• Journal of Chest Surgery
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• v.57 no.2
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• pp.128-135
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• 2024

Background: This retrospective study aimed to determine the treatment patterns and the surgical and oncologic outcomes after completion lobectomy (CL) in patients with locoregionally recurrent stage I non-small cell lung cancer (NSCLC) who previously underwent sublobar resection. Methods: Data from 36 patients who initially underwent sublobar resection for clinical, pathological stage IA NSCLC and experienced locoregional recurrence between 2008 and 2016 were analyzed. Results: Thirty-six (3.6%) of 1,003 patients who underwent sublobar resection for NSCLC experienced locoregional recurrence. The patients' median age was 66.5 (range, 44-77) years at the initial operation, and 28 (77.8%) patients were men. Six (16.7%) patients underwent segmentectomy and 30 (83.3%) underwent wedge resection as the initial operation. The median follow-up from the initial operation was 56 (range, 9-150) months. Ten (27.8%) patients underwent CL, 22 (61.1%) underwent non-surgical treatments (chemotherapy, radiation, concurrent chemoradiation therapy), and 4 (11.1%) did not receive treatment or were lost to follow-up after recurrence. Patients who underwent CL experienced no significant complications or deaths. The median follow-up time after CL was 64.5 (range, 19-93) months. The 5-year overall survival (OS) and post-recurrence survival (PRS) were higher in the surgical group than in the non-surgical (p<0.001) and no-treatment groups (p<0.001). Conclusion: CL is a technically demanding but safe procedure for locoregionally recurrent stage I NSCLC after sublobar resection. Patients who underwent CL had better OS and PRS than patients who underwent non-surgical treatments or no treatments; however, a larger cohort study and long-term surveillance are necessary.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.614-618
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• 2005

A benign metastasizing pulmonary leiomyoma (BMPL) is a rare disease that usually occurs in women with a prior or coincident history of uterine leiomyoma. Although leiomyoma is histologically benign, it has the potential to metastasize to a distant site such as the lung. A 35 year old woman who had undergone a hysterectomy due to uterine leiomyoma 5 years prior was admitted for an investigation of multiple pulmonary nodules on a routine chest roentgenogram. An open lung biopsy was taken to make a pathological diagnosis. The microscopic finding of the nodules was leiomyoma and was similar to those of the uterine leiomyoma that had been resected 5 years ago. The woman underwent wedge resections of all pulmonary nodules. This is the first case of BMPL in Korea, which was treated with wedge resections of all multiple pulmonary nodules.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1025-1028
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• 2004

Epithelioid hemangioendothelioma (HE) is a very rare malignant tumor that is pathologically benign tumor originating from endothelial cell but clinically presents metastasis and recurrence. A 29-year-old asymptomatic man, preoperatively diagnosed as lung cancer in the left lower lung, underwent a lobectomy, a wedge lung resection of left upper lung, and partial resection of diaphragm. Left lower lobar lesion was confirmed as pulmonary epithelioid hemangioendothelioma, but the lesions of the left upper lung and diaphragm were remained calcified by spontaneous regression of HE. We report a case of subcutaneous metastasis that occurred two times at 10 months and 19 months after previous surgical treatment of pulmonary EH.

• Journal of Gastric Cancer
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• v.12 no.4
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• pp.258-261
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• 2012

Ewing's sarcoma is a neoplasm of the undifferenciated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. We present a case of gastric Ewing's sarcoma; a 35-year-old female who had no symptoms. While she was at a routine medical checkup, a protruding mass in her gastric antrum was incidentally found on esophagogastroduodenoscopy. Endoscopic ultrasonogram showed a submucosal mass on the same lesion and a laparosopic wedge resection was done. Pathologic gross findings showed a granular grape appearance tissue and histoloigc examination revealed a small round cell tumor with CD 99 immunoexpression positive. In general, a combined modality therapy for Ewing's sarcoma such as surgical resection with chemotherapy, is accepted as an effective method. However, this patient had no adjuvant chemotherapy after surgery and she has no recurrence for eleven months.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.881-886
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• 1990

Thirty-three patients less than 40 years of age were diagnosed at CS Dept. of Catholic University Medical College between 1979 and 1988 as having primary lung cancer. There were 22 men and 11 women; the average age was 36.3 years. The youngest patients was 23 years old. Eighteen male patients were only habitual smokers more than 1 pack per day. In the 33 cases, the distribution by tumor type was as follows: squamous cell carcinoma 36.4%[13 cases]; adenocarcinoma 33.3%[11 cases]; small cell carcinoma 24.2%[8 cases]; and large cell carcinoma 3.0%[1 case]. At the time of diagnosis, 2 patients[6.1%] had stage I disease, 2[6.1%] had stage II disease, 5[15.6%] had stage IIIA disease, 10[30.3%] had stage lllB disease, and 14[42.4%] had stage IV disease. Thirteen patients[36.4%] underwent an exploratory thoracotomy. Of these patients, 9[27.3%] had surgical resection[six lobectomies, two pneumonectomies, and one wedge resection]. Thirty-one patients were treated with palliative radiation therapy, chemotherapy, or combinations of each. The survival rate at 1 year, 3 year, and 5 year were 48.2%, 14.5%, and 8.3% respectively. But in the resectable 9 patients, they were 78.1%, 43.6%, and 33.3% respectively.

