• 제목/요약/키워드: Wedge resection

검색결과 204건 처리시간 0.025초

폐양성 종양 61례의 외과적 고찰 (Clinical Study of 61 cases Benign Lung Tumor)

  • 박종원
    • Journal of Chest Surgery
    • /
    • 제22권2호
    • /
    • pp.272-289
    • /
    • 1989
  • Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

  • PDF

자연기흉의 외과적 치료 (Surgical Treatment of Spontaneous Pneumothorax)

  • 허용;김경훈;김철환;박성동;박해홍;문준호;김병열;이정호
    • Journal of Chest Surgery
    • /
    • 제27권12호
    • /
    • pp.1002-1007
    • /
    • 1994
  • The spontaneous pneumothorax occurs subsequent to a disruption in the continuity of the visceral pleura with escape of free air into the pleural space included primary & secondary pneumothorax that is unrelated to identifiable etiologies such as trauma. In. the 33 year period 1960 to 1993, the 230 cases of open thoracotomy were carried out for definitive treatment of spontaneous pneumothorax, at the Dept. of Thoracic & Cardiovascular Surgery, National Medical Center, Seoul, Korea. There were 193 men & 37 women. They ranged in age from 15 years old to 72 years old. The lesion site was on the right side in 117 and on the left in 97, the 16 cases were in bilateral lesions.Surgical indications included recurrence in 98 cases, persistent air leak in 68 cases, nonexpansion of the lung 37 cases, roentgenologically apparent bullae & blebs in 23 cases, bilateral lesions in 16 cases,combined hemothorax & prevent for recurrence in each 2 cases. The types of operation were bullectomy in 207 cases, wedge resection in 13 cases, decortication & B.P.F. closure in 6 cases,lobectomy in 2 cases, pneumonectomy, plication in each I case. The post operative complication developed in 18 cases[7.8 %], there was I case of death due to sepsis. We believed that open thoracotomy with resection or obliteration of blebs & pleurodes is provided the best protection against recurrence.

  • PDF

횡격막의 원발성 악성 섬유성 조직구종 -1례 보고- (Primary Malignant Fibrous Histiocytoma of the Diaphragm -One Case Report-)

  • 김대현;김범식;조규석;박주철
    • Journal of Chest Surgery
    • /
    • 제36권2호
    • /
    • pp.118-121
    • /
    • 2003
  • 25세 여자 환자가 우측 하흉부 및 좌측 상복부의 불쾌감을 주소로 입원하였다. 흉부 X-선 및 흉부 전산화 단층촬영 소견상 우폐 하엽에 위치하며 횡격막과 접하고있는 4$\times$4$\times$4cm 크기의 둥근 종괴가 관찰되고, 우폐하엽과 우폐 중엽에서 전이성 병변들이 관찰되었나. 시험적 개흉술 결과 우측 횡격막에서 기시한 종괴가 우폐 하엽에 직접 침범되어있었으며. 우폐 하엽과 우폐 중엽의 흉막하에 전이성 병변들이 발견되었다. 종괴에 대한 냉동 절편 조직 검사상 육종으로 진단되어 종괴 기시부의 횡격막 및 종괴에 의해 침범된 부위의 우폐 하엽을 일괄 절제하고 우폐 하엽과 우폐 중엽의 전이성 병변들을 쐐기 절제하였다. 최종 조직 검사상 횡격막의 악성 섬유성 조직구종이었고, 보조적 항암 약물 치료를 추가로 시행하였다. 저자들은 횡경막에서의 발생이 극히 드문 악성 섬유성 조직구종 1례를 문헌고찰과 함께 보고하는 바이다.

Maximum standardized uptake value at pre-treatment PET in estimating lung cancer progression after stereotactic body radiotherapy

