• 한국임상수의학회지
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• 제35권4호
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• pp.166-169
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• 2018

A 14-year-old, 3.9 kg, castrated male Maltese presented with an intermittent cough. A solitary mass ($1.6{\times}2{\times}1.8cm$) was located in right middle lung lobe on CT examination and thoracoscopic right middle lung lobectomy was performed without lung separation. The patient recovered uneventfully and was discharged at POD3. With a histopathologic diagnosis of pulmonary bronchoalveolar carcinoma, Re-evaluation via CT scanning with contrast on POD 50 and 255 revealed no evidence of residual, metastatic or recurrent lesions. The patient has been doing well since surgery during a 9-month follow-up period.

• Journal of Chest Surgery
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• 제33권10호
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• pp.798-805
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• 2000

Background : the prediction on changes in the lung function after lung surgery would be an important indicator in terms of the operability and postoperative complications. In order to predict the postoperative FEV1 - the commonly used method for measuring changes in lung function- a comparison between the quantitative CT and the perfusion lung scan was made and proved its usefulness. Material and Method : The subjects included 22 patients who received perfusion lung scan and quantitative CT preoperatively and with whom the follow-up of PFT were possibles out of the pool of patients who underwent right lobectomy or right pneumonectomy between June of 1997 and December of 1999. The FEV1 and FVC were calibrated by performing the PFT on each patient and then the predicted FEV1 and FVC were calculated after performing perfusion lung scan and quantitative CT postoperatively. The FEV1 and FVC were calibrated by performing the PFT after 1 week and after 3 momths following the surgery. Results : There was a significant mutual scan and the actual postoperative FEV1 and FVC at 1 week and 3 months. The predicted FEV1 and FVC(pneumonectomy group : r=0.962 and r=0.938 lobectomy group ; r=0.921 and r=913) using quantitative CT at 1 week postoperatively showed a higher mutual relationship than that predicted by perfusion lung scan(pneumonectomy group : r=0.927 and r=0.890 lobectomy group : r=0.910 and r=0.905) The result was likewise at 3 months postoperatively(CT -pneumonectomy group : r=0.799 and r=0.882 lobectomy group : r=0.934 and r=0.932) Conclusion ; In comparison to perfusion lung scan quantitative CT is more accurate in predicting lung function postoperatively and is cost-effective as well. Therefore it can be concluded that the quantitative CT is an effective method of replacing the perfusion lung scan in predicting lung function post-operatively. However it is noted that further comparative analysis using more data and follow-up studies of the patients is required.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2871-2877
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• 2013

Objectives: To evaluate the safety, efficacy, and invasiveness of lobectomy by video-assisted thoracoscopic surgery (VATS) in the treatment of stage I/II non-small cell lung cancer (NSCLC). Methods: A total of 148 patients presenting with Stage I or II NSCLC were enrolled into our study, comprising 71 who underwent VATS and 77 patients undergoing conventional thoracotomic lobectomy, in combination with systematic lymph node resection. Results: It was found that VATS was superior to conventional thoracotomy in terms of the duration of surgery, intraoperative blood loss, frequency of the need to administer postoperative analgesia, thoracic intubation indwelling time, post-operative hospital stay, and survival rate (P<0.05). We saw no obvious difference in the number of resected lymph nodes with either approach. Conclusions: VATS lobectomy is a safe and reliable surgical approach for the treatment of Stage I/II NSCLC, characterized by significantly minimal invasiveness, rapid post-operative recovery, and markedly lower loss of blood.

• Journal of Chest Surgery
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• 제55권1호
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• pp.1-9
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• 2022

Lung cancer is a fatal disease, highlighting the importance of research on related topics, including surgery for lung cancer. However, systematic research analyzing surgery on a national scale is limited. This study aimed to investigate the research on lung cancer using nationwide data in South Korea and to analyze trends in lung cancer surgery, including its clinical implications. Published articles and data from the Korean National Health Insurance database were used. Although the incidence and mortality of lung cancer have been improving, it is predicted to be the most common and fatal type of cancer in South Korea in 2021. The number of surgical procedures for lung cancer is increasing, especially among women, those ≥76 years of age, residents of non-metropolitan cities, and middle-income patients. Lobectomy and sublobectomy, including segmentectomy, are increasingly common. However, the proportion of pneumonectomy relative to other procedures is not increasing. Surgery has shown a reasonable survival rate, especially after lobectomy, but survival remains poor in patients ≥76 years of age who undergo pneumonectomy. The frequency of lung cancer surgery is increasing concomitantly with various socioeconomic changes. Lobectomy has become increasingly common, and the clinical results of surgery are satisfactory. Further research on the changing composition of surgical candidates is required.

