• 제목/요약/키워드: Segmentectomy

검색결과 89건 처리시간 0.033초

폐에 발생한 다발성 경화성 혈관종 수술 치험 1 례 (Multiple Sclerosing Hemangiomas of the Lung - A Case Report -)

  • 전순호;정태열;전양빈;정원상;김영학;강정호;지행옥;홍은경;전석철
    • Journal of Chest Surgery
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    • 제32권4호
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    • pp.408-412
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    • 1999
  • 1956년 Liebow and Hubbell 의해 폐에 생긴 경화성 혈관종이 처음 보고된 이후 단독결절에 대해서는 여러 차례 발표된 예가 있었으나 다발성으로 경 \ulcorner\ulcorner혈관종이 생긴 예는 극히 드물다. 이 종양의 조직생성 원인은 아직 논란의 여지가 있으며 그 기원에 대한 여러가설이 있는 것으로 알려져 있다. 환자는 57세 여자 주부였으며 3개의 다른 결절이 발견되였고 하나는 우중엽에 또 다른 하나는 좌상엽의 폐첨후 분절에 나머지는 좌하엽의 상분엽에 위치하였다. 환자의 유일한 증상은 마른기침 이였다. 수술은 좌상엽의 폐첨후 분절 절제술 및 좌하엽의 상분절 쐐기 절제술의 방법으로 시행하였다. 수술후 경과는 큰 문제가 없었으며 환자는 술후 15일에 퇴원하였다.

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재발성 기흉의 유인 (A Study of Cause of Recurrent Pneumothorax)

  • 최용대;김민호;김공수
    • Journal of Chest Surgery
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    • 제25권11호
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    • pp.1286-1291
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    • 1992
  • We have experienced 456 cases of spontaneous pneumothorax from January, 1981 to December, 1991 at the department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 102 cases were recurrent pneumothorax. These 102 cases were based on the retrospective clinical analysis, and the results were as follows: The ratio of male to female was 6.2: 1 in male predominance and the old aged patients, over 50 years old, occupied 46.8%a of all patients. Primary spontaneous pneumothorax was 43 cases[42.6%] and secondary spontaneous pneumothorax was 59 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis: 31 cases[30.4%], emphysema and chronic obstructive pulmonary disease: 27 cases[26.1%], Most frequent operative and pathologic findings in the primary and the secondary spontaneous pneumothorax was bullae and blebs at apex. The employed managements were only closed thoracostomy in 41 cases, open thoracot-omy in 61 cases. The operative procedures at thoracotomy were bullectomy or bullae ligation in 37 cases, bullae resection with wedge resection in 8 cases, bullae resection with segmentectomy in 6 cases, bullae resection with decortication in 3 cases, lobectomy in 5 cases, decortication in 2 cases. Complications were subcutaneous emphysema[5 cases], wound infection[1 case], and temporary pulmonary insufficiency[1 cases]

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An Imported Case of Cystic Echinococcosis in the Liver

  • Ahn, Keun Soo;Hong, Sung-Tae;Kang, Yu Na;Kwon, Jung Hyeok;Kim, Mi Jeong;Park, Tae Jun;Kim, Yong Hoon;Lim, Tae Jin;Kang, Koo Jeong
    • Parasites, Hosts and Diseases
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    • 제50권4호
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    • pp.357-360
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    • 2012
  • A 25-year-old Uzbek male presented with right upper abdominal pain for 20 days. On radiologic studies, a huge cystic mass was noticed in the right liver which was suspected as parasitic. The patient received right hepatic segmentectomy (segment 7), and the surgically resected mass was confirmed as cystic echinococcosis (CE), measuring 10.5 cm in its diameter. The inner surface of the cyst was bile-stained. The patient was discharged on the 8th hospital day, and was rechecked 6 months after the surgical intervention without any evidence of recurrence. The present report describes findings of an imported case of CE which represented ultrasound images of the 'ball of wool'.

임신성 융모상피암의 전이성 폐암에 대한 외과적 고찰 (Surgical Management of Metastatic Lung Cancer from Gestational Chorocarcinoma)

  • 정진용
    • Journal of Chest Surgery
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    • 제24권10호
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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.

