• Title/Summary/Keyword: 기관 수술

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Laser Safety in Laryngeal Microsurgery Using $CO_2$Laser (후두미세수술에서 탄산가스 레이저를 이용한 레이저 수술의 안전성)

  • 이정구;정필상;정필섭
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.159-164
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    • 1998
  • The developmental and subsequent addition of laser technology to existing surgical techniques offered new and exciting Possibilities for improving traditional endoscopic operations and expanding the scope of the specialty of otolaryngology-head and neck surgery. Lasers were found to be Precise, but potentially dangerous, surgical instruments whose use was associated with certain distinct and unprecedented advantages, but also with many unique and potentially serious, and sometimes catastrophic complications. The Purpose of this study was to evaluate the of elation technique of $CO_2$laser, kinds of anesthesia, equipments of operating room, and education of medical staff. Four hundreds 4 cases of $CO_2$laser laryngeal microsurgery were reviewed for the safety of $CO_2$laser in laryngeal microsurgery. Vocal polyp (46,3%) was the most common pathology in our cases. The others were vocal nodule, Reinke`s edema, epiglottic cyst, laryngeal granuloma, laryngeal papilloma, intracordal cysts, laryngeal tuberculosis, laryngeal web, laryngotracheal stenosis, and laryngeal cancer. Following complete equipment controls, treatment area controls, maintenance, service and procedural controls, personel protective equipment, and warning signs, no complications were found in our cases. In conclusion, laryngeal microsurgery with $CO_2$laser could be done safely without complication if complete preoperative preparation and education of medical staff preceded.

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Bleomycin Sclerotherapy of Lymphatic Maformation in Head and Neck (Bleomycin을 이용한 선천성 림프관기형의 경화요법)

  • 성명훈;장선오;정종우;김진영
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.108-108
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    • 1993
  • Cystic hygroma is a congenital anomaly of the lymphatic system for which the exact pathogenetic mechanism remains to be elucidated. It is filled with lymphatic fluid and commonly present in the cervical area in either single isolated or multiple form. It is usually innocuous without any pain but may be life-threatening when it is large enough to compromise the airway or interfere with swallowing. Since spontaneous regressions rarely occur, it requires surgical removal. However, this may be rendered difficult in multiple forms and in those with extensive infiltration into the surrounding tissue. This is a presentation of 10 pediatric patients with cystic hygroma who have been successfully treated by sclerotherapy using bleomycin at the authors' department.

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Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis (기관 또는 기관지 협착을 가진 소아에서의 스텐트 적용)

  • Jang, Ju Young;Kim, Hyo-Bin;Lee, So Yeon;Kim, Ja Hyung;Park, Seong Jong;Shin, Ji Hoon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.512-517
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    • 2005
  • Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

Dual Stent Application on Congenital Tracheobronchial Stenosis - 1 case - (선천성 기관기관지 협착에서의 이중 스텐트의 적용 - 1례 보고 -)

  • 강문철;황성욱;김용진;김희수;김종성;성명훈
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.149-152
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    • 2002
  • We report successful application of dual trachcobronchial stcnt to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with COB retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stunt. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

Congenital Esophageal Stenosis due to Tracheobronchial Remnants - 3 Case Reports - (기관기관지 잔유조직에 의한 선천성 식도협착증 수술 치험 -3예 보고-)

  • Kim, Dong-Won
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.64-67
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    • 2010
  • Congenital esophageal stenosis due to tracheobronchial remnants is a rare anomaly, resulting in dysphagia and recurrent pneumonia, We have experienced three cases of csophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. Two patients were 20 months and five year old male with a chief complaints of swallowing difficulty from birth and the other was a twenty three year old female with a slowly increasing symptom of dysphagia for twenty years. Esophagogram of the patient with tracheobronchial remnants shows abrupt narrow segment at distal esophagus with marked proximal dilatation, and linear barium collections perpendicularly projecting from the stenotic esophagus. All of them were performed surgical correction by esophagectomy of the stenotic portion and esopahgo-gastrostomy with anti-reflux procedures, The resected specimens of these patients showed ectopic tracheobronchial chondroepithelial tissue within the esophageal wall histopathologically. Postoperative course was uneventful and have been in good condition without any problems.

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A Case of Bronchial Foreign Body With Contralateral Pneumothorax (기흉을 동반한 기도이물 1예)

  • 나기상;김무명;김광현;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.5.3-6
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    • 1982
  • Foreign body in the air passage is not uncommon in the field of otolaryngology. The majority of bronchial foreign bodies can be removed by bronchoscopy, but some cases may require surgical procedure. Recently, we experienced an impacted foreign body (ball-pointed pen cap) in the left main bronchus with pneumothorax on the right side. Authors tried bronchoscopic removal under the general anesthesia but failed. Lateral thoracotomy was performed by chest surgeon and foreign body was successfully removed.

