• Title/Summary/Keyword: space resection

Search Result 114, Processing Time 0.025 seconds

Development of Castleman Disease in the Paravertebral Space Mimicking a Neurogenic Tumor

  • Kwak, Yu Jin;Park, Samina;Kang, Chang Hyun;Kim, Young Tae;Park, In Kyu
    • Journal of Chest Surgery
    • /
    • v.52 no.1
    • /
    • pp.51-54
    • /
    • 2019
  • Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.

Microvascular Reconstruction of the Cranial Base Defects (두개저 결손의 미세수술적 재건술)

  • Minn, Kyung-Won;Kim, In-Chul;Lee, Min-Goo
    • Archives of Reconstructive Microsurgery
    • /
    • v.8 no.1
    • /
    • pp.71-76
    • /
    • 1999
  • Until recently, the cranial base tumors were deemed unresectable due to the inability to diagnose the extent of the involvement accurately and to approach and excise the tumor safely. With refinements in CT and NMR scanning and development of craniofacial techniques, reconstruction becomes absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, the free tissue transfer was a useful alternative because it can provide large amount of well-vascularized tissues and reliable separation of intracranial space from bacterial flora of the upper airway. The microvascular free tissue transfer was used in 9 patients at our center to reconstruct the cranial base defects. Of these, 8 were free rectus muscle flaps, and 1 was free latissimua dorsi muscle flap. There were 1 case of partial flap loss and 1 case of postoperative wound infection. The large, complex defects were successfully reconstructed by one stage operation and the functional and aesthetic results were satisfactory with acceptable complication rates.

  • PDF

Surgical Treatment of Pulmonary Aspergillosis (폐 Aspergillosis의 외과적 치료)

  • Go, Yeong-Sang;Kim, Min-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
    • /
    • v.26 no.9
    • /
    • pp.696-700
    • /
    • 1993
  • Pulmonary aspergillosis is relatively rare disease, most commonly presenting pre-existing cavitary disease. This investigation is designed to illustrate the clinical features, preoperative diagnosis and surgical role in the management of this disease. In retrospective review of opeative cases since Jan. 1988, total 16 cases were analysis. Peak incidence of age lies in the 3rd & 5th decade[81.3%].The common presenting symptoms were hemoptysis & blood tinged sputum[90.9%] & all cases had a history of treatment with antituberculous drugs, but the tuberculosis was revealed in only 3 cases in the pathologic studies on specimen after resection. The locations of lesion were upper lobes in 13 cases, lower lobe in 2 cases, and left whole lobe in 1 case. The operative procedures for treatment of aspergillosis were performed. The lobectomy was performed in 7 cases, lobectomy & segmentectomy in 2 cases, lobectomy & decortication in 2 cases, segmentectomy in 3 cases, bilobectomy & segmentectomy in 1 case and pneumonectomy in 1 case. There was one death due to respiratory insufficiency 21 days later,postoperatively, and empyemas & residual space problems were developed in 2 & 3 cases,respectively. The empyemas were treated with open thoracostomy and the dead spaces was filled with granulation tissues within 6 months. During follow up, there was no recurrence. In conclusion, surgical resection is the treatment of choice for symptomatic aspergillosis and needed in asymptomatic patient to prevent possible fatal sequelae in the future.

  • PDF

Limb-Salvage Surgery using Ilizarov Technique - Report of 2 cases - (Ilizarov술식을 이용한 사지 구제술 - 2례 보고 -)

  • Cho, Duck-Yun;Koh, Eun-Sung;Lee, Ji-Sup
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.1 no.2
    • /
    • pp.226-232
    • /
    • 1995
  • Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

  • PDF

Clinical Study of Pulmonary Resection for Tuberculosis (II) (결핵에 대한 폐절제술의 임상적 고찰 (제 II 보))

