A Successful Direct Phrenic Nerve Reconstruction in the Course of Malignant Thymoma Resection

악성 흉선종 절제술 중의 성공적인 횡격막 신경 직접 재건술

  • Lee, Seong-Kwang (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Yeon-Soo (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Park, Kyung-Taek (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Jang, Woo-Ik (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Ryoo, Ji-Yoon (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Chang-Young (Department of Thoracic and Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Cho, Seong-Joon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kangwon National University) ;
  • Choe, Hyun-Min (Department of Cardiovascular Surgery, Ilsan Paik Hospital, College of Medicine, Inje University)
  • 이성광 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 김연수 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 박경택 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 장우익 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 류지윤 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 김창영 (인제대학교 의과대학 일산백병원 흉부외과학교실) ;
  • 조성준 (강원대학교병원 흉부외과) ;
  • 최현민 (인제대학교 의과대학 일산백병원 순환기내과학교실)
  • Published : 2009.06.05

Abstract

We performed nerve resection and reconstruction of the phrenic nerve in a 63-year-old female patient who underwent complete resection of a malignant thymoma. The left phrenic nerve was completely encased by the tumor for 2 cm. Thus, a 3 cm long piece of phrenic nerve with 5 mm margins of safety on each end was resected and it was directly anastomosed in an end-to-end fashion. At 11 months after reconstruction, fluoroscopy demonstrated adequate and symmetric motion of both hemidiaphragms, which indicated the restoration of phrenic nerve function. The pulmonary function test results were comparable to those obtained preoperatively at 30 months. There has been no evidence of recurrence at the recent follow up visits.

63세 여자 환자의 악성 흉선종 절제수술 시에 횡격막 신경의 절제 및 복원술이 시행되었다. 수술 소견상 좌측 횡격막 신경이 2 cm정도의 길이로 종양에 완전히 둘러싸여 있어서 위아래로 5 mm 길이의 여유를 두고 3 cm정도의 횡격막 신경을 절제하였으며 직접 단단 문합 하였다. 수술 후 11개월에 시행한 투시진단에서 양측 횡격막은 적절하고 대칭적인 움직임을 보임으로서 신경기능의 회복을 시사했다. 수술 후 30개월에 시행한 폐 기능 검사 결과는 수술 전의 소견과 유사하였다. 환자는 재발 없이 현재 외래 추적 관찰 중이다.

Keywords

References

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