• 제목/요약/키워드: lung lobectomy

검색결과 429건 처리시간 0.026초

폐결핵에 병발된 폐 Aspergilloma (Pulmonary Aspergilloma Associated Pulmonary Tuberculosis)

  • 심성보
    • Journal of Chest Surgery
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    • 제24권10호
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    • pp.1011-1018
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    • 1991
  • From September, 1985 to March, 1991, 33 patients under went thoracotomy for treatment of pulmonary aspergilloma with Pulmonary tuberculosis on the department of Thoracic and Cardiovascular Surgery, National Kongju Hospital. 1. There were 25 male and 8 female patients ranging from 19 to 57 years old [mean age, 36.2 years]. 2. Hemoptysis was the most common symptom [recurrent minor hemoptysis: 24cases, severe hemoptysis [200cc /day]: 4 cases, massive hemoptysis [600/day]: 4 cases]. 3. In the chest X-ray films, intracavitary fungus balls [air meniscus sign] were noted in 20 cases [61%] and upper lobe involvements were 29 cases [88%]. 4. All cases had a history of treatment with antituberculosis drugs under diagnosis of pulmonary tuberculosis for an average of 10 years and 2 months. 5. The most common indication for operation was hemoptysis [32 cases] - hemoptysis with total destroyed lung or lobe: 12cases, hemoptysis with open AFB [t-] cavity: 6cases, recurrent or massive hemoptysis: 14 cases. 6. The operative procedures was as follows - - - lobectomy . 16 cases, pneumonectomy: 8 cases, bilobectomy, segmentectomy, cavernoplasty and lobectomy with segmentectomy: each 2 cases, lobectomy with cavernoplasty: 1 case. 7. 6 complications appeared postoperatively which included empyema with BPF [2 cases], empyema [2 cases] and wound infection [2 cases]. In conclusion, surgical resection is the treatment of choice in the management of pulmonary aspergilloma associated pulmonary tuberculosis.

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흉부 세침 흡인 생검 후 발생한 폐암의 이식성 체벽 전이 2례 (Implantation Metastasis of Lung Cancer to Chest Wall after Percutaneous Fine-Needle Aspiration Biopsy)

  • 정승묵;원태경;김태형;황흥곤;김미영;정원제;임병성
    • Tuberculosis and Respiratory Diseases
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    • 제50권6호
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    • pp.718-725
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    • 2001
  • 세침흡인생검을 통한 폐암의 파종성 체벽 전이는 매우 드물기는 하나 환자의 예후를 현저히 악화시킬 수 있는 매우 심각한 합병증이다. 그러나 그 보고가 매우 드문데, 본 저자등은 2예를 경험하여 이를 성공적으로 치료하였기에 문헌고찰과 함께 보고하고자 한다. 43세 여자환자는 선암 IB로 수술 후 2년후에 이식성 체벽 전이암이 발생하여 이를 종양 적출술 및 방사선 치료를 하였다. 다른 65세 남자환자는 편평상피세포암 IB로 수술을 시행한 8개월 후 무통성 체벽 전이암이 발생하여 종양 적출술과 방사선 치료를 병행하였다. 그 후 이들은 체벽의 이식성 전이암을 제거한지 각각 15개월과 37개월이 지난 현재까지 생존해 있다. 아직까지 세침흡인 생검 후 발생한 암의 이식성 체벽전이에 대한 확립된 치료 지침은 없으나, 그간의 문헌의 고찰 및 본 저자등의 경험을 비추어 암 적출술과 방사선 치료를 병행하였을 경우 성공적으로 치료될 수 있을 것으로 생각된다.

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폐종양 환자에서 방사선치료에 의한 폐손상 (Radiation-induced Pulmonary Damage in Lung Cancer Patients)

