• Journal of Chest Surgery
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• 제12권2호
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• pp.93-96
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• 1979

One case is presented in which there was radiographic evidence that pleural space fluid disappeared at the 15th day after pneumonectomy. Clinical course was uneventful and the space was refilled at the postoperative fifth month. This complication was probably due to the presence of small a bronchopleural fistula, in spite of the difficulty experienced in its demonstration. Conservative management is recommended with frequent clinical and radiographic observations, so that early surgical intervention may be undertaken if an overt bronchopleural fistula results.

• Journal of Chest Surgery
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• 제27권12호
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• pp.1047-1051
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• 1994

Airway obstruction may be caused by extreme mediastinal shift and rotation after right pneumonecotmy or after left pneumonecotomy in the presence of right aortic arch.We experienced such a complication after right pneumonectomy, so called right postpneumonectomy syndrome. The patient was 28 years old female, and 4 month ago she had undergone right pneumonecotomy via video assisted thoracoscopic surgery[VATS] for endobronchial tuberculus dissemination and secondary pulmonary infection. She was treated by mediastinal repositioning which were composed of substernal fixation of pericardium and insertion of expandable prosthesis of 1000 cc capacity. She had good postoperative course and now she feels no obstructive symptoms.

• Journal of Chest Surgery
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• 제27권5호
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• pp.374-378
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• 1994

Bronchoplastic and angioplastic operation in lung surgery is appropriate treatment for a wide range of benign endobronchial lesions and low grade malignancies. Between March 1990 to February 1994, four patients underwent bronchial sleeve resection and one patient received left upper lobe lobectomy with pulmonary artery angioplasty. Types of disease includes two cases of endobronchial tuberculosis and three cases of lung cancer. The main operation performed are one pneumonectomy, two right upper lobectomy and one each of left upper lobectomy and left lower lobectomy. All cases received sleeve resection not due to decreased respiratory reserve but due to anatomic suitability. One patient who received pneumonectomy had postoperative complication of empyema thoracis.

• Journal of Chest Surgery
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• 제36권6호
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• pp.444-447
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• 2003

기관분기부에 침범한 악성 종양의 치료로 이용되는 소매 전폐 절제술은 수술 후 높은 유병률과 사망률을 동반하나 기관 분기부위의 악성 종양이 일측 폐를 완전히 허탈시키고 반대편 기관지의 허탈의 가능성이 있는 경우는 좋은 수술적 방법이 될 수 있다. 본 64세된 남자환자는 과거력에서 13년 전에 승모판 협착증 및 삼첨판 폐쇄 부전증으로 타 병원에서 승모판 치환술 및 삼첨판륜 성형술을 시행 받았으며 2년 전에는 성대에 생긴 유두종으로 종양절제술을 시행받았다. 최근에는 혈담을 주소로 내원하여 기관지내시경 및 흉부 컴퓨터단층촬영에서 하부 기관부터 좌측 주 기관지까지 약 3.5 cm의 악성 편평상피세포암이 관찰되었으며 좌측 주 기관지를 완전히 막고 있는 소견이 있었고 grade III의 삼첨판 폐쇄부전이 있었다. 심폐 바이페스 없이 순차적 양측 후측방 개흉술을 통해 좌측 소매 전폐절제술을 시행하였고 수술 후 병리 조직검사에서 T4N0M0인 악성 편평상피세포암으로 확인되었고 수술 후 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제31권6호
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• pp.624-628
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• 1998

전폐 절제술후 증후군은 드문질환이지만 종격동내 혈관의 정상적인 해부학적인 구조를 가진 대부분의 환자에서 전폐 절제술후에 지연 합병증으로 올수 있다. 이증후군의 임상증상으로는 대개 수술후 1년 이내에 나타나는 호흡곤란과 남아 있는 우측폐의 반복되는 감염이다. 전폐절제술후 이차적인 변화로 종격동이 좌측으로 끌려가면서 심장과 대혈관이 시계방향으로 회전하고 우측폐가 좌측 흉부 전방까지 확장되면서 나타나는 것으로 믿어지고 있다. 이와 같은 변화로 우측 폐동맥과 흉추사이에 끼이면서 기관과 우측 주기관지가 눌려지게 된다. 본 영동세브란스병원 흉부외과에서는 21세 여자환자에서 6년전에 기관지확장증으로 좌측 전폐절제술후 발생한 전폐절제술후 증후군을 좌측 개흉술후 종격동의 박리와 확장 보조물을 삽입하여 종격동 정복(mediastinal repositioning)을 시행하였고 환자의 증상은 수술후 소실되었으며 수술후 별다른 합병증 없이 퇴원하여 외래 추적관찰 중이다.

• 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.

