• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.327-331
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• 1997

One of the most difficult airway problems is a subglottic stenosis combined with a tracheal stenosis. Laryngotracheal stenosis has not been completely solved with classic methods like cricotracheal split with autogenous cartilage graft, thyrotracheal anastomosis, and free hyoid or hyoid-sternohyoid myo-osseous flap reconstruction. A 28-near-old male patient who had had laryngotracheal stenosis was successfully treated by laryngotracheal reconstruction using vascularized clavicle. This method has a several advantages: the vascularized clavicle harvesting in the same operative fields, one stage operation, less restenosis due to plentyful blood supply, md prevention of airway collapse due to a clavicle provided framework. It is too early to make a definite conclusion, but the authors suggested that this method could become one of the most effective methods of laryngotracheal stenosis.

• Journal of Chest Surgery
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• v.41 no.3
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• pp.399-403
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• 2008

Carinal resection is technically demanding and the surgical risk is relatively high. When tumor is confined around the carina, then lung parenchymal sparing surgery is technically feasible in selected cases. We performed carinal resection and reconstruction without pulmonary resection for a patient suffering with squamous cell carcinoma that involved the carina and this patient had undergone right upper lobectomy 19 months previously due to lung cancer.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.670-673
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• 2009

A 20 year old woman had developed stenosis at the lower part of the trachea, right main bronchus, and right upper lobe bronchus as a complication of endobronchial tuberculosis. The patient had complained of severe dyspnea. Tracheobronchial stenosis was so extensive that we did reconstruction of the trachea and right bronchus with resection of the lower trachea and right main bronchus and right upper lobectomy. She has been doing well without any respiratory symptoms or complications.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.3-14
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• 1983

In recent years there has been considerable interest in reconstructive surgery of the trachea for cervical tracheal stenosis developed by complication of endotracheal intubation or tracheotomy, or trauma of the neck. The methods used to reconstruct the tracheal defects can be repaired with end-to - end anastomosis, cervical flaps, and autogenous graft materials. Since Grillo had undertaken tracheal reconstruction after circumferential resection in dogs, resection and end - to - end anastomosis was used in cases of circumferential stenosis. And, costal, nasal septal and auricular cartilage have been used for the autogenous graft materials. Since Caputo and Consiglio had undergone tracheoplasty with auricular cartilage, Morgenstein reported successful repair of a tracheal defect with a composite postauricular cartilage graft. The advantages of the auricular cartilage graft are its easy accessibility, availability and familiarity to the otolaryngologist. In past 2 years, We performed the tracheoplasty with auricular cartilage graft and end- to end an astomosis after segmental resection in 5 patients who had suffered from tracheal stenosis. And we obtained good results. So, we reported the cases with review of the literatures.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.283-291
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• 2009

Background: Tracheal reconstruction after extended tracheal resection still remains as a major surgical challenge because good clinical outcomes are usually correlated with limited tracheal resection. Recent investigations with a using cryopreserved trachea for the reconstruction of a trachea have been carried out to overcome this problem. In this study, we analyzed viability of tracheas, which is an important determining factor for the success of transplanting a cryopreserved trachea and the development of post-transplantation tracheal stenosis, according to three different experimental factors: 1) the warm-ischemic time, 2) the cryopreservation solution and 3) the preserving temperature, to determine a better cryopreservation protocol and a better composition of the cryopreservation solution. Material and Method: Rats tracheas were harvested for different warm-ischemic times (0 hr, 12 hrs, 24 hrs). The tracheas were treated with recombinant insulin growth factor-1 (IGF) and they were stored at three different temperatures $(4^{\circ}C,\;-80^{\circ}C,\;-196^{\circ}C)$ for two weeks. After two weeks, we thawed the stored trachea and isolated the cells of the tracheas with using type II collagenase. We cultured the cells for seven days and then we compared the cellular viability by the MTT reduction assay. Result: Though cryopreservation is required to preserve a trachea for a longer time period, the viability of the tracheas stored at $-80^{\circ}C$ and $-196^{\circ}C$ was significantly reduced compared to that of the tracheas stored at $4^{\circ}C$. The viability of the tracheas with warm-ischemic times of 12 hrs and 24 hrs was also reduced in comparison to the tracheas with a warm-ischemic time of 0 hrs. Our data showed that the warm ischemic time and the parameters of crypreservation negatively affect on trachea viability. However, a cryopresrvation solution containing IGF-1 improved the cellular viability better than the existing cryopreservation solution. For the warm ischemic time group of a 0 hr, the addition of IGF-1 improved the viability of trachea at all the preserving temperatures. Conclusion: These experiments demonstrate that the viability of cryopreserved trachea can improved by modifying the components of the crypreservation solution with the addition of IGF-1 and reducing the warm-ischemic time.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.63-70
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• 1996

