Hyperthermic intrathoracic chemotherapy with cisplatin for ovarian cancer with pleural metastasis

Intrathoracic metastasis of ovarian cancer has poor prognosis regardless of treatment modality. Recent development of surgical techniques and the new concept of direct infusion of chemotherapeutic agents with hyperthermia could help with the treatment of disseminated diseases in ovarian cancer. Using video-assisted thoracoscopic surgery and intracavitary chemotherapy with hyperthermia, we tried hyperthermic intrathoracic chemotherapy for a case of stage IV high-grade serous ovarian cancer with pleural metastasis. There was no high-grade complication related to the procedure. The patient is alive without disease at 32 months after initial treatment.

The Prognostic Factors of Traumatic Diaphragmatic Rupture / 대한흉부외과학회지

BACKGROUND: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. MATERIAL AND METHOD: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. RESULT: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. CONCLUSION: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

Risk Factor for Recurrence in Completely Resected Stage IB Non-small Cell Lung Cancer / 대한흉부외과학회지

BACKGROUND: Complete surgical resection is the most effective treatment for stage IB non-small cell lung cancer (NSCLC). Recurrence accounts for the disappointing survival rates after resection. There has been renewed interest in adjuvant therapy after complete resection. Appropriate selection of effective adjuvant therapy will depend on the prognostic factors for recurrence. MATERIAL AND METHOD: The study included 114 patients with completely resected stage IB NSCLC. The variables selected for the study were gender, age, the type of resection, cell type, the degree of differentiation, the tumor size and the presence of visceral pleura invasion. The Kaplan-Meier method was used to estimate the survival and disease-free survival rate. The results were compared using the log rank test. Multivariate analysis was performed by Cox's proportional hazard model. Two-sided p-valves <0.05 were considered to be statistically significant. RESULT: The 3-year overall survival and the disease-free survival rates were 87.0% and 79.4%, respectively. The degree of differentiation showed a significant influence on disease-free survival according to the univariate analysis. According to the multivariate analysis, a poor grade of differentiation was a significant poor prognostic factor. CONCLUSION: These results demonstrate that poor differentiation may be a poor prognostic factor for patients with completely resected IB NSCLC. Therefore, the patients with a poor grade of differentiation may require adjuvant therapies.

Clamp and Sew Technique without Distal Perfusion for the Management of Traumatic Descending Thoracic Aortic Rupture / 대한흉부외과학회지

BACKGROUND: Traumatic aortic rupture is a highly fatal condition in which a patient's outcome is strongly affected by other associated injuries. Selection of the appropriate surgical timing and the management plan is important. MATERIAL AND METHOD: The medical records of the 15 traumatic descending thoracic aortic rupture patients who underwent the clamp & sew technique were retrospectively reviewed and checked for the presence of associated injuries and the postoperative course. RESULT: The hospital mortality was 6.67% (one patient). This patient died intraoperatively and the cause of the death was delayed hemoperitoneum. The mean operative time and aortic clamp time were 231+/-53.1 and 13.1+/-5.3 minutes, respectively. One patient complained the bowel obstructive symptoms at postoperative 10 days. We found the mechanical bowel obstruction on computed tomography of the abdomen, and segmental bowel resection was done. CONCLUSION: Although several surgical strategies may be appropriate for managing traumatic aortic rupture, the clamp & sew technique is a safe and effective method for the treatment of traumatic aortic injury.

Mitral Valve Repair in Patient with Severe Mediastinal Shift to Right due to Pulmonary Hypoplasia: A case report / 대한흉부외과학회지

Pulmonary hypoplasia is an entity of pulmonary agenesis. Pulmonary agenesis is a rare congenital anomaly, usually diagnosed soon after birth. It is commonly associated with other anomalies, mainly of the cardiovascular systems. Although it may hasten the death of a child, sometimes it is compatible with normal growth. We report a right lateral thoracotomy approach for mitral valve repair in a young woman with pulmonary hypoplasia, in whom preoperative computed tomography showed severe right side shifting of the mediastinum and total collapse of the right lung.

Metastatic Pulmonary Hemangiopericytoma from Retroperitoneum: A case report / 대한흉부외과학회지

Hemangiopericytoma is a rare vascular tumor derived from the pericyte and usually occures in the lower extremities and the retroperitoneum. Complete excision is treatment of choice. Regular follow up is strongly recommended due to its potential malignancy which is recurrence and metastasis. We experienced surgical excision of metastatic pulmonary hemangiopericytoma from retroperitoneal hemangiopericytoma completely excised 10 years ago.