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一側肺 全剔出術 100例에 對한 臨床的 考察

A Clinical Review of the 100 Cases of Pneumonectomy

대한흉부외과학회지 1970년 3권 1호 p.3 ~ 12
金珍植, 金義潤, 孫載鉉,
소속 상세정보
金珍植 (  ) - 釜山醫大 胸部外科
金義潤 (  ) - 釜山醫大 胸部外科
孫載鉉 (  ) - 釜山醫大 胸部外科

Abstract


During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital.
This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage.
The results were obtained as follows.
1. Left pneumonectomy was done in sixty-six of 100 patients (66 per cent) and the right one was done in the rest thirty-four (34 per cent). The ratio between left and right was nearly 2:1.
2. Of all postoperative complications, the intrapleural infection was most common, and these were 53 per cent in empyema thoracis and 12.7 per cent in pulmonary tuberculosis respectively.
3. More postoperative complications could be seen after right pneumonectomy than the left one.
4. It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy, postoperative tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver.
5. The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window.
6. Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy.
7. The mortality rate was 10 per cent in our cases and and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.

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