Reconstruction for hypopharynx and cervical esophagus after wide resection of extensive hypopharynx and larynx cancers have been used various methods including myocutaneous flaps, gastric pull up, md jejunal or large bowel free graft. Recently, the authors had experienced hypopharynx and larynx cancers with extension to the posterior hypopharyngeal wall and thoracic esophagus. Of course, these reconstructive methods should be selected in accordance with the patient's age, physical status, extend of prim.:W lesion, and defect after on block resection, however, gastric pull up was performed in hypopharynx cancer which had skipped lesion in the thoracic esophagus and jejunal free grafts were performed in case 2, 3 which had a extended lesions to the posterior pharyngeal wall. Some complications were noted, which were successfully stabilized by conservative managements. The gastric pull up and jejunal free graft were considered suitable methods for reconstrunction of hypopharynx and cervical esophagus, however, further studies are necessary about it.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.30-32
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• 2010

Tracheo-gastric fistula is a very rare late complication of total laryngopharyngoesophagectomy with gastric pull-up procedure. It usually occurs after transhiatal esophagectomy, but it has only rarely been reported after total laryngopharyngoesophagectomy with gastric pull-up procedure. Chronic irritation and gastric ulcer may be the cause of tracheogastric fistula. To prevent fistula formation, active management of gastric ulcer and avoidance of mucosal irritation are necessary. We report a case of a tracheogastric fistula which occurred two years after total laryngopharyngoesophagectomy with gastric pull-up procedure that maybe occurred by chronic irritation and gastric ulcer.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1995.04a
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• pp.92.2-92
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• 1995

후두암 및 하인두암의 광역절제후 결손된 하인두 및 경부식도의 재건방법에는 여러 근피판, 인두위 문합이나 유리공장이식술과 같은 소화장기의 이용 및 전박유리피판술 등이 있다. 저자들은 1985년부터 1994년까지 10년간 세브란스병원에서 후두 및 하인두암으로 수술적 치료를 받은 예중 인두위문합술로 재건한 7례, 유리공장이식술로 재건한 9례, 전박유리피판술로 재건한 7례의 치료성적을 후향적으로 고찰하여 하인두 및 경부식도의 재건에 사용할 수 있는 술식들의 치료결과 및 장단점을 알아보고자 하였다. 피판의 생존은 세가지 술식 모두에서 양호하였으며 구강을 통한 식이섭취가 전례에서 가능하였다. 발생한 합병증으로는 인두피부누공, 문합부위의 협착 등이 있었으며 보존적인 방법으로 치유가 가능하였다.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.15-26
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• 1998

The first successful transthoracic esophagectomy and intrathoracic esophago- gastric anastomosis reported in 1938. Stomach, small intestine, and colon as well as free revascularized grafts have been substituted for excised esophagus. During the past 60 years, there have been substantial advances in preoperative assessment, nutritional support, anesthetic and operative techniques, and postoperative care of patients undergoing esophageal resection and reconstruction. However the hospital mortality and morbidity of esophageal resection and reconstruction is still high and disruption of an intrathoracic esophagogastric anastomosis continues to be the most dreaded complication of esophageal surgery, And the choice of the conduit is still controversial. In this paper, I would like to review the current surgical options available to patients who require esophageal resection and reconstruction as well as the advantages and disadvantages of each technique.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.128-139
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• 2001

The purpose of this study was to review the literatures of experimental tracheal reconstruction. Although there have been significant advancements in the surgical treatment of the long circumferential tracheal injuries, there still has been a difficult problem with high morbidity and mortality. The method for tracheal reconstruction after circumferential resection is preferred end-to-end anastomosis for defects up to 6 cm in length, but larger tracheal defects require the use of tracheal allograft, various artificial prosthesis or autogenous organs. The tracheal allotransplantation has been widely used as there was significantly improved the method of surgical technique, preservation and immunosuppression. But it has been limited by a number of factors such as few donor, limited use of immunosuppressant, delayed revascularization and re-epitheliazation. Experimental studies on the tracheal prosthesis have a long history and they tried to use silicone, polytetrafluoroethylene, polypropylene mesh, Dacron, Marlex mesh, external or internal stents. Other experimental studies were reported the use of autogenous tissues that were cartilage. jejunum, aorta, skin, muscle, periostium or esophagus. But a great variety of these protheses have been resulted unsatisfactory in a significant Proportion of cases. Alternatively, the tissue-engineering technique has showed a new approach to reconstruct trachea and much progress in tissue-engineering bas been made recently. In conclusion, although the tracheal allotransplantation and the use of prosthesis and allograft have been reported a lot of limitation to overcome, we could sooner expect good result of ideal tracheal prosthesis.