• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3071-3074
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• 2014

Background: To investigate the related risk factors of postoperative nosocomial pneumonia (POP) in patients withI-IIIa lung cancer. Methods: Medical records of 511 patients who underwent resection for lung cancer between January 2012 to December 2012 were retrospectively reviewed. Risk factors of postoperative pneumonia were identified and evaluated by univariate and multivariate analyses. Results: The incidence of postoperative pneumonia in these lung cancer patients was 2.9% (15 cases). Compared with 496 patients who had no pneumonia infection after operation, older age (>60), histopathological type of squamous cell carcinoma and longer surgery time (>3h) were significant risk factors by univariate analysis. Other potential risk factors such as alcohol consumption, history of smoking, hypersensitivity, hypertension, diabetes mellitus and so on were not showed such significance in this study. Further, the multivariate analysis revealed that old age (>60 years) (OR 5.813, p=0.018) and histopathological type of squamous cell carcinoma (OR 5.831, p<0.001) were also statistically significant independent risk factors for postoperative pneumonia. Conclusions: This study demonstrated that being old aged (>60 years) and having squamous cell carcinoma histopathological type might be important factors in determining the risk of postoperative pneumonia in lung cancer patients after surgery.

• Journal of Chest Surgery
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• v.26 no.4
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• pp.329-332
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• 1993

Breakdown of the normal protective function of the larynx, either through primary or neurologic cause, leads to chronic aspiration, recurrent pneumonitis and possibly death. Lindemann`s tracheoesophageal diversion has three main advantages; first, it eliminates intractable aspiration in all patients who underwent the procedure, second, it preserves larynx, and third, if the underlying neurologic condition is recorved, the procedure can be reversed. We had performed tracheoesophageal diversion in two cases of intractable aspiration pneumonia patients. The postoperative courses were uneventful and they were receiving oral alimentation on the 22th and 9th postoperative days respectively, and could be discharged on 43th and 20th postoperative days respectively.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.133-139
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• 1984

Ten cases of the right middle lobe syndromes were experienced. Nine out of ten were treated surgically, six-right middle lobectomy, one-right middle and lower lobectomy, one-right middle lobectomy and decortication, one-incidental right pneumonectomy. Pathologic diagnosis were tuberculosis in five, bronchiectasis in two, organizing pneumonia in one, and foreign body granuloma in one. There were three postoperative complications, postoperative empyema-1, pleural effusion-1, pneu-monia-1. The surgical candidates for middle lobe syndromes were; 1.Suspicious malignancy 2.Fixed bronchiectasis 3.Bronchostenosis 4.Intractability to medical treatment or recurrent atelectasis and obstructive pneumonia.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3259-3263
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• 2016

Aims: To determine suitable food textures for videofluoroscopic study of swallowing (VFSS), in order to predict and prevent subsequent aspiration pneumonia in esophageal cancer patients with dysphagia after surgery. Materials and Methods: We evaluated 45 hospitalized esophageal cancer patients who underwent surgery between January 2012 and December 2013. The control group consisted of 43 patients treatmed from January 2010 until December 2011 and were not examined by VFSS. Test foods, which were presented in order of increasing thickness, included thin barium sulfate (Ba) liquid (3 or 10 ml), slightly thickened Ba liquid (3 or 10 ml), a spoonful of Ba jelly, and a spoonful of Ba puree. Results: Patients could most safely swallow puree, followed by jelly. The 3-mL samples of both the thin and thick liquids put patients at risk for aspiration pneumonia, with incidence rates of 13% and 11%, respectively. While 64.4% of patients could swallow all test foods and liquids safely, 35.6% were at risk for aspiration pneumonia when swallowing liquids. Even though >30% of patients were at risk, only 1 (2.2%) in the VFSS group developed aspiration pneumonia, which occurred at the time of admission. Following VFSS, no incidence of aspiration pneumonia was observed. However, aspiration pneumonia occurred in 4 (9.3%) control patients during hospitalization. Conclusions: Postoperative esophageal cancer patients were more likely to aspirate any kind of liquid than solid foods, such as jellies. VFSS is very useful in determining suitable food textures for postoperative esophageal cancer patients.

• Journal of Gastric Cancer
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• v.20 no.3
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• pp.267-276
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• 2020

Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58-0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.613-619
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• 1993

As developing surgical techniques and postoperative cares, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other type of pulmonary resection, but a postpneumonectomy complication is a life-threatening serious problem if it occurred. We performed one hundred twenty-five cases of pneumonectomy for treatment of various causes of pulmonary diseases in Kosin Medical College during about ten years, and we experienced 41 cases of postoperative complications in 29 patients, so we analyzed them. The most common complication is an empyema thoracis in 13 cases[10.4%], of which one case combined with bronchopleural fistula died on early postoperative day. Of them except one case, the early postoperative empyema thoracis[within 30 days] were 6 cases, and the late postoperative empyema thoracis[above 30 days] were 6 cases. The main etiologic pathogens were a staphylococcus in early postoperative empyema and a streptococcus in late postoperative empyema, but the most cases were mixed infections with pseudomonas, klebsiella, acinectobacter, and candida. The treatment of postoperative empyema thoracis were that 4 cases were treated with open drainage using chest tube, 7 cases with Clagett`s operation, and 1 case with thoracoplasty. The next common complication was a postoperative serious respiratory insufficiency in 7 cases. And the other complications were massive postoperative bleeding in 5 cases, of which 2 cases advanced to occurrence of postoperative empyema thoracis, and wound disruption in 4 cases, cardiac arrhythmia in 3 cases, contralateral pneumothorax and pneumonia in each of 2 cases, esophagopleural fistula in 1 case. The postoperative deaths were 9 cases[7.2%] of 125 cases, the causes of death were respiratory insufficiency in 6 cases, sepsis in 2 cases, and cardiac arrhythmia in 1 case.

• Women's Health Nursing
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• v.23 no.1
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• pp.42-51
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• 2017

Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1052-1055
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• 1994

Congenital esophageal atresia without tracheoesophageal fistula which called isolated esophageal atresia is a very rare entity and the neonate classified as category C by Waterston`s classification has high mortality rate. We experienced a case of isolated esophageal atresia. This patient was a male with 1,750gm in body weight and had been suffered from bilateral pneumonia. The patient was managed with staged operation. Feeding gastrostomy was made as the first intervention and delayed primary anastomosis was performed 3 months later. The postoperative course was uneventful and he was discharged on the 22nd postoperative day.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.309-315
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• 1990

The introduction of end-to-end anastomosis stapler [EEA stapler] into esophageal surgery has reduced the mortality and morbidity associated with esophageal resection mainly owing to a reduction in the incidence of accidence of anastomotic leak. We now report the results of the 37 patients undergoing esophagectomy or esophagogastrectomy with EEA stapler in the department of cardiothoracic Surgery, Kosin Medical Center No leakage was demonstrated in the 37 esophagogastric anastomotic sites, but dehiscence of the TA stapled gastrotomy suture line occurred in two patient One patient was recovered with conservative treatment but the other patient was died due to hepatic metastasis of esophageal carcinoma during conservative treatment. And one severe esophagogastric anastomotic stricture was developed at the 30th postoperative day, but improved after dilatation with balloon dilatation catheter of Swiss Med. Tech. Company. The other complications were postoperative pneumonia[1 case], wound disruption and infection[3 cases], but all of 4 patients were recovered with conservative treatment. We experienced relative good postoperative results with use of EEA stapler in esophageal surgery. On the basis of our experience, we believe that the EEA stapler has definite place in esophageal surgery.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.