• Title/Summary/Keyword: 기관 수술

Search Result 659, Processing Time 0.025 seconds

Diagnostic Methods of Traumatic Tracheobronchial Injury (외상성 기관-기관지 손상의 진단 방법)

  • Son, Shin-Ah;Cho, Suk-Ki;Do, Young-Woo;Lee, Hong-Kyu;Lee, Eung-Bae
    • Journal of Chest Surgery
    • /
    • v.43 no.6
    • /
    • pp.675-680
    • /
    • 2010
  • Background: The aim of this study was to identify the distinguishing clinicoradiologic findings of traumatic tracheobronchial injury. Material and Method: Between January 2003 and December 2009, six patients who underwent surgical repair for traumatic tracheobronchial injury due to blunt trauma were included in this study. We evaluated the mechanism of the injury, the coexisting injuries, the time until the making diagnosis and treatment, the diagnostic methods, the anatomic location of the injury and the surgical outcomes. Result: The mechanisms of injury were traffic accident and crushing forces. The frequent symptoms were subcutaneous emphysema, dyspnea and pain, and the common radiologic findings were pneumothorax, mediastinal emphysema, rib fracture and lung contusion. Only 2 patients were diagnosed by chest CT and the others were not diagnosed preoperatively. The location of injury was the trachea in 2 patients and the bronchial tree in 4 patients. There was no postoperative mortality or anastomotic leak; however, vocal cord palsy occurred in one patient. The most distinguishing sign was persistent lung collapse even though the chest tube was connected with negative pressure. Conclusion: Although it was not easy to diagnose traumatic tracheobronchial injury without a clinical suspicion, the distinguishing clinical symptoms and CT findings could help to make an early diagnosis without performing bronchoscopy.

Anterior Tracheoplasty -Two Cases Report- (전방 기관성형술 -2례 보고-)

  • Sun, Kyung;Lee, Seo-Won;Kim, Joung-Taek;Kim, Kwang-Ho;Lim, Hyun-Kyoung
    • Journal of Chest Surgery
    • /
    • v.32 no.7
    • /
    • pp.675-680
    • /
    • 1999
  • We describe here two cases of anterior tracheoplasty utilizing an autologous pericardial patch. One patient was a 9 year-old female who had a congenital long tracheal stenosis associated with major vascular anomalies including pulmonary artery sling. One-stage correction was done under the support of an extracorporeal membrane oxygenation system. She required a prolonged ventilation support for 10 days postoperatively until the implanted pericardium was fixed to the mediastinal structures. The other patient was a 8 year-old male who had acquired tracheal stenosis following a complicated tracheostomy. By applying additional support over the pericardial patch with the costal cartilage, an endotracheal tube could be removed immediately after the operation. Both patients have been doing well in a postoperative follow-up of over a year, and there have been evidences of growth in the reconstructed trachea.

  • PDF

PECTORALIS MAJOR MYOCUTANEOUS FLAP FOR THE COMPLICATIONS OF POSTIRRADIATION HEAD & NECK CANCER SURGERY (방사선 치료후 두경부암 수술의 합병증에 대한 Pectoralis Major Myocutaneous Flap의 이용)

  • 송달원;백재한;김중강
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1987.05a
    • /
    • pp.19.2-19
    • /
    • 1987
  • 방사선치료후 재발성 또는 잔존성 두경부암의 수술후에 피부판의 괴사 및 slough, 감염, 누공, 부종과 경동맥 노출 심지어는 경동맥 파열 등의 술후 합병증이 빈발함으로 수술에 큰 어려움을 겪게 된다. Pectoralis major myocutaneous flap은 진행된 두경부암의 광범위한 절제후에 그 결손부를 보충해 주는 데 좋은 방법으로 사용할 수 있을 뿐아니라 방사선치료후에 생긴 합병증에도 이 flap을 이용하여 좋은 치료결과를 얻을 수 있다. 저자들은 수술 전에 방사선치료를 받고 심한 부종으로 후두조직의 괴사 및 기능이 손실된 환자와 방사선 치료후 재발된 상인두암환자의 경우에서 수술 후 생긴 pharyngocutaneous fistula와 피부판감염 및 경동맥노출 등으로 치유가 곤란하여 여기에 pectoralis major myocutaneous flap을 사용하여 pharyngostoma를 재건하고 노출된 경동맥부위를 보호하여 좋은 치료효과를 얻었기에 문헌을 고찰하여 보고하는 바이다.