  • Park, Jisun;Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
    • /
    • 제37권1호
    • /
    • pp.30-36
    • /
    • 2019
  • Purpose: This study aimed to identify the feasibility of the maximum standardized uptake value (SUVmax) on baseline 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) as a predictive factor for prognosis in early stage primary lung cancer treated with stereotactic body radiotherapy (SBRT). Materials and Methods: Twenty-seven T1-3N0M0 primary lung cancer patients treated with curative SBRT between 2010 and 2018 were retrospectively evaluated. Four patients (14.8%) treated with SBRT to address residual tumor after wedge resection and one patient (3.7%) with local recurrence after resection were included. The SUVmax at baseline PET/CT was assessed to determine its relationship with prognosis after SBRT. Patients were divided into two groups based on maximum SUVmax on pre-treatment FDG PET/CT, estimated by receiver operating characteristic curve. Results: The median follow-up period was 17.7 months (range, 2.3 to 60.0 months). The actuarial 2-year local control, progression-free survival (PFS), and overall survival were 80.4%, 66.0%, and 78.2%, respectively. With regard to failure patterns, 5 patients exhibited local failure (in-field failure, 18.5%), 1 (3.7%) experienced regional nodal relapse, and other 2 (7.4%) developed distant failure. SUVmax was significantly correlated with progression (p = 0.08, optimal cut-off point SUVmax > 5.1). PFS was significantly influenced by pretreatment SUVmax (SUVmax > 5.1 vs. SUVmax ≤ 5.1; p = 0.012) and T stage (T1 vs. T2-3; p = 0.012). Conclusion: SUVmax at pre-treatment FDG PET/CT demonstrated a predictive value for PFS after SBRT for lung cancer.

폐결핵의 절제요법 640례에 대한 수술 및 원격성적 (Resection in Pulmonary Tuberculosis: Results and Follow-up of 640 Cases)

  • 이성구
    • Journal of Chest Surgery
    • /
    • 제5권2호
    • /
    • pp.125-134
    • /
    • 1972
  • Pulmonary resectlon has evolved as the treatment of choice in certain pulmonary tuberculosis cases. This study represents an analysis of 640 cases of pulmonary resections between March, 1953 and August, 1966 and 370 cases of 13 years follow-up results at the 36th Army Hospital. 1] The ages ranged from 20 to 45 years and all cases were males. 2] The extent of disease revealed 116 Far advanced, 472 Moderate advanced and 52 Minimal Cases. 3] The extent of resections were 373 lobectomies, 130 segmental resections, 58 pneumonectomies,25 multlple lobectomies, 25 lobectomies with thoracoplasties, 22 lobectomies with segmental resections, and 7 wedge resections. 4] The postoperative complications occurred in 71 cases[11.09 percent]. Of these complications,bronchopleural fistula occurred in 13 cases [2.03 percent]. 5] The early operative mortality within 24 hours was 2.0 percent and late mortality within 6 months was 1.4 percent, a total mortality from all causes of 3.4 percent: 15.5 percent following pneumonectomy, 2.1 percent following lobectomy, 1.5 percent following segmental resectlon. 6] All 370 patients were followed for periods ranging from 6 months to 5 years and 5 years to 13 years. Of these former group of 241 patients, 73.3 percent of the cases had returned to full active llfe and remained well, while 15.4 percent were still under treatment. Of these latter group of 129 patients, 76.0 percent of the cases were well and 4.7 percent were still under treatment. 7] In the follow-up results according to extent of disease, the cure rate was greatest in cases of minimal group and lowest in cases of far advanced group. 8] In the results by extent of resection, the cure rate was greatest in cases of lobectomy group. 9] Through the all follow-up periods, 11 patents [3.0 percent] were died. Of these, 3 were suicide and 8 were unknown causes.

  • PDF

Surgical Correction of Canine Brachycephalic Syndrome Including Resection of Elongated Soft Palate and Everted Laryngeal Saccules Using Harmonic Scalpel: A Retrospective Study of 21 Cases

  • Shin, Jung-In;Kim, Minkyung;Kim, Jong-Hoon;Lee, Chaeyeong;Kim, Young-Hwan;You, Young-Sung;Lee, Dong-Bin;Lee, Jae-Hoon
    • 한국임상수의학회지
    • /
    • 제39권1호
    • /
    • pp.1-8
    • /
    • 2022
  • The current, retrospective study aimed to assess the short-term prognosis and postoperative complications associated with the surgical correction of elongated soft palate using harmonic scalpel and to compare the postoperative complications associated with the application of harmonic scalpel and traditional surgery using Metzenbaum scissors. Harmonic scalpel was used to perform staphylectomy in 21 dogs. A total of ten dogs underwent sacculectomy; six dogs with harmonic scalpel and four dogs using Metzenbaum scissors. Stenotic nares were corrected by wedge resection. Postoperative complications were recorded through monitoring and radiographic examinations. Telephone interviews were conducted on the first, third, and seventh day after discharge and continued until the resolution of postoperative complications. Postoperative edema at the surgical site was identified and mitigated within a day or two. Snoring and dyspnea improved dramatically in the group that underwent staphylectomy alone. Moreover, three dogs presented with postoperative gastrointestinal complications, especially retching. The symptoms persisted for seven days and ten days in two dogs that underwent sacculectomy with harmonic scalpel and for two days in one dog that underwent sacculectomy with Metzenbaum scissors. The clinical signs and symptoms of brachycephalic syndrome disappeared without recurrence. Harmonic scalpel provides a hemostatic effect during staphylectomy, is convenient, and does not cause postoperative complications. Conversely, the use of harmonic scalpel during sacculectomy necessitated a longer period for the resolution of complications without any significant hemostatic efficacy, compared to traditional surgery.