  • 유영선;유회성
    • Journal of Chest Surgery
    • /
    • v.7 no.2
    • /
    • pp.139-144
    • /
    • 1974
  • Clinical observations were made on 513 cases of pulmonary resection for tuberculosis, those were treated at the Department of Thoracic Surgery in National Medical Center from January 1964 to December 1973. 1. The ratio of male to female cases of operation was 2.8:1 in male predominence and age from 21 to 30 occurred 74.3% of the total cases. 2. The extent of disease showed 59.3% moderately advanced, 38.4% far advanced and 2.3% minimal cases. Duration of chemotherapy before surgery was more than one year in 92.7% and only 7.3% was treated less than one year. Preoperative sputum examination for AFB was persistent negative in 8.6,% of cases. 3. Different operative procedures were performed in 513 cases, lobectomy in 230, pneumonectomy and Pleuropneumonectomy in 172, segmentectomy in 63, lobectomy and supplemental segmentectomy with conventional thoracoplasty in 32 cases. 4. The postoperative complications occurred in 67 cases [13.0%]. Of these complications, bleeding in 4.6% , dead space problem in 2.5% and empyema with or without bronchopleural fistula occurred in 2.3% of cases. 5. Overall mortality within 5 months postoperative period was 1.5,0/0 and the most common causes of death were due to shock and empyema with bronchopleural fistula. 6. In all our 867 cases of report I and II, complications occurred in 13.9% and mortality rate was 1.8%.

  • PDF

Clinical Evaluation of Surgical Resection of Pulmonary Tuberculosis (폐결핵 환자에 적용된 폐절제 요법에 관한 검토: Automatic stapling device를 이용한 절제례의 검토)

  • 최강주
    • Journal of Chest Surgery
    • /
    • v.24 no.8
    • /
    • pp.782-791
    • /
    • 1991
  • In Pusan Paik Hospital, Inje University, we experienced 174 cases of pulmonary resections for pulmonary tuberculosis from Jun. 1979 to Feb. 1990. In all of them automatic stapling devices were used for division of lung parenchyme and /or bronchial closure. The results were as follows; l. In 174 cases[male 100, female 74], third and fourth decades were 116 cases [66.7%]. 2. Indications for lung resection in the radiographic findings were destroyed lung 47 cases[27.0%], destroyed lobe 42 cases[24.1%], cavitary lesions 42 cases[24.1%], tuberculoma 22 cases[12.7%], and bronchial lesions 21 cases[12.1%]. 3. The mean of staplers used in the operations was 1.6, and possible stapler-associated complications were only 2 cases of bronchopleural fistula after pneumonectomy. 4. Twenty-seven of 36 patients with bilateral lesions and 52 of unilateral ones on chest X-ray films were AFB positive on preoperative sputum smears. Twenty-three[85.2%] of bilateral lesions and 51[98.1%] of unilateral ones were AFB negative at 6 months after operations. 5. Main complications of resections were operative death 1[0.6%], empyema 4[2.3%], respiratory insufficiency 3[1.7%], pleural dead space 5[2.9%], and bronchial spreading of tuberculosis 2[1.1%]. Bronchopleural fistula were only 2 cases after pneumonectomy and none after lobectomy or segmentectomy. 6. One hundred and forty two patients[92.8%] of 153 with available follow-up data were in the state of good quality of life.

  • PDF

Surgical treatment of pulmonary aspergillosis (폐 Aspergillosis의 외과적 치료)

  • Jeon, Sang-Hun;Lee, Jong-Tae;Kim, Gyu-Tae
    • Journal of Chest Surgery
    • /
    • v.22 no.1
    • /
    • pp.170-175
    • /
    • 1989
  • Eleven cases of pulmonary resection had been performed for pulmonary aspergilloma in the department of thoracic and cardiovascular surgery, School of Medicine, Kyungpook National University from August 1984 to July 1988. The patients were consisted of six males and five females and were evenly distributed from third decade to sixth decade. Hemoptysis was usually presenting symptom [72.2%] and the variable was the interval between symptom onset to surgical resection, which was ranged from few months to several years In the plane chest films, intracavitary fungus balls were noted in five cases [5/11] and upper lobe involvements were seven cases [7/11]. Aspergillus fumigatus was identified preoperatively in three cases among the eight cases of sputum culture. Mean preoperative FVC and FEV 1.0 values were in normal range. Eleven pulmonary resections were done by eight lobectomies, two segmentectomies and one pneumonectomy. The lesion was superimposed upon old tuberculosis in eight patients, in one upon bronchiectasis and in two upon tuberculous bronchiectasis. Five complications appeared postoperatively which included ARDS [1 case] bleeding [2 cases], persistent air leak[1 case], and dead space [1 case].

