulmonary aspergillosis which had been diagnosed and treated as tuberculosis for 6 years. Sputum culture, immunologic study and X-ray findings constitute essential part of diagnosis. Surgical resection is the treatment of choice combined with systemic administration of anti-fungal agents to eradicate the disease completely.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.315-320
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• 1992

Pulmonary arteriovenous fistula is a rare congenital vascular malformation resulting from abnormal capillary development with incomplete formation of vascular septum normally dividing the primitive connections between the venous and arterial plexuses. Recently we have experienced a case of the bilateral pulmonary arteriovenous fistula in 7 years-old female patient. On admission, clinical manifestations were cyanosis of lips, clubbing and cyanosis of digits, and exertional dyspnea. The PO2 in arterial blood gas analysis was 43.3mmHg. In left upper and right lower lobe pulmonary arteriovenous fistulas were confirmed by bilateral pulmonary angiography. Left upper lobectomy and wedge resection of right lower lobe were performed respectively. Postoperative results were good.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1070-1075
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• 1992

Bilateral intralobar and extralobar pulmonary sequestration is an extremely rare anomaly. At present, four pathologically proven cases and two possible cases have been reported in the literature insofar as we know. We have found no previous reports in the literature in which simultaneous bilateral intralobar and extralobar pulmonary sequestration were present. We report a first case presenting as bilateral intralobar and extralobar pulmonary sequestration, recently performed staged bilateral resection, and emphasize the importance of computed tomography and angiography in diagnosis and operation.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.998-1002
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• 1990

We managed a 30 years old female pulmonary aspergillosis patient concomitant with staged pneumothorax bilaterally whose lung function decreased severely. Operative indication was fetal hemoptysis. She discharged at four weeks after left upper lobectomy in good general condition. And we .concluded that early resection should be considered in patients with pulmonary aspergilloma and coexistent pulmonary tuberculosis because those are at greater risk of fetal hemorrhage, particularly once severe hemoptysis has occurred although poor lung function in our country.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.484-489
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• 2006

A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6061-6064
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• 2013

Objective: To explore the feasibility of pulmonary lobectomy combined with pulmonary arterioplasty by complete video-assisted thoracic surgery (VATS) in patients with lung cancer, and summarize its surgical methods. Materials and Methods: Twenty-one patients with lung cancer in Beijing Chest Hospital Affiliated to Capital Medical University from Feb., 2010 to Jun., 2013 were selected, males and females accounting for 15 and 6 cases, respectively. Ten underwent right upper lobectomy, 5 right lower lobectomy, 4 left upper lobectomy (in which left upper sleeve lobectomy was conducted for 2) and 2 left lower lobectomy. At the same time, local resection of pulmonary arterioplasty was performed for 12 patients, and sleeve resection of pulmonary arterioplasty for 9. Results: Twenty-one patients recovered well after surgery. Thoracic drainage tube was maintained for 3-8 days, with an average of 4.9 days, and hospital stays were 8-15 days, with an average of 11 days. There were no deaths in the perioperative period, and the complications like pulmonary embolism, bronchopleural fistula, chest infection and pulmonary atelectasis did not occur after surgery. Conclusions: Performance of pulmonary lobectomy and pulmonary arterioplasty together by complete VATS is a safe and effective surgical method, which can expand the indications of patients with lung cancer undergoing thoracoscopic pulmonary lobectomy, and make more patients profit from such minimally invasive treatment.