• Title/Summary/Keyword: Upper thoracic

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Right Lower Sleeve Bilobectomy for Lung Cancer with Posteparterial Tracheal Bronchus

  • Kim, Hongsun;Kim, Jinsik;Cho, Jong Ho;Shin, Su Min;Kim, Hong Kwan;Kim, Jhingook
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.300-304
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    • 2017
  • A 42-year-old man was diagnosed with cancer of the right lower lung lobe with a posteparterial type of tracheal bronchus, in which the posterior segmental bronchus of the right upper lobe arose from the distal bronchus intermedius. A mass involved the distal bronchus intermedius, requiring a right lower bilobectomy with an additional posterior segmental resection of the right upper lung lobe. Thus, we performed a right lower bilobectomy and sleeve anastomosis of the posterior segmental bronchus of the right upper lobe to the proximal bronchus intermedius, sparing the pulmonary parenchyma of the same lobe.

Surgical Treatment of Pulmonary Aspergillosis -One Case Report- (폐면균증(肺麵菌症)의 외과적(外科的) 치료(治療) -일례(一例) 보고(報告)-)

  • Kim, Hark Jei;Lee, Nam Soo;Song, Yo Jun;Kim, Hyong Mook
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.139-142
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    • 1976
  • A 33 year old male patient was admitted with 20 years history of recurrent hemoptysis. On clinical examination, mild left chest discomfortness and foul odored sputum with occasional rusty hemoptysis were principal complaints noted. Chest X-ray film revealed moderately advanced active tuberculosis lesion on both upper lung fields, and hen-egg sized mass surrounded with linear crescent of air shadow in a cavity on his left upper lung field. On left thoracotomy, dense pleural adhesions on left apicoposterior segmental surface with multiple lymphnode enlargements were noted, and the soft encapsulated mass of $5{\times}5{\times}8cm$ was localized in the apicoposterior segment of the left upper lobe. Apicoposterior segment with anterior segment of the left upper lobe was resected. Cavity was opened to find a rusty grayish colored, fragile mass, which was confirmed as "fungus ball" of aspergillosis by histological section slide with Gomori staining. The authors report one case of pulmonary aspergilloma superinfected with previous long standing pulmonary tbc.

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Esophageal Leiomyoma in the Upper Thoracic Esophagus (상부 식도에 발생한 식도 평활근종 -2례 보고-)

  • 최영호
    • Journal of Chest Surgery
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    • v.28 no.11
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    • pp.1063-1066
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    • 1995
  • Though leiomyoma is the most common benign esophageal tumor, it is rare in the upper third of esophagus. Recently, we experienced two cases of esophageal leiomyoma in the upper third of esophagus. The patient were a 53 year old female and a 40 year old male. On esophagoscopy, masses were found at 20\ulcorner23 cm, 22\ulcorner26 cm from upper incisor with normal overlying mucosa. Enucleation was done through a right posterolateral thoracotomy without complications.

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The Role of Surgery for the Treatment of Upper Esophageal Cancer (상부 식도암에서 수술적 치료의 유용성)

  • Park, Jae-Kil;Sa, Young-Jo;Nam, Sang-Yong;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.685-690
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    • 2007
  • Background: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaker to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. Material and Method: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 424 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. Result: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of post-operative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. Conclusion: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.

The Clinical Experiences and Complications of Percutaneous Neurolysis of Upper Thoracic Sympathetic Ganglion by Using Ethylalcohol -A report of three cases- (알코올을 이용한 흉부교감신경절차단술에 대한 임상경험 및 합병증 -증례 보고-)

  • Kwon, Ok-Hee;Kim, Jong-Il;Ban, Jong-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.8 no.2
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    • pp.374-377
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    • 1995
  • Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed by simultaneously injecting 3 ml of pure alcohol into the $T_2$ and $T_3$ levels after testng with same amount of local anesthetics on the same sites. We experienced poor sympatholytic effect or intercostal neuritis and Horner's Syndrome as the result of complication of thoracic sympathetic ganglion block. In Case 1, in spite of the good testing result, neurolytic block effect was poor. In Case 2, intercostal neuritis occurred, but neuralgia subsided within 3 weeks. In Case 3, Horner's Syndrome occurred for 1 day. To increase the success rate of block and decrease the incidence of complications, good radio-opaque dye appearance and good test block effect should be obtained.

