식도 장 문합수술의 임상적 고찰

백효채,이두연,Baek, Hyo-Chae,Lee, Du-Yeon 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.11

Thirty patients who underwent esophageal resections due to esophageal carcinoma and benign strictures, and esophagovisceral anastomoses were performed by hand suture in 11 patients[Group I and by using the end to end anastomosis[EEA stapler in 19 patients[Group II . Anastomoses were performed in the thoracic cavity in 24 patients[Right 19, Left 5 and in the cervical area in 6 patients. There was one operative mortality[3.3% in a cancer patient who underwent Ivor-Lewis operation using EEA stapler. She expired on POD 38 days due to renal failure and sepsis. There were two anastomotic leakage in the sutured group and no anastomotic leakage in the stapled group. Late anastomotic strictures occurred in 10 patients[52.6% in the stapled group compared to 2 patients[18.1% in the sutured group. Most of the patients with late anastomotic strictures responded to one or two trials of TTS dilations. Using EEA stapler in performing esophagovisceral anastomosis is a safe method with acceptable range of complication rate, and total admission period after the operation for group I was 30.3 days compared to 25.4 days in group II although it had no clinical significance. The follow up was possible in 23 patients; 5 patients in group I died within mean 12.6 months and 9 patients in group II within mean 14.2 months.

폐동맥에서 공급받는 외엽형 폐격리증;1례 보고

백효채,박재희,이두연,Baek, Hyo-Chae,Park, Jae-Hui,Lee, Du-Yeon 대한흉부심장혈관외과학회 1993 Journal of Chest Surgery (J Chest Surg) Vol.26 No.11

Pulmonary sequestration is an uncommon congenital pulmonary malformations characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries. We have experienced a 30 year old male patient with a mediastinal mass complaining of intermittent chest pain, and the mass was histologically confirmed as extralobar pulmonary sequestration. The anomalous blood supply origined from the right pulmonary artery but there was no communication with the tracheobronchial tree. He underwent operation through midsternotomy incision for the purpose of concurrent resection of enlarged thymus noted on chest CT.

폐에 발생한 선편평상피세포암종;1례 보고

백효채 대한흉부심장혈관외과학회 1992 Journal of Chest Surgery (J Chest Surg) Vol.25 No.10

Adenosquamous carcinoma of the lung is a rare disease entity and its clinical characteristics, treatment, and prognosis are poorly described. Stage I disease are amenable to operation as in bronchogenic carcinoma of non-small cell type, but stage III adenosquamous carcinoma shows highly aggressive behavior with rapid progression. We have experienced a case of stage III adenosquamous carcinoma of the lung in a 38-year-old male with a large mass in the right upper lobe with multiple metastasis in the mediastinal lymph nodes. Interestingly, all of the metastatic lymph nodes proved to be adenous component histologically. After right pneumonectomy and extensive lymph node dissection, the patient had received one cycle of chemotherapy. However, clinical signs of distant metastasis to bone and brain were discovered within 5 months postoperatively.

식도의 소세포함 치험 1례

백효채 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.12

Small cell carcinoma is a highly malignant esophageal tumor composed of anaplastic small cells with features very similar to those of its pulmonary counterpart. The prognosis is poorer than that of squamous carcinoma of the esophagus because of its propensity of generalized spread and metastasis. Once the diagnosis of small cell carcinoma was established, surgery should be undertaken as early as possible. We have described an experience of small cell carcinoma of the lower esophagus in a 72 year old male patient with a review of the literatures regarding treatment methods and prognosis.

특정 분야에서 종양외과의사의 역할 : 흉부종양분야에서 종양외과의사의 역할

백효채 대한임상종양학회 2008 대한임상종양연구 심포지엄 Vol.2008 No.14

심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 1예 보고

백효채,홍유선,김도형,함석진,이교준,이두연,권혁문,김형중,조상호 대한흉부외과학회 2003 Journal of Chest Surgery (J Chest Surg) Vol.36 No.6

Heart-lung transplantation is a widely accepted treatment for Eisenmenger's syndrome. The patient is a 41-years-oldmale diagnosed with Eisenmenger's syndrome due to patent ductus arteriosus. The pressures were checked asfollows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg,right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery(diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligationof patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and wasdischarged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with nosigns of rejection. 심장-폐이식은 현재 선천성 심장 질환에 의한 이차성 폐동맥 고혈압 환자에서 최종적 치료로 알려져 있다. 본 41세 남자 환자는 동맥관 개존증에 의한 이차성 폐동맥 고혈압으로 진단되었으며 심도자 검사 결과 대동맥압 130/80 mean 100 mmHg, 폐동맥 130/80 mean 109 mmHg, 우심실 130/20 mmHg, 우심방 mean 20 mmHg이었고 우측 폐동맥의 직경이 7.5 cm로 심한 확장소견이 있어 심폐이식을 필요로 하였다. 장기 공여자는 24세 남자 환자로 교통사고에 의해 뇌 경막하 출혈로 타 병원에서 뇌사 판정을 받았다. 수술은 심폐 바이페스하에 동맥관 개존증을 결찰하고 심폐이식술을 시행하였다. 수술 후 1일째 호흡기를 이탈하였으며 3일째 일반 병실로 전원되었고 33일째 퇴원하였으며 41일째 시행한 심근과 폐 조직 검사 소견에서 거부 반응은 없었다.

흉강경을 이용한 식로근 절개술 -1례 보고-

백효채 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.8

Extramucosal esophagomyotomy by thoracotomy, first described by Heller in 1913 was the principal therapy for achalasia. Recently however, video-assisted thoracoscopic surgery has been implied in esophageal surgery, and we have experienced 23 year old male patient with dysphagia and was diagnosed as achalasia who underwent thoracoscopic esophagomyotomy. The esophagogram showed typical bird beak appearance and the lower esophageal sphincter pressure was increased to 35 mmHg. Thoracoscopic surgery was done twice due to incomplete myotomy in first operation and the patient was released of dysphagia in the second operation.

흉부종양분야에서 종양외과의사의 역할

백효채 대한종양외과학회 2008 대한임상종양학회 학술대회지 Vol.2008 No.3

전폐절제술 후 생긴 기관지 흉막루의 치료

백효채 대한흉부심장혈관외과학회 1994 Journal of Chest Surgery (J Chest Surg) Vol.27 No.8

A bronchopleural ~stula[BPF] is a major therapeutic challange to the thoracic surgeons due to difficulties in its management. We have experienced 9 cases of postpneumonectomy BPF, and all of them occured after the right side pneumonectomy. Seven patients underwent pneumonectomy due to lung cancer, and one patient each received pneumonectomy due to bronchiectasis and pulmonary tuberculosis. The most frequently used method of treatment was Eloesser operation which was done in 7 patients, and one had open thoracostomy and one had betadine irrigation until he died suddenly due to pulmonary vein rupture. The result of treatment was poor with five mortalities including one operative death. Two patients are in good condition in 28 months and 4 years of follow-up, but two are lost in follow-up. Tissue sealant such as Tisseel was used in three patients but seems to have no effect at all in the treatment of postoperative BPF.

폐 유육종증 1례 보고

백효채 대한흉부심장혈관외과학회 1995 Journal of Chest Surgery (J Chest Surg) Vol.28 No.10

Sarcoidosis is a granulomatous disease of unknown etiology. It frequently involves thoracic lymph node and pulmonary parenchyme characterized by non-caseating granulomas and varying degrees of fibrosis. We have experienced a pulmonary sarcoidosis in the left lower lobe of the lung in a 40 year old man who underwent left lower lobectomy by video-assisted thoracic surgery.