  • 정수미;최일봉;강기문;김인아;신경섭
    • Radiation Oncology Journal
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    • 제11권2호
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    • pp.321-330
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    • 1993
  • Purpose: A retrospective analysis was performed to evaluate the incidence of radiation induced lung damage after the radiation therapy for the patients with carcinoma of the lung. Method and Materials: Sixty-six patients with lung cancer (squamous cell carcinoma 27, adenocarcinoma 14, large cell carcinoma 2, small cell carcinoma 13, unknown 10) were treated with definitive, postoperative or palliative radiation therapy with or without chemotherapy between July 1987 and December 1991. There were 50 males and 16 females with median age of 63 years (range: 33~80 years). Total lung doses ranged from 500 to 6,660 cGy (median 3960 cGy) given in 2 to 38 fractions (median 20) over a range or 2 to 150 days (median in days) using 6 MV or 15 MV linear accelerator. To represent different fractionation schedules of equivalent biological effect, the estimated single dose (ED) model, $ED=D{\dot}N^{-0.377}{\dot}T^{-0.058}$ was used in which D was the lung dose in cGy, N was the number of fractions, and T was the overall treatment time in days. The range of ED was 370 to 1357. The endpoint was a visible increase in lung density within the irradiated volume on chest X-ray as observed independently by three diagnostic radiologists. Patients were grouped according to ED, treatment duration, treatment modality and age, and the percent incidence of pulmonary damage for each group was determined. Result: In 40 of 66 patients, radiation induced change was seen on chest radiographs between 11 days and 314 days after initiation of radiation therapy. The incidence of radiation pneumonitis was increased according to increased ED, which was statistically significant (p=0.001). Roentgenographic changes consistent with radiation pneumonitis were seen in $100\%$ of patients receiving radiotherapy after lobectomy or pneumonectomy, which was not statistically significant. In 32 patients who also received chemotherapy, there was no difference in the incidence of radiation induced change between the group with radiation alone and the group with radiation and chemotherapy, among the sequence of chemotherapy No correlation was seen between incidence of radiation pneumonitis and age or sex. Conclusions: The occurrence of radiation pneumonitis varies. The incidence of radiation pneumonitis depends on radiation total dose, nature of fractionation, duration of therapy, and modifying factors such as lobectomy or pneumonectomy.

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피하전이를 일으킨 폐 유상피 혈관내피종 (Pulmonary Epithelioid Hemangioendothelioma Association with Subcutaneous Metastasis -Surgical experience of one case-)

  • 이해영;조성호;변정훈;김종인;박진경;천봉권;조성래
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1025-1028
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    • 2004
  • 폐 유상피 혈관내피종은 조직학적으로는 혈관내피에서 발생하는 양성종양이나 임상적으로는 전이와 재발을 보이는 매우 드문 악성종양 중의 하나이다. 무증상의 좌하엽 폐암으로 진단받은 29세의 남자에서 좌하엽 폐절제술, 좌상엽 페 쐐기 절제술, 횡격막 부분절제술을 시행하여 좌하엽 폐의 병변에서는 유상피 혈관내피종으로 확진되었으나 좌상엽 폐와 횡격막의 병변은 유상피 혈관내피종이 자연 관해되어 석회화만 남은 것으로 진단되었다. 술 후 10개월과 19개월 두 차례에 걸쳐 폐 유상피 혈관내피종으로부터 피하 전이를 일으킨 환자를 수술 치험하였기에 보고한다.

급격히 진행한 원발성 폐 융모막 암종 (Rapidly Progressed Primary Choriocarcinoma of the Lung)

  • 장성욱;박정옥;이계영;이원애;류재욱;박성식;김삼현;서필원
    • Journal of Chest Surgery
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    • 제37권9호
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    • pp.805-808
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    • 2004
  • 피가래를 주소로 69세 남자 환자가 내원하였다. 환자는 술 전 검사상 좌상엽에 5${\times}$2.8 cm의 종괴를 가지고 있었다. 좌상엽 절제술 및 림프 곽청술을 시행하였고 종괴는 원발성 폐 융모막 암종으로 진단되었다. 적절한 치료에도 불구하고 술 후 환자는 폐렴의 악화로 인해 항암 화학요법이 지연되었으며 암종은 급격한 진행을 보였다. 환자는 58병일째 폐렴으로 사망하였다. 원발성 폐 융모막 암종은 매우 드문 질환이며 치료 원칙도 정립되지 않았다. 이에 저자들은 수술 후에 진단된 원발성 폐 융모막 암종 1예를 치험하였기에 보고하는 바이다.