  • PDF

SURGICAL MANAGEMENT OF CHRONIC ASPIRATION (만성적 기도흡인에 대한 수술적 치료)

  • Choi, Jong-Wook;Choi, Gun;Jung, Kwang-Yoon;Yoo, Hong-Kyun
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1991.06a
    • /
    • pp.36-36
    • /
    • 1991
  • 기도흡인은 후두의 고유기능중 방어기능을 소실함으로써 지속되는 경우 하기도에 치명적인 손상을 초래하게된다. 기도흡인에 대한 치료는 고식적 치료법과 수술적 치료법으로 대별되는데 일반적으로 고식적으로 치료법이 우선적으로 선택되어지고 있으나 흡인의 정도가 심하여 하기도에 폐렴, 무기폐 등의 위급한 합병증을 유발하거나 그 원인이 비가역적이어서 탈진 또는 악액질을 초래하는 경우 부득이 수술적 요법율 선택하게 된다. 수술적 요법의 선택시기에 대하여는 논란이 많으나 현재까지는 고통을 받고있는 환자의 상태에 따라 결정되고 있는 실정에 있다. 저자들은 최근 5년간 경험한 만성 기도흡인 환자 6례에 대하여 수술적 요법 즉, cricopharyngeal myotomy 1례, cricopharyngeal with medialization laryngoplasty 1례, laryngeal suspension with cricopharyngeal myotomy 2례, laryngeal diversion 1례, total laryngectomy 1례를 각각 시행함으로써 얻은 치료경험을 분석 검토하여 만성 기도흡인에 대한 치료상의 문제점과 보다 효율적인 치료법의 선택에 도움을 얻고자 문헌고찰과 함께 보고하는 바이다.

  • PDF

Clinical Analysis for 970 Cases of Middle Ear Surgery (최근 4년간에 시행한 중이수술 970예에 대한 임상적 고찰)

  • 김기령;김영명;박인용;홍원표;정태인;조경열;이춘근
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1978.06a
    • /
    • pp.8.4-9
    • /
    • 1978
  • Since the first success of simple mastoidectomy, about 100 years ago by Schwartze (1873). Zollner (1951) and Wullstein (1952) had formulated systemically the basic principles of restorative surgery of chronic ear diseases. Although the last century has shown a remarkable advances in surgical technique, there are still lots of debatable problems yet. The authors experienced 970 cases of middle ear surgery during last four years and clinical and statistical analysis were done as a preliminary report.

  • PDF

Left Bronchial Rupture Following Endobronchial Intubation - One case report - (기관 삽관후 발생한 좌측 주기관지 파열 - 1례 보고 -)

  • 김건일;지현근;김형수;이희성;이원용
    • Journal of Chest Surgery
    • /
    • v.31 no.10
    • /
    • pp.1014-1016
    • /
    • 1998
  • Rupture of the bronchus following endotracheal intubation with a double-lumen tube is extremely rare in all complications of endotracheal intubation. We experienced a case of left main bronchial rupture following endotracheal intubation. This 58-year old female patient was diagnosed of well-differentiated adenocarcinoma of right lower lobe, stage IIB, preoperatively. She was intubated with Robertshaw double-lumen tube(35 Fr.) for Rt. lower lobectomy. Intraoperatively, Lt. main bronchial rupture was suspected because of pneumomediastinum and ventilation insufficiency and immediately repaired with monofilament absorbable sutures(PDS) through left thoracotomy. Postoperative course was uneventful.