폐(肺)에 발생한 Hamartoma 치험 2예 (The Adult Form of Pulmonary Hamartoma -Two Case Report-)

  • 이두연;윤여준;조범구;홍승록;이옥순;최인준
    • Journal of Chest Surgery
    • /
    • 제9권1호
    • /
    • pp.90-93
    • /
    • 1976
  • Pulmonary hamartoma is often incidental, asymptomatic finding on routine chest roentgenogram. It has been considered a congenital malformation. Since the original description by Albrecht in 1908, it has been classified into two types, a small, fibrocartilaginous mass in adults, and a cystic lobar mass in infants. We experienced two cases of pulmonary hamartoma which proved to be the adult form of hamartoma. One was located in left upper lobe of a 58 year old male patient, the other was located in the perihilar region of the right middle lobe of a 38 year old male patient. The former case was treated by wedge resection: the latter by right middle lobectomy and the postoperative courses of both cases were very good and without complication.

  • PDF

폐로의 전이성 악성 섬유성 조직구종 -1예 보고- (Metastatic Malignant Fibrous Histiocytoma in Lung -One Case Report-)

  • 이석열;이만복;이길노;고은석
    • Journal of Chest Surgery
    • /
    • 제32권7호
    • /
    • pp.671-674
    • /
    • 1999
  • 42세 여자환자가 외래 추적검사에서 1998년 12월에 흉부 방사선 사진상 우측폐 하엽에 고립성 폐결절이 관찰되었다. 경피적 경흉부 세침흡인 세포검사 실패후 진단과 치료를 위해 우측폐 하엽 상기저폐구역의 쐐 기절제를 하였다. 환자는 3년전에 좌측 둔부에 종괴가 있어서 제거후 병리조직검사에서 악성 섬유성 조직구 종으로 진단받고 35일간 4500 rad의 방사선치료를 받았었다. 병리조직 講瀯\ulcorner폐로 전이된 악성 섬유성 조직 구종으로 진단되었다.

  • PDF

Pleural Aspergillosis 치험 1례 (Surgical Treatment of Pleural Aspergillosis a case report)

  • 양현웅;최종범;최순호
    • Journal of Chest Surgery
    • /
    • 제30권5호
    • /
    • pp.544-547
    • /
    • 1997
  • 저자들은 흉막 아스페르길루스증을 치험하였다. 50세 여자가 2주 동안의 권태감, 식욕부진, 객담을 동반한 기침 및 우측 홉막성 흉통을 주소로 내원하였다. 과거력상 10여년전 폐결핵으로 약물치료를 받은 적이 있었 다. 일반 흉부 사진상 폐우상엽에 공동을 동반한 농기흉을 보였으며,흉부 전산화 단층촬영상 우측 폐에 분 획된 농기흉 및 기관지 늑막루 소견을 보이는 공동이 관찰되었다. 폐 박피술과 부분절제,그리고 흉막절제술 을 시행하였으며 술후 경과는 만족스러웠다. 흉막 아스페르길루스증은 매우 드물고 잘 치유되지 않는 질병 이나 전신적 항진균제제 투여 및 수술적 치료로 별다른 합병증 없이 좋은 결과를 얻을 수 있었으나 재발의 가능성 때문에 계속 추적 관찰 중이다.

  • PDF

위 사구종양 1예 (A Case of Gastric Glomus Tumor)

  • 이진성;최선택;이현욱;권병진;이지은;이시형
    • Journal of Yeungnam Medical Science
    • /
    • 제28권2호
    • /
    • pp.165-172
    • /
    • 2011
  • Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dennis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5 cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

  • PDF