• 제목/요약/키워드: bronchopleural fistula

검색결과 86건 처리시간 0.018초

기관지확장증의 임상적 고찰 (Clinical evaluation of bronchiectasis)

  • 김수성
    • Journal of Chest Surgery
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    • 제17권1호
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    • pp.41-47
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    • 1984
  • We experienced 48 operations in 46 surgical patients of bronchiectasis admitted to the Department of Thoracic and Cardiovascular Surgery of Jeonbug National University Hospital from January, 1975 to August, 1982. Among 46 patients, 27 patients [59%] was age group between 21 to 30 years. Common symptoms were cough with sputum, hemoptysis, dyspnea, fever and chilliness, and chest pain. The duration of the symptoms was variable between below one year and above 10 years. The most frequent associated disease, probably the cause of the bronchiectasis, was secondary bacterial infection after viral infection. The left lower lobe and lingular segment was involved most frequently, and the most frequent pathologic type was mixed type [40%]. Single lobectomy, and combined lobectomy and segmentectomy were performed in 77% of the patients. Bilateral resection was performed in three patients with good result. In those patients, the isolated pulmonary function test on each side of the lung performed 2 month later primary lung resection could make them be prevented from pulmonary insufficiency after secondary lung resection. The results were good except two patients who developed pulmonary insufficiency and chronic empyema with bronchopleural fistula.

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폐암의 임상적 고찰 (Clinical Study of 45 Cases of Primary Carcinoma of the Lung)

  • 한병선
    • Journal of Chest Surgery
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    • 제18권2호
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    • pp.334-340
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    • 1985
  • The results of the clinical observations on the bronchogenic carcinoma of forty-five cases treated in the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, during the period of 6 years from June.1978 to Aug. 1984, are as follows: 1. Of 45 cases, 44 cases were over 40 years of age and the sex ratio was 4.6:1 in male`s favor. 3. Among 50 cases, 45 cases were confirmed histopathologically. Of these, 30 cases [66.7%] were squamous cell carcinoma, 8 cases [17.8%] adenocarcinoma, and 7 cases [15.6%] undifferentiated cell carcinoma. 4. The thoracotomy was performed in 31 cases [68.9%] of 45 cases and the resection of the lesion in 16 cases [51.6%]. The empyema and bronchopleural fistula developed in 2 cases.

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기관지확장증의 외과적 요법 (Surgical Treatment of Bronchiectasis)

  • 이영욱
    • Journal of Chest Surgery
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    • 제15권1호
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    • pp.15-20
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    • 1982
  • During the past ten years from 1972 to 1981, a total of 100 cases of bronchiectasis were treated by pulmonary resection at C.A.F.G.H. Pulmonary tuberculosis and frequent U.R.I. were the most frequent associated disease and encountered in 54% in this series. Various types of pulmonary resection were performed on 100 patients; left lower lobectomy in 40 cases, left lower lobectomy and lingular segmentectomy In 29 cases, right lower lobectomy in 12 cases, right middle and lower lobectomy in 12 cases, lingular segmentectomy in 3 cases, left pneumonectomy in 3 cases and both lower lobectomy in 1 case. Complications developed in 9 cases and 1 case among them died of sepsis following secondary opera-tion. Among complications of 9 cases, postoperative atelectasis showed in 4 cases, hemorrhage in 2 cases, bronchopleural fistula in 2 cases, pulmonary edema in 1 case. Complications were treated by conservative and secondary operative management with satisfactory result except one death. Remainders without complication showed good result without symptom in postoperative and follow-up periods.

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폐암 환자에서의 기관지 성형술 -5례 보고- (Sleeve Resection of Lung Cancer - A report of 5 cases-)

  • 두홍서
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.408-413
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    • 1988
  • Sleeve resection is safe, effective, and appropriate treatment for a wide range of endo-bronchial lesions including neoplasms of low grade malignant potential and selected cases of bronchogenic carcinoma. Five cases of bronchoplastic procedures were performed for primary bronchogenic carcinoma patients at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital from Aug. 1983 to Oct. 1987. Of the 5 patients, four were male and one patient was female and ages ranged from 51 years to 66 years old. Histopathologically, 4 cases were squamous cell carcinoma and one case small cell carcinoma. Operative procedures of the 5 patients were as follows: Right upper sleeve lobectomy, 1 case; Left upper sleeve lobectomy, 1 case; left lower sleeve lobectomy, 1 case; Left lower lobe and lingular segment sleeve resection, 2 cases. The early and late postoperative complications of the above operations were pneumonia, atelectasis, bronchopleural fistula, empyema, brain metastasis, and local recurrence of primary tumor.