  • PDF

Surgical Treatment of a Tuberculous Abscess of the Chest Wall

  • Keum, Dong-Yoon;Kim, Jae-Bum;Park, Chang-Kwon
    • Journal of Chest Surgery
    • /
    • v.45 no.3
    • /
    • pp.177-182
    • /
    • 2012
  • Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

Is conservative treatment (enucleation using modified Carnoy's solution) of odontogenic keratocyst in the maxilla good prognosis?

  • Woo Young Jeon;Jung Ho Park;Jeong-Kui Ku;Jin-A Baek;Seung-O Ko
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.49 no.5
    • /
    • pp.287-291
    • /
    • 2023
  • Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, suchas resection. As an alternative, this report introduces a modified Carnoy's solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy's solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy's solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy's solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

Clinical Results Following Early Tailoring Thoracoplasty in Patients Undergoing Pulmonary Resection (폐의 부분절제수술를 시술받은 환자에서 조기 변형식 흉곽성형수술에 따른 임상결과)

  • Choi, Soon-Ho;Cha, Byung-Ki;Lee, Mi-Kyung;Park, Kwon-Jae;Lee, Sam-Youn;Choi, Jong-Bum
    • Journal of Chest Surgery
    • /
    • v.40 no.7 s.276
    • /
    • pp.485-491
    • /
    • 2007
  • Background: Thoracoplasty has become a rarity in current clinical practice, although it has been widely employed for well over a century as a procedure for reducing the capacity of the thoracic cavity. Yet we have perform tailoring thoracoplasty following or concomitant with pulmonary resection in 20 patients. The aim of this study is to evaluate the early and late clinical results and also the significance of tailoring thoracoplasty. Material and Method: From March 1995 to June 2005, modified thoracoplasty following or concomitant with pulmonary resection was performed in 20 patients out of a total of 298 pulmonary resections for closing air leaks and for treating persistent pleural space following pulmonary resections, and to tailor the thoracic cavity to accept a diminished lung volume. Of the 20 patients, 14 patients had tailoring thoracoplasty performed concomitant with pulmonary resection, and the remaining 6 patients also had tailoring thoracoplasty performed following pulmonary resection. The subjects ages ranged from 24 to 77 (mean $59.1{\pm}6.4$) and a male preponderance was noted (17 : 3); the number of left and right surgeries was equal. The preoperative primary underlying diseases were lung cancer in 7 patients, pneumothorax with giant bullous change in 6 patients, bronchiectasis in 2 patients, previous pulmonary tuberculosis associated with aspergilloma in 2 patients, empyema with fibrothorax in 2 patients and multiple lung abscesses & destruction due to previous trauma in 1 patient. The operative methods were apicolysis and subperiosteal removal of the 2nd, 3rd and 4th ribs (the costochondral junction to the posterior portions of the ribs) with preservation of the first rib and compression of the anterior chest via cotton bags and elastic bandages. Result: The mean duration of the air leaks after thoracoplasty was $1.6{\pm}0.2$ days (range: $0{\sim}7$ days) and the mean duration of an indwelling chest tube was 7 days (range: $5{\sim}11$ days); the mean duration of hospitalization was $19.2{\pm}2.8$ days (range: $8{\sim}47$ days). The postoperative complications were wound infection (2) and pneumonia (2); reoperation was done due to bleeding (1) in one patient who underwent concomitant thoracoplasty and there was 1 case of wound infection (1) after postresection thoracoplasty. The mortality was 1 patient in the early phase and 4 patients in the late phase. Conclusion: We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural spaces and to accommodate the diminished lung volume with acceptable cosmetic results when this procedure is combined with pulmonary resection in selected patients.