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흉부 수술에 있어 수직액와 근육보존 개흉술의 적용 (Vertical Axillary Muscle Sparing Thoracotomy in Thoracic Surgery)

  • 원태희;성숙환
    • Journal of Chest Surgery
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    • 제28권1호
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    • pp.42-46
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    • 1995
  • Vertical axillary muscle sparing thoracotomy is newly appeared and excellent alternative method of standard posterolateral thoracotomy.It has many advantages compared to standard posterolateral thoracotomy , less postoperative pain, well preserved thoracic muscle strength, full range of motion of the shoulder girdle and attractive cosmetic results. We performed vertical axillary muscle sparing thoracotomy in 36 patients from November 1993 to July 1994. The ages of the patients ranged from 6 months to 71 years[mean 45.1 years , and the patients consisted of 20 males and 16 females.The preoperative diagnosis were as follows : lung cancer in 17 patients, tbc destroyed lung in 7, bronchiectasis in 3, bullous emphysema in 3 and the others are mediastinal tumor, bronchogenic cyst, lung abscess, empyema, esophageal diverticulum, and CCAM [congenital cystic adenomatoid malformation . The operative procedures were as follows : lobectomy and bilobectomy in 16 patients, segmentectomy in 4, wedge resection in 3, penumonectomy in 7, and the others were open biopsy, lobectomy with diaphragm excision, sleeve right upper lobectomy, decortication, mediastinal mass excision, and esophageal diverticulectomy. We had 6 complications : postoperative bleeding in 2 cases, operative wound infection, arrrhythmia[atrial fibrillation , Horner`s syndrome, hoarseness. The subcutaneous seroma occurred in 4 cases but did not require drainage and relieved within 4 weeks spontaneously. We concluded that vertical axillary muscle sparing thoracotomy could be done in most of all thoracic surgery with safety. Comparing to standard posterolateral thoracotomy vertical axillary muscle sparing thoracotomy has many advantages such as less postoperative pain, well preserved muscle strengths and good cosmetic results.

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Surgical Extent for Ground Glass Nodules

  • Cho, Suk Ki
    • Journal of Chest Surgery
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    • 제54권5호
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    • pp.338-341
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    • 2021
  • As diagnoses of small ground glass nodule (GGN)-type lung adenocarcinoma are increasing due to the increasing frequency of computed tomography (CT) screening, surgical treatment for GGN-type lung adenocarcinoma has rapidly become more common. However, the appropriate surgical extent for these lesions remains unclear; therefore, several retrospective studies have been published and prospectively randomized controlled trials are being undertaken. This article takes a closer look at each clinical study. Convincing evidence must be published on 2 issues for sublobar resection to be accepted as a standard surgical option for GGN lung adenocarcinoma. In the absence of such evidence, it is better to perform lobar resection as long as the patient has sufficient lung function. The first issue is the definition of a sufficient resection margin, and the second is whether lymph node metastasis is conclusively ruled out before surgery. An additional issue is the need for an accurate calculation of the total size and solid size on CT. Given the results of clinical studies so far, wedge resection or segmentectomy shows a good prognosis for GGNs with a total size of 2 cm or less. Therefore, sublobar resection will play a key role even in patients who can tolerate lobectomy.

Current Status of Lung Cancer and Surgery Based on Studies Using a Nationwide Database

  • Kim, Dohun;Lee, Jung-Won
    • Journal of Chest Surgery
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    • 제55권1호
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    • pp.1-9
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    • 2022
  • Lung cancer is a fatal disease, highlighting the importance of research on related topics, including surgery for lung cancer. However, systematic research analyzing surgery on a national scale is limited. This study aimed to investigate the research on lung cancer using nationwide data in South Korea and to analyze trends in lung cancer surgery, including its clinical implications. Published articles and data from the Korean National Health Insurance database were used. Although the incidence and mortality of lung cancer have been improving, it is predicted to be the most common and fatal type of cancer in South Korea in 2021. The number of surgical procedures for lung cancer is increasing, especially among women, those ≥76 years of age, residents of non-metropolitan cities, and middle-income patients. Lobectomy and sublobectomy, including segmentectomy, are increasingly common. However, the proportion of pneumonectomy relative to other procedures is not increasing. Surgery has shown a reasonable survival rate, especially after lobectomy, but survival remains poor in patients ≥76 years of age who undergo pneumonectomy. The frequency of lung cancer surgery is increasing concomitantly with various socioeconomic changes. Lobectomy has become increasingly common, and the clinical results of surgery are satisfactory. Further research on the changing composition of surgical candidates is required.