• Journal of Chest Surgery
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• 제26권11호
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• pp.851-855
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• 1993

Among elevn consecutive cases having undergone Completion Pueumonectomy[CP]between 1958 and Aug. 1993 at the Dep. of Thoracic & Cardiovascular Surgery in National Medical Center. The patient`s mean age was 43 years[range 28 yrs, to 68yrs.],& they consisted with 10 males and 1 female. The indications for CP were benign diseases in 9 cases & 2 cases of lung cancer. The mean interval between the first operation & CP was 62.3 months[from 17 days to 288 months]. The several special intraoperative procedures such as intrapericardial pulmonary vesselsdivision & suture ligation, reinforcement of bronchial stumpmargin, & applied the Fibrin glue & hemostatics. The mean intra operative bleeding was 3582ml.[1500ml. to 6500ml.] The post orerative complication were developed in 5 cases[45.5%] they were empyema with BPF in 2 cases, empyema in 2 cases, & 1 case of repiratoy insufficiency which leading to death. We concluded that the C P noted high morbidity & mortality compared with ordinary first pulmonary resectional surgery. But, it will be a challenge to improved the morbidity because of increasing trend of completion pneumonectomy in a furture time.

• Journal of Chest Surgery
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• 제50권1호
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• pp.50-53
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• 2017

A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.

• Journal of Chest Surgery
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• 제26권10호
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• pp.769-774
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• 1993

Thoracic empyema is defined as purulent pleural effusion or effusion with positive bacteriology. Recently, the empyema has markedly decreased by developement of antibiotics, but empyemas following thoracotomy were occasionaly reported. During the period of January, 1985 to May,1991, 18 patients with postthoracotomy empyema have been treated in the Department of Thoracic and Cardiovascular Surgery of Chonbuk National University Hospital.There were 17 males and 1 female ranged from 18 years to 67 years of age. The underlying diseases of empyema were tuberculosis [50%], lung cancer [33.3%], esophageal cancer [11.1%],and aspergillosis with tuberculosis[5.6%]. In surgical procedures causing the empyema, there were lobectomy[38.9%], pneumonectomy[22.2%], decortication[16.7%], decortication & lobectomy[11.1%], and esophagectomy [11.1%]. Etiologic organisms in the pleural fluid were Pseudomonas [27.7%], S.aureus [16.7%], mixed infection [16.7%], K.pneumonia [5.6%], M.tuberculosis [5.6%], and no isolation [27.7%]. In 6 cases with BPF, completion pneumonectomy was performed in 1 case, and open thoracostomy in 5 cases. In 12 cases without BPF, closed thoracostomy was performed in 1 case, decortication in 2 cases, decortication & open thoracostomy in 2 cases, and open thoracostomy in 7 cases. In 6 cases with BPF, the fistulas were closed in 4 cases at follow up, the other 2 cases died from pulmonary insufficiency after completion pneumonectomy and open thoracostomy,respectively. In 12 cases without BPF, the empyema cavities were filled with expanded lungs and granulation tissues, except 1 case died from sepsis.

• Journal of Chest Surgery
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• 제21권1호
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• pp.109-115
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• 1988

With the decreasing incidence of new cases and the highly effective results with antituberculous drug therapy, there is a marked decline in the need for surgery which was formerly such an important part in the successful program of management of this disease. During the period of two years and a half from Jun. 1984 to Dec. 1986, this study represents an analysis of 163 cases of several surgical management for eventual control of pulmonary tuberculosis at National Kon-ju tuberculosis Hospital. 1. Mode of surgical treatment was: Resection; 123 cases [Pneumonectomy: 83, lobectomy: 35, lobectomy plus segmentectomy; 4 segmentectomy: 1], thoracoplasty: 20 and others: 20. 2. Age distribution ranged 16and 68 with average of 34 years. Male and female ratio was 1.2: 1. 3. Surgical indications were: totally destroyed lung; 64, Destroyed lobe of segment; 13, cavity positive sputum; 10, cavity c negative Sputum; 6, Bronchostenosis c atelectasis; 2, empyema c or s BPF; 46, Aspergilloma; 8, Questions of Associated tumor; 4 and other 5. 4. Incidence of Complications was 10.4% and the mortality was 5.5 percent. The cause of mortality were analyzed. The main causes of death were respiratory insufficiency; 4, fulminant hepatitis; 1, hemorrhage; 1 and unknown; 1 in pneumonectomy, and asphyxia; 1 in lobectomy and sepsis; 1 in other procedure. 5. Conversion rare of positive sputum to negative state related to resectional surgery was 91.5%. In pneumonectomy, drug resistant group preoperatively showed 88.1% conversion rate postoperatively and drug sensitive group showed that 100% conversion rate. In lobectomy, both drug resistant and sensitive groups showed that 100% conversion rate postoperatively.