• 한국임상수의학회지
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• 제32권1호
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• pp.9-15
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• 2015

본 연구는 10 kg 미만의 소형견에서 흉강경을 이용한 우측 중폐엽 절제술을 적용할 때, 적합한 포트 접근법의 설정을 위하여 실시되었다. 평균 체중 $8.67{\pm}0.49kg$의 비글견 10마리에서 전신 마취를 실시한 후 기관 내시경 유도하에 우측 주기관지를 폐쇄하여 편측성 분리폐 환기를 실시하였다. 포트는8-6-10 늑간과 8-6-5 늑간을 통한 두 가지 접근법으로 위치시켰고, 흉강경 우중폐엽 절제술에는 복강경용 자가 절단 스테플러와 검체 회수 주머니가 사용되었다. 각 접근법은 1) 시각화, 2) triangulation; 흉강내 기구간 충돌, 3) 스테플러의 폐문부 접근 및 적용의 용이성, 4) 검체 회수 주머니 사용의 장해 여부, 5) 술자의 편의도의 5가지 항목을 점수화하여 평가하였다. 모든 개체에서 편측성 분리 폐 환기에 의해 양호한 작업 공간이 확보되었고, 성공적인 흉강경 우중폐엽 절제술이 완료되었다. 어느 경우에서도 포트 위치를 수정할 필요는 없었으며, 의인성 합병증 역시 발생하지 않았다. 두가지 접근법 모두 높은 점수를 얻어, 이들은 10 kg미만의 개에서 편측성 분리폐 환기하에 자가 절단 스테플러를 이용한 흉강경 우중폐엽 절제술을 실시함에 적합한 것으로 확인되었다.

• Journal of Chest Surgery
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• 제17권1호
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• pp.89-93
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• 1984

These two pulmonary actinomycosis cases had undergone right upper lobectomy and left lower lobectomy individually under the diagnosis of lung cancer and lung abscess. Recently pulmonary actinomycosis is very rare by the widespread use of antibiotics. In addition to clinical similarity to lung cancer and pulmonary tuberculosis, lack of suspicion and difficulty in obtaining adequate culture material also hamper the precise preoperative diagnosis. The purpose of this report is to review of our experiences and to enhance consideration of pulmonary actinomycosis.

• Journal of Chest Surgery
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• 제53권2호
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• pp.53-57
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• 2020

Background: Video-assisted thoracoscopic surgery (VATS) lobectomy has become the major surgical option for the treatment of non-small cell lung cancer (NSCLC). Endoscopic instruments such as stapler cartridges are essential for VATS procedures. In this study, we investigated the factors that affect the number of stapler cartridges used in VATS lobectomy. Methods: A retrospective analysis was conducted of patients who underwent complete VATS lobectomy for NSCLC from January 2013 to December 2015. Results: In total, 596 patients underwent complete VATS lobectomy. The average number of stapler cartridges used for VATS lobectomy was 5.3±1.9. The number of stapler cartridges used for VATS lobectomy was higher in men (5.5±1.9 vs. 5.0±18, p=0.006), those aged older than 70 years (5.5±2.1 vs. 5.1±1.7, p=0.038), those who underwent upper or middle lobectomy procedures (5.7±1.9 vs. 4.1±1.2, p<0.001), those with a higher fissure sum average (p<0.001), and those in whom surgery was performed by a surgeon with a preference for staplers (5.6±2.0 vs. 4.9±1.6, p<0.001). Conclusion: The number of stapler cartridges required to perform VATS lobectomy in NSCLC patients appears to be influenced by sex, age, the location of the tumor, the degree of fissure development, and the surgeon's preference.

• Journal of Chest Surgery
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• 제26권3호
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• pp.236-240
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• 1993

Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

• 한국임상수의학회지
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• 제30권6호
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• pp.409-414
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• 2013

본 연구에서는 개에서 일반 개흉술을 통한 폐엽절제술과 흉강경을 이용한 폐엽절제술에서 심폐기능 및 생체 내 산화스트레스 상태에 미치는 영향을 비교 연구 하였다. 10 마리의 건강한 혼혈종을 사용하였고 일반 개흉술을 통한 폐엽절제술군 (group 1, n=5)과 흉강경을 이용한 폐엽절제술군 (group 2, n=5)으로 분류하였다. 심혈관계 측정 항목 및 superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx)의 농도를 측정하였다. 두 군에서 동맥혈액 가스의 유의적인 변화를 관찰 할 수 있었다. 총 마취 및 수술 시간은 개흉수술군에 비해 흉강경 폐엽 절제술군에서 유의하게 짧았다. 혈장 SOD와 CAT 수준의 증가, 그리고 GPX 수준의 감소는 수술 후 두 군 모두에서 관찰되었다. 두 군을 비교했을 때 GPX 수준에서 유의한 차이가 발견되었다. GPX 수준은 개흉 수술 군과 비교 흉강경 폐엽 절제술 군에서 유의하게 낮았다.

• Journal of Chest Surgery
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• 제55권3호
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• pp.225-232
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• 2022

Background: Pulmonary lobectomy is the standard of care for the treatment of early-stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national database and assessed the effect of regional block (RB) on postoperative outcomes. Methods: Patients who underwent lobectomy for lung cancer between 2014-2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program. The patients' primary mode of anesthesia and supplemental anesthesia were recorded. Preoperative characteristics and postoperative outcomes were compared between 2 surgical groups: those who underwent general anesthesia (GA) alone versus GA with RB. Multivariable regression analyses were performed on the outcomes of interest. Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative comorbidities were comparable between groups. Patients who underwent VATS were more likely to receive RB than those who underwent thoracotomy. RB was most often utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher rate of surgical site infections (SSIs). Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia in patients undergoing lobectomy for lung cancer. RB utilization was associated with a shorter length of hospital stay and an increase in SSI incidence.