소음인 곽향정기산으로 오치(誤治)한 소음인 망양증 환자 치험 1례 (Case Report of a Soeumin Patient with Yang Collapse Syndrome Mistreated with Soeumin Gwakhyangjunggi-san)

  • 이지은;김민우;천세은;신용진;신선호
    • 대한한방내과학회지
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    • 제42권2호
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    • pp.95-103
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    • 2021
  • We report on a Soeumin patient with spontaneous sweating after a lung segmentectomy resulting from aspergillosis. During her inpatient stay, the patient received Soeumin Gwakhyangjunggi-san, Hwanggigyeji-tang, and Seungyangikgi-tang for herbal medication. She also received acupuncture, moxibustion, pharmacopuncture, and cupping therapy. A numeric rating scale (NRS) was used to assess the improvement of symptoms. Sweating was reduced, as reflected by an NRS change from 7 to 0, when the herbal medication changed from Soeumin Gwakhyangjunggi-san to Hwanggigyeji-tang. General weakness and chest discomfort were also relieved after using Hwanggigyeji-tang and Seungyangikgi-tang. These results suggest that Hwanggigyeji-tang and Seungyangikgi-tang are clinically effective for Soeumin patients who are appropriately diagnosed with yang collapse syndrome in the postoperative setting.

십이지장루를 동반한 횡행결장암 1예 (Transverse Colon Cancer with Duodenal Fistula)

  • 임성경;박선자;박무인;문원;김성은;백승언
    • Journal of Digestive Cancer Research
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    • 제2권2호
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    • pp.68-71
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    • 2014
  • 한 달 동안의 점점 커지는 복부의 종괴를 주소로 방문한 57세 남자 환자에서 대장-십이지장루를 동반한 대장암을 진단하였으며, 이에 대해 수술 전 동시 항암방사선 치료를 시행하여 수술 범위를 줄일 수 있었던 좋은 예였다. 국소적으로 진행된 대장암 환자에서 본 증례와 같은 합병증으로 수술의 범위가 커질 가능성이 있다면, 보존적 치료 및 수술 전 동시 항암방사선 치료를 시행하여 수술 범위를 좁히는 것이 환자의 치료 경과에 도움이 될 것으로 생각된다.

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Congenital Cystic Adenomatoid Malformation with Bronchial Atresia in Elderly Patients

  • Kwak, Hyun-Jung;Moon, Ji-Yong;Kim, Sa-Il;Kim, Tae-Hyung;Sohn, Jang-Won;Kim, Sang-Heon;Shin, Dong-Ho;Park, Sung-Soo;Chung, Won-Sang;Yoon, Ho-Joo
    • Tuberculosis and Respiratory Diseases
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    • 제72권6호
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    • pp.501-506
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    • 2012
  • Congenital cystic adenomatoid malformation (CCAM) is an uncommon, nonhereditary anomaly caused by arrest of lung. Patients with CCAM may present with respiratory distress as newborns, or may remain asymptomatic until later in life. CCAM type I is rarely found in association with bronchial atresia (BA) in adults; we present such a case. Case: A 54-year-old female presented with chronic cough and blood-tinged sputum. Physical examination and laboratory tests were unremarkable. Chest radiographs and a CT scan of the chest showed multiple large air-filled cysts consistent with a CCAM in the right lower lobe, and an oval-shaped opacity in the distal right middle lobal bronchus. Based on the radiologic findings, right middle lobectomy and a medial basal segmentectomy of the right lower lobe were performed via a thoracotomy. These lesions were consistent with Stocker's Type I CCAM and BA in the different lobes.