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Surgical Repair of Tracheal Stenosis with Tracheoesophageal Fistula Induced by Prolonged Endotracheal Intubation - Report of A Case - (기관삽관에 의한 기관협착및 기관 식도루: 수술치험 1례)

  • 허강배
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.581-587
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    • 1992
  • Tracheoesophageal fistula[TEF] is a rare but life-threatening lesion that may occur from ventilation with a cuffed tube. It occurs most frequently when an inlying esophageal tube is also being used-usually for feeding purposes. The mechanism of injury appears to be pressure experted on the tracheal wall by the cuff, which then compresses the "party wall" of the trachea and esophagus against the foreign body that lies in the esophagus. The patient was 32 years old female who had been receiving a treatment of respiratory failure induced by postoperative sepsis with assist ventilator and nasogastric tubal feeding. Sudden attack of abdominal gas distention and massive drainage of gas through N-G tube were developed during assist ventilation in that patient, so we diagnosed as tracheal stenosis with a tracheoesophageal fistula induced by prolonged endotracheal intubation We performed tracheal reconstruction and primary closure of perforated esophagus after weaning ventilator. The postoperative course was uneventiful.eventiful.

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National hospital discharge survey for the hospitals with fewer than 100 beds: A pilot project and evaluation (100병상미만 의료기관대상 퇴원환자조사 시범운영 및 평가)

  • Kim, Kwang-Hwan
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.579-581
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    • 2010
  • 2007년1월1일부터 12월 31일까지 퇴원환자조사에서 제외되었던, 100병상미만 의료기관을 조사대상으로 선정하였다. 퇴원환자조사를 위해 조사 기반자료인 의무기록을 토대로 손상퇴원환자의 일반적 특성, 진료비지불방법, 질병 및 수술 양상과 의료이용 실태를 파악하였다. 2007년 한 해동안 전국 100병상미만의 급성기 의료기관을 퇴원한 추정 환자수는 총 4,697,095명으로 이는 전체 인구의 9.7%에 해당 한다. 인구 10만명당 퇴원율은 9,693명이며 평균재원일수는 9.8일이었다. 퇴원후 귀가한 퇴원환자수는 전체 4,538,861명이었고 이중 남성은 1,784,041명, 여성은 2,754,821명이었다. 타병원으로 이송된 환자는 119,378명이었으며 의뢰병원으로 회송된 환자도 8,970명 이었다.

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Low Grade Mucoepidermoid Carcinomas of the Lung (폐의 저 등급 점액표피양 암 - 2 Cases -)

  • 최영호;김태식;신재승;황재준;손영상;김학제
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.225-230
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    • 1998
  • Mucoepidermoid carcinoma of the lung is a very rare and potentially malignant tumor that arises from submucosal gland of the trachea and bronchi. We experienced two cases of mucoepidermoid carcinoma which was located in the left main bronchus and right intermediate bronchus. They were treated with left sleeve resection and right bilobectomy. Postoperative course was uneventful, and the followed up for each of them was 3 year and 18 months without any evidence of recurrence.

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ENDOLARYNGEAL AND EXTRALARYNGEAL ARYTENOIDECTOMY FOR BILATERAL VOCAL CORD PARALYSIS (양측성 정중위 성대마비에 대한 피열연골제거술)

  • Kim, Myeon-Ju;Oh, Dae-Kwon;Choi, Gun;Choi, Jong-Wook;Ko, Jun-Young;Yoo, Hong-Kyun;Shin, Hong-Soo
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.16.1-16
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    • 1987
  • 양측성 정중위 성대마비는 양측 반회신경의 마비나 윤상피열연골관절이 염증이나 외상에 의하여 고정되는 경우에 발생하며 조기에 심한 호흡곤란을 초래하게 되므로 기관절개술을 요하게 되고, 또한 영구적인 기도확보를 목적으로 Woodman(1946), Orton(1948), Thornell(1959), Downey(1968)등의 여러 학자들에 의하여 다양한 방법으로 피열연골에 대한 수술법이 시도되어 왔다. 최근 10년간 본 교실에서 양측성 정중위 성대마비 7례, 양측성 윤상피열연골관절고정 2례에 대하여 endolaryngeal arytenoidectomy (Thornell's method) 6례 , extralaryngeal arytenoidectomy 3례 (Woodman's method l례, Downey's method 2례)를 각각 시행하여 비교적 좋은 성적을 거두었기에 이들을 비교 검토하여 문헌고찰과 함께 보고하는 바이다.

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