Surgical Treatment of Bronchial Restenosis Occuring After Insertion of Self-Expandable Metalic Stent in Patients with Bronchial Stenosis -2 Cases Reports-

기관지협착환자에서 기관지내 팽창성 급속 스텐트 삽입후 재발한 기관지협착 치험 2례

  • Kim, Woo-Chan (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Jin, Ung (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Rha, Suk-Joo (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Jo, Keon-Hyon (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Lee, Sun-Hee (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Kwack, Moon-Sub (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Kim, Se-Wha (Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College)
  • 김우찬 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 진웅 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 나석주 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 조건현 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 이선희 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 곽문섭 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 김세화 (가톨릭대학교 의과대학 흉부외과학교실)
  • Published : 1995.05.01

Abstract

Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.

Keywords

References

  1. Radiology v.158 Tracheobronchial tree : expandable metallic stents used in experimental and clinical applications Wallace,M.J.;Charnsangavej,C.;Ogawa,K.(et al.)
  2. 대한방사선과 의학회지 v.27 no.3 팽창선 금속 스텐트 : Tracheobronchial tree에서의 실험적 연구 및 예비적 임상 경험 송호영;이상용;정진영(등)
  3. AJR v.159 Bronchial stenosis due to endobronchial tuberculosis : sucessful treatment with self expanding metalic stent Han,J.K.;Im,J.G.;Park,J.H.;Han,M.C.;Kim,Y.W.;Shin,Y.S.
  4. Ann Thorac Surg v.54 Expanding wire stents in benign tracheobronchial disease indications and complications Samer,A.M.N.;Claire,D.;Jean-Francois,V.;Louis,L.;Louis,C.
  5. 결핵 및 호흡기질환 v.41 결핵성 기관지 협착시 팽창성 금속 스텐트 시행후 발생한 육아종 형성 1례 임성희;유관희;이용철;이양근
  6. Ann Thorac Surg v.56 Indications for a expandable metalic stent for tracheobronchial stenosis Hiroaki,N.;Ryuichirou,K.;Kenichi,K.;Shojiroh,M.;Kenji,O.