• 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.

• Journal of Gastric Cancer
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• v.4 no.2
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• pp.95-108
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• 2004

This nationwide survey was conducted to evaluate the current status of clinical practice for gastric cancer patients in Korea. The Information Committee of the Korean Gastric Cancer Association (KGCA) sent questionnaires containing 45 items about the preoperative diagnosis, medical and surgical treatment, and postoperative follow-up for gastric cancer patients to all 298 KGCA members in 108 institutes. Response rates were $32.6\%$ (97/298) for individuals and $59.3\%$ (64/108) for institutes. Most university hospitals responded (response rate of university hospitals: $71.6\%$, 48/67). The preoperative staging work up was performed primarily by abdominal CT, followed by bone scans, abdominal ultrasound, endoscopic ultrasound, and so on. Gastric cancer patients with stages II, III, and IV usually received adjuvant chemotherapy after a curative operation. About half of the surgeons regarded 2 cm as a safe resection margin in early gastric cancer and 5 cm in advanced gastric cancer. More than half of surgeons usually performed a D2 lymph node dissection in early gastric cancer and D2+$\alpha$ lymph node dissection in advanced gastric cancer. About $20\%$ of surgeons performed less invasive surgery and/or function-preserving surgery, such as a pylorus-preserving gastrectomy, a laparoscopic wedge resection, or a laparoscopy-assisted distal gastrectomy.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.217-219
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• 2023

A 50-year-old male presented gradually growing pancreatic body mass. An abdominal computed tomography showed a 9.9-cm mass, larger than the 8.9-cm mass one year ago. As the patient did not have complaints for any symptomatic problems, the gastroenterologist decided to check it with regular follow-up. However, as the tumor grew faster than expected, the patient was recommended for surgical resection. Laparoscopic pylorus preserving pancreaticoduodenectomy was done. Since the tumor abutted to the superior mesenteric vein and the portal vein, wedge resection of vessel was inevitable. Pathology was serous cystadenoma. The patient was discharged without postoperative complications. Herein, we report this case with asymptomatic large serous cystic neoplasm treated by laparoscopic approach. The appropriateness of current guidelines for surgery in serous cystic neoplasm is also discussed.

• Journal of the Korean Orthopaedic Association
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• v.56 no.2
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• pp.157-163
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• 2021

Purpose: Xanthomatosis of the Achilles tendons is rare. In some patients, however, the lesions in the Achilles tendon need to be removed, which may be painful and disfiguring. While studies of successful surgical outcomes for the total resection and reconstruction of the Achilles tendon have been reported, reconstruction surgery has a technical challenge, and extended surgical exposures are required. This study analyzed five cases of bilateral xanthoma of the Achilles tendon, which was treated surgically using a wedge-shaped tendon-sparing approach to eliminate the need for tendon reconstruction. Materials and Methods: From July 2010 to May 2018, five patients with xanthomatosis in both Achilles tendons underwent wedge-shaped tendon preserving surgery. The average age was 49 years (range, 40-55 years), and the follow-up period was 21.4 months (range, 12-31 months). The patients consisted of three males and two females. Complications related to surgery were recorded. The outcome measures included the range of motion of the ankle joint, American Orthopaedic Foot and ankle Society (AOFAS) ankle/hindfoot score, and visual analogue scale (VAS) for overall satisfaction at the last follow-up. The availability of a single-limb heel raise and returning time to work were also measured. Results: Wound dehiscence that did not require secondary surgery was noted in one patient. At the last follow-up, the range of motion of the ankle joint was normal in all patients. The mean AOFAS ankle/hindfoot score was 91 (range, 85-96) and the VAS for the overall satisfaction ranged from 8 to 10. The average time between surgery and return to work was 27.6 days (range, 17-58 days) and all patients could perform a single-limb heel raise test. Conclusion: The tendon-sparing technique, which can preserve the anatomical functioning of the Achilles tendon, could be an excellent surgical approach because it has very promising functional and cosmetic surgical outcomes in patients with Achilles tendon xanthomatosis.

• Journal of Chest Surgery
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• v.30 no.10
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• pp.1044-1047
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• 1997

Pulmonary blastoma are a family of tumors in which the glands or mesenchyme composing the neoplasm are primitive or emb yonal in appearance. We report a pulmonary blastoma occurring in a 31 years old man. An abnormal shadow was detected in the right lower lung field in a routine chest X-ray film. The preoperative imaging films showed about a 5cm sized well circumscribed solid tumor of the right lung. A preoperative clinical diagnosis of primary lung cancer was considerd. The operative field showed that the hard, round mass, 6$\times$5$\times$4cm in diameter was localized in middle lobe of the right lung, and partially adhered to the upper lobe, pericardium and diaphragm. Right middle lobe lobectomy, right upper lobe wedge resection, partial pericardiectomy and diaphragm resection with plication was performed with radical Iymph node dissection. Histopathologic diagnosis was pulmonary blastoma (Biphasic blastoma). It is considered that the prognosis of biphasic blastoma is worse than WDFA(well differentiated fetal adenocarcinoma). There are no other available treatments except for surgical resection. It is suggeste that it is necessary to collect as many cases as possible, to make definite classifications and to examine the clinical course and prognosis of pulmonary blastoma.