폐공동성 병변의 임상적 고찰 (A Clinical Study for the Cavitary Lesion of the Lung)

  • 이정래;김종원;정황규
    • Journal of Chest Surgery
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    • 제18권3호
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    • pp.474-481
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    • 1985
  • Pulmonary cavity is the result of necrosis of lung parenchyma with evacuation of the necrotic material via the tracheobronchial tree. A communication with the tracheobronchial tree permits air to enter the area of necrosis, so the radiologic result show the a lucent defect. The radiologic characteristics of the wall of a cavity are determined by the reaction of the lung parenchyma to the pathologic process. Therefore, the shadows of the chest films in cavitary lesion were variable in its nature. The author, in 42 cases which have a cavitary lesion in X-ray findings among 172 cases resected lung obtained in P.N.U.H. from 1979 to June, 1985, studied similarities and differences between the pathogenesis of these lesions and the radiologic findings. The author reviewed the 42 cavitary lesions and the following results were obtained. 1. The cavitary lesions were seen in 42 [24.4%] out of 172 cases of resected lung disease. 2. Histopathologically, pulmonary tuberculosis was 47.6% and primary lung cancer was 9.5%. 3. The most common site of the lesion was right upper lobe. 4. The most common size of the cavity was from 3 to 6 cm in diameter. 5. Lobectomy was the most common operated method.

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Isolated Unilateral Absence of Pulmonary Artery Associated with Contralateral Lung Cancer

  • Kim, Kun Woo;Lee, Jae-Ik;Son, Kuk-Hui;Kim, Eun Young;Park, Kook-Yang;Park, Chul-Hyun
    • Journal of Chest Surgery
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    • 제51권4호
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    • pp.280-282
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    • 2018
  • Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly that may present with various symptoms, depending on the nature and severity of other cardiovascular anomalies. Furthermore, contralateral lung surgery in patients with UAPA is extremely rare, and clinical experience is limited. This report describes a case of surgical treatment of contralateral primary lung cancer in a patient with isolated UAPA. A 56-year-old man was diagnosed with primary lung cancer accompanied by isolated UAPA on the contralateral side. He underwent meticulous cardiorespiratory function tests preoperatively. We performed a right lower lobectomy. Although in the immediate postoperative period, the patient suffered from a mild decline in his respiratory function, he recovered uneventfully. The present case shows that preoperative awareness of UAPA and meticulous perioperative management enable contralateral lung surgery to be performed safely.

근치적 수술 후 소장으로 단독 전이된 폐의 다형성 암종 1예 (Single Small Bowel Metastasis after Curative Operation in a Pleomorphic Lung Carcinoma)

  • 김기원;이호성;최재성;서기현;오미혜;조성식;김용훈;나주옥
    • Tuberculosis and Respiratory Diseases
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    • 제71권2호
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    • pp.139-143
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    • 2011
  • Small bowel metastasis of pleomorphic carcinoma of the lung is very rare. A 58-year-old man was admitted to our hospital with abdominal palpable mass in the right upper quadrant area. He underwent right middle and lower lobectomy for early stage pleomorphic carcinoma of the lung approximately 3 months ago. USG-guided biopsy was performed for abdominal mass. Pathologic examination revealed a metastatic pleomorphic carcinoma from the lung. He received chemotherapy followed by radiation therapy but died due to septic shock caused by intestinal stenosis and adhesion. We report the first case of small bowel metastasis by pleomorphic carcinoma of the lung after curative surgery.

Lung lobe torsion in a dog with a tracheal stent for severe tracheal collapse

  • Taeho Lee;Aryung Nam;Dong-Kwan Lee;Han-Joon Lee;Kun-Ho Song
    • 한국동물위생학회지
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    • 제46권4호
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    • pp.349-355
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    • 2023
  • A 7-year-old castrated male Pomeranian dog presented with severe goose honking cough and dyspnea. Thoracic radiographs revealed a narrowed tracheal diameter at the thoracic inlet, classified as tracheal collapse grade 4. Despite medical treatment, the dog's life-threatening airway obstruction did not improve. Subsequently, tracheal stent placement resulted in a significant improvement in respiratory condition, with no recurrence of symptoms observed during the 4-month period, except for coughing induced by excitement and anxiety. However, the patient presented with a one-week history of productive cough, exercise intolerance, and loss of appetite. Radiographs and computed tomography scans revealed torsion of the left cranial lung lobe. The patient underwent affected lung lobectomy, which involved the removal of the necrotized cranial portion and heavily congested caudal portion. Unfortunately, the patient did not recover and eventually passed away. Histopathological examination of the resected lung tissue confirmed coagulative necrosis and marked peribronchiolar edema, consistent with lung lobe torsion.

Delayed Iatrogenic Diaphragmatic Hernia after Left Lower Lobectomy

  • Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • 제50권6호
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    • pp.456-459
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    • 2017
  • A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed. The diaphragmatic defect was repaired via VATS. The postoperative course was uneventful, and he was discharged with resolved digestive tract symptoms.