• Journal of Chest Surgery
• /
• v.27 no.3
• /
• pp.215-220
• /
• 1994

From Jan. 1981 to Dec. 1993, 24 cases of pulmonary hamartoma were experienced sugically at the Department of Thoracic Surgery, College of Medicine, Seoul National University. They consisted of 11 females and 13 males. The age distribution was 24 years to 71 years with a mean age of 49 years. They included 3 cases of endobronchial hamartoma, and 21 cases of pulmonary parenchymal hamartoma. Fifty eight percent of patients [14/24] were asymptomatic. One patient had a multiple pulmonary parenchymal hamartoma, and 1 patient also had combined lung cancer. The operative procedures were 9[37.5%] wedge resections, 5[20.8%] lobectomies, 3[12.5%] enucleations, 3[12.5%] segmental resections, 2[8.3%] bilobectomies, 1[4.2%] lobectomy and segmentectomy, and 1[4.2%] lobectomy, wedge resection, and enucleation. All of the operative results were excellent and without complication.

• Journal of Chest Surgery
• /
• v.26 no.10
• /
• pp.775-780
• /
• 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.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.793-796
• /
• 1988

Pulmonary sequestration is an unusual congenital malformation characterized by the presence of nonfunctioning lung tissue which usually has no communication with the normal bronchial tree and receives its blood supply from an anomalous systemic artery. We present a case of extralobar pulmonary sequestration experienced recently. The patient was 13 month old female with a complaint of fever, coughing and tachypnea. Chest film showed large homogeneous opacity in left lower lung field. At operation, a homogeneous mass was located between the left upper lobe and lower lobe, measuring 4X6X5cm in dimension. The aberrant artery was originated from the descending thoracic aorta, 1 cm in length and 3 mm in diameter. After division and ligation of the aberrant artery, sequestrectomy and lingular segmentectomy was done due to abscess formation. The postoperative course was smooth. She was discharged on postoperative thirteenth day.

• Journal of Chest Surgery
• /
• v.29 no.4
• /
• pp.397-402
• /
• 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%.

• Journal of Chest Surgery
• /
• v.35 no.4
• /
• pp.315-317
• /
• 2002

Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.1007-1013
• /
• 1995

We managed 80 patients of bronchiectasis from Jan.1983 to Dec.1992 admitted to the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. We evaluated clinically these patients and summarized as follows. Alpha-hemolytic streptococcus was the most commonly found bacterial strain in microbial study. For the conservative treatment, first generation cefalosporins, aminoglycosides and ampicillin were used as antibiotic therapy in this order of frequency. The preoperative final diagnosis was made by bronchography and HRCT. In the image study saccular type bronchiectasis was 47.1%, cylindrical 27.5%, mixed 17.6% and varicose 7.8%. Anatomically left side involvement was more frequent than the right as 61.2% to 38.8% and the most commonly invading lobar area was left lower. Reversibility after conservative treatment for all the types of bronchiectasis was 66%. Surgical treatment were done in 50 cases, among these left lower lobectomy was 38.0%, left lower lobectomy with ligular segmentectomy 22.0%, right middle and lower bilobectomy 16.0%, right lower lobectomy 10.0%, left pneumonectomy 10.0%, right pneumonectomy 4.0%. In 10 cases, there remained some lesion in the other sites of lung parenchyme after first attempt surgical resection because the distribution of lesion is too broad to resect out in single thoracotomy hoping improvement by medical management.

• Journal of Chest Surgery
• /
• v.25 no.9
• /
• pp.955-961
• /
• 1992

In this study, 237 cases of spontaneous pneumothorax experienced at the department of Thoracic and Cardiovascular Surgery, Kosin Medical College during from January 1986 to December 1990 were analysed retrospectively. 1. The ratio of male to female was 4.6: 1, predominent in male. The incidence of age group was highest as 36% between 21 and 40 years old. 2. The associated diseases of pneumothorax were 27 cases, in which pyothorax were 8 cases, and hydrothorax were 19 cases. 3. The site of pneumothorax was as follows: right side was 53%, left side was 45%, and both side was 2%, so right side was slight high. 4. The empolyed managements were as follows: bed rest with oxygen inhalation in 13 cases, closed thoracostomy in 155 cases, open thoracotomy in 69 cases. 5. The operative procedures of thoracotomy were as follows; simple pleurodesis in 2 cases, blebectomy & bullectomy in 38 cases, parietal pleurecttnny in 4 cases, segmentectomy in 12 cases, lobectomy in 9 cases. 6. The indication of open thoracotomy were as follows, recurrent history in 35 cases, contralateral pneumothorax history in 2 cases, continuous air leakage in 24 cases, bilateral pneumothorax in 2 cases, and visible blebs & bullaes on the chest X-ray in 6 cases. 7. The hospital duration after management was as follow, open thoracotomy in 13.2 days, closed thoracostomy in 22.4 days. The recurrent pneumothorax after closed thoracostomy was 25 cases, about 15%.

• Journal of Chest Surgery
• /
• v.24 no.8
• /
• pp.782-791
• /
• 1991

In Pusan Paik Hospital, Inje University, we experienced 174 cases of pulmonary resections for pulmonary tuberculosis from Jun. 1979 to Feb. 1990. In all of them automatic stapling devices were used for division of lung parenchyme and /or bronchial closure. The results were as follows; l. In 174 cases[male 100, female 74], third and fourth decades were 116 cases [66.7%]. 2. Indications for lung resection in the radiographic findings were destroyed lung 47 cases[27.0%], destroyed lobe 42 cases[24.1%], cavitary lesions 42 cases[24.1%], tuberculoma 22 cases[12.7%], and bronchial lesions 21 cases[12.1%]. 3. The mean of staplers used in the operations was 1.6, and possible stapler-associated complications were only 2 cases of bronchopleural fistula after pneumonectomy. 4. Twenty-seven of 36 patients with bilateral lesions and 52 of unilateral ones on chest X-ray films were AFB positive on preoperative sputum smears. Twenty-three[85.2%] of bilateral lesions and 51[98.1%] of unilateral ones were AFB negative at 6 months after operations. 5. Main complications of resections were operative death 1[0.6%], empyema 4[2.3%], respiratory insufficiency 3[1.7%], pleural dead space 5[2.9%], and bronchial spreading of tuberculosis 2[1.1%]. Bronchopleural fistula were only 2 cases after pneumonectomy and none after lobectomy or segmentectomy. 6. One hundred and forty two patients[92.8%] of 153 with available follow-up data were in the state of good quality of life.

• Journal of Gastric Cancer
• /
• v.11 no.1
• /
• pp.64-68
• /
• 2011

A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.

• Journal of Chest Surgery
• /
• v.23 no.4
• /
• pp.750-757
• /
• 1990

Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.