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Bleomycin Used for Esophageal and Lung Carcinoma: Clinical Two Cases Report (악성 종양에 대한 Bleomycin 사용 경험례: 식도 및 폐암의 2예)

  • Lee, Yang-Sam;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.3 no.2
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    • pp.143-148
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    • 1970
  • Bleomycin is known as a antibiotic agent for malignant tumors especially sguamous cell carcinoma. We have treated 2 cases of malignant tumors, each one esophageal and lung carcinoma with bleomycin, 630 mg and 510 mg respectively. In case of esophageal carcinoma. the subjective symptoms such as dysphagea and swallowing disturbance are temporally relieved, but the irregular filling defect is not significantly changed in esophagogram. In case of lung carcinoma, the atelectasis of right upper lobe on chest X-ray was slightly regressed in its size without effective improvement of subjective symptoms. However, following additional radioactive $^60{Co}$ irradiation therapy (5200r), marked regression of tumor density and aeration of right upper lobe was observed. But 2 weeks later of ceasatioil of irradiatio:J, atelectasis of right upper lobe was again developed. Fever, anorexia, headache and eruption were developed during the treatmeat with bleomycin in both cases but the sign or symptoms of hone marrow depression, renal or liver damage were not noted.

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Giant Cell Tumor of Upper Thoracic Spine

  • Lee, Chul Gab;Kim, Sung Hoon;Kim, Dong Min;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.167-169
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    • 2014
  • Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature.

Vertebroplasty for the Treatment of Compression Fractures in the Upper and Middle Thoracic Spine

  • Kim, Seok Won;Lee, Seung Myung;Shin, Ho;Lim, Kyung Joon
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.142-145
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    • 2005
  • Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

Aneurysm of the Descending Thoracic Aorta -Report of a Case- (하행흉부대동맥류(下行胸部大動脈瘤) 치험(治驗) 1례(例))

  • Lee, Dong June;Kim, Sang Hyung
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.44-49
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    • 1976
  • Aneurysm of the Aorta is a grave disease mostly producing disabling symptoms and ultimate death by rupture and hemorrhage without surgical intervention. The author recently experienced one case of surgical correction of descending thoracic aortic aneurysm treated with excision of the aneurysm and replacement of Dacron artificial vessel under temporary external by pass technique in November, 10th, 1975. 9mm internal diameter arterial cannula was inserted into upper and below the aneurysm. Bypass time was about 1 hour. The case was 35 years old women who had small egg sized saccular aneurysm in the upper third of the descending thoracic aorta involving the 1t. subclavian artery. Histopathological diagnosis was arteriosclerotic. Immediate postoperative course had been uneventful except low pressure and pulse of the left arm. The follow-up was possible up to date about 3 months. The patient has been doing well with ordinary activities except mild left chest discomfort.

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Clinical Evaluation of Esophageal Cancer (식도암의 임상적 고찰)

  • Hyeon, Myeong-Seop;Im, Seung-Gyun;Jeong, Gwang-Jin
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.280-286
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    • 1995
  • In our hospital we have seen 38 cases of esophageal cancer from June 1984 until June 1994. They composed of 34[89% men and 4[11% women, their age distributed from 35 to 74, mean age was 57.55 7.43. Their symptoms were varied, dysphagia[97% , pyrosis[58% , chest pain[31% , weight loss[31% , anemia[8% , vomiting[5% , and hoarseness[1% . Surgical treatment was done with esophagectomy and upper GI reconstruction 35 cases, and palliative gastrostomy was 3 cases. There was no operative mortality, and operative morbidity was 8 cases of anastomotic leakage, 5 cases of wound infection, 5 cases of pleural effusion, hoarseness, pneumothorax, and lung abscess. Pathologic lesion distribution: upper thoracic esophagus 6 cases[16% , middle thoracic esophagus 17 cases[45% , and lower thoracic esophagus 15 cases[39% . There was no statistical difference of transhiatal esophagectomy and transthoracic esophagectomy in complications and hospitalization period in this study but we proved the superiority of gastric upper GI reconstruction rather than colon upper GI reconstruction in anastomotic leakage and hospitalization period. Cumulative survival rate was 76.2% in 1 year survival, 33.9% in 3 year survival, 25.4% in 5 year survival, 12.7% in 10 year survival. There was no relationship with the time of dysphagia with survival in this study.

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