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폐 국균증의 수술적 치료 (Surgical treatment of pulmonary aspergilloma)

  • 박승일;손광현
    • Journal of Chest Surgery
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    • 제26권10호
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    • pp.775-780
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    • 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.

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정중흉골절개하 경심낭적 기관지 흉막누공의 폐쇄 치험 1예 (Transpericardial closure of postpneumonectomy bronchopleural fistula -Report of a case-)

  • 김주현;이재원
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.528-533
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    • 1986
  • Total anomalous pulmonary venous connection is relatively rare cyanotic congenital heart diaease, which represents 1-4% of all congenital cardiac defects. Generally in the majority cases, severe heart failure and cyanosis develops in the early infancy. Because of high mortality in the untreated infants and surgical risk, there are still many things to be improved. Two patients with total anomalous pulmonary venous connection are presented, which we recently experienced. The one was 10 year old female with supracardiac type drained through left innominate vein, and survived the operation and continuous to do well for 1 year. The other 5 year old female with mixed type (right pulmonary vein drained via coronary sinus and left pulmonary vein through left innominate vein) was operated successfully under hypothermia and extracorporeal circulation, and followed up for 6 months without problem. It was very rare case in the literature.

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Kinchu 술식에 의한 만성 농흉의 수술치험 -1례 보고- (One Case Report of Kinchu Method for Chronic Empyema Thoracis)

  • 이철세;안욱수
    • Journal of Chest Surgery
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    • 제22권5호
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    • pp.862-866
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    • 1989
  • We are experienced one case of \ulcornerinchu" method operation for chronic thoracic empyema with bronchopleural fistula. A 30-years old male was admitted to our hospital because of right thoracic empyema. In spite of pleural tube drainage, the right entire lung was poorly expanded. The right upper lobectomy and decortication for visceral side of empyema peel were done but expansion of right middle and lower lobe was not enough to fill the pleural space remained Extraperiosteal detachment without performing thoracoplasty was done as the method proposed by Kinchu. The patient recovered without significant problem and the good expansion of remained lung with acceptable pulmonary function was obtained.ined.

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자발성 흉곽 내 만성 팽창성 혈종 1예 (A Case of Spontaneous Chronic Expanding Hematoma in the Thorax)

  • 주용원;손창남;정경희;박혜정;김상헌;김태형;손장원;윤호주;최요원;정원상;신동호;박성수
    • Tuberculosis and Respiratory Diseases
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    • 제65권3호
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    • pp.216-221
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    • 2008
  • 저자들은 대량 객혈로 발현한 흉곽 내 만성 팽창성 혈종 1예를 보고한다. 이 증례는 이전의 증례와 달리 결핵성늑막염이나 흉부 수술, 외상의 과거력 없이 자연 발생한 증례라는 점에서 의의가 있다. 또한 무증상, 호흡곤란 등으로 발현했던 대부분의 증례와는 달리 드물게 대량객혈로 발현하였으며, 이러한 대량객혈이 기관지흉막루를 동반하여 발생하여 기관지동맥 색전술과 수술로 치료되었다는 점에서 특징적이다. 증례보고와 함께 문헌고찰을 통해 과거 보고된 흉곽 내 만성 팽창성 혈종의 임상양상에 대해 표로 정리하였다.

Early and Long-term Outcomes of Pneumonectomy for Treating Sequelae of Pulmonary Tuberculosis

  • Byun, Chun-Sung;Chung, Kyung-Young;Narm, Kyoung-Sik;Lee, Jin-Gu;Hong, Dae-Jin;Lee, Chang-Young
    • Journal of Chest Surgery
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    • 제45권2호
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    • pp.110-115
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    • 2012
  • Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

외과적 자연기흉의 임상적 고찰 (Clinical Investigation of Surgical Spontaneous Pneumothorax)

  • 윤윤호
    • Journal of Chest Surgery
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    • 제1권1호
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    • pp.19-24
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    • 1968
  • A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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