  • PDF

Analysis of the propensity of medical expenses for auto insurance patients by type of medical institution (의료기관 종류별 자동차보험 환자의 진료비 성향 분석)

  • Ha, Au-Hyun
    • Journal of Convergence for Information Technology
    • /
    • v.12 no.2
    • /
    • pp.184-191
    • /
    • 2022
  • This study aims to provide basic information necessary to find an efficient management plan for patients using auto insurance. The analysis was conducted on the five-year auto insurance medical expenses review data registered in the health care bigdata Hub from 2016 to 2020. As a result of the analysis, the number one composition ratio of auto insurance inpatient treatment expenses was treatment and surgery fees for Certified tertiary hospitals, hospitalization fees for general hospitals, hospitals and clinics, and treatment and surgery fees for oriental medical institutions and dental hospitals. outpatient treatment expenses was doctor's fee for medical institution, treatment and surgery fees for oriental medical institutions and dental hospitals. The ratio of medication, anesthesia, and special equipment significantly affected the cost of inpatient. And the ratio of physical therapy significantly affected the cost of outpatient.

Surgical Treatment of Tracheal Restenosis following Operation for Postintubation Tracheal Stenosis - Two cases report - (기관 삽관에 의한 기관 협착의 수술 후 발생한 기관 재협착에 대한 수술적 치료-2예 보고-)

  • Kim Dae Hyun;Yi In Ho;Youn Hyo Chul;Kim Soo-Chul;Kim Bum Shik;Cho Kyu Seok;Hwang En Gu;Park Joo Chul
    • Journal of Chest Surgery
    • /
    • v.38 no.11 s.256
    • /
    • pp.795-798
    • /
    • 2005
  • The treatment of choice for post-intubation tracheal stenosis is partial tracheal resection and end-to-end ana-stomosis. The surgical treatment of tracheal restenosis that results from unsuccessful repair of post-intubation tracheal stenosis is not easy. Failed reoperation results in permanent tracheostomy and loss of voice. If the first operation fails, about $4\~6$ months of period for resolution of inflammatory reaction, edema, and fibrosis is needed. The exact evaluation of the patient's status is necessary and success rate of reoperation for the appropriate candidates is over $90\%$. We report the results of treatment in two cases of tracheal restenosis that resulted from unsuccessful repair of post-intubation tracheal stenosis with review of literatures.

COMBINED THERAPY OF ADVANCED MALIGNANT PARANASAL SINUS TUMOR (진행된 악성 부비동 종양의 병용치료법)

  • 이인자;김민식;조승호;서병도
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1991.06a
    • /
    • pp.42-42
    • /
    • 1991
  • 부비동에 발생하는 악성종양은 자각증상이 비교적 늦게 나타나 병변이 많이 진행된 후에 발견되는 경우가 대부분이다. 진행된 부비동압의 치료는 수술, 화학요법, 방사선요법의 병용치료법이 종래부터 시도되어왔으며 대부분의 경우 광범위한 수술적 절제가 필요하여 이에 따른 후유증이 크고 치료결과는 아직 많은 논란이 있다. 저자들은 진행된 부비동암 (T4)환자 10명에서 유도화학요법 (Cisplatin, 5-FU)후 수술 (상악절제술 4예, 두개안면 절제술 1예 )과 방사선 치료 (약 7000 cGy)를 받은 5명과 유도화학요법후 방사선치료만 받은 5명을 비교하여 다음과 같은 결과를 얻었다. 1. 수술을 포함한 병용요법을 받은 환자 6명중 3명은 평균추적기간 28개월 동안 재발의 증거가 없었으나 2명에서 국소재발이 있었고 이들은 국소 절제술 및 방사선치료후 현재 1년 이상 무병상태이다. 2. 수술을 포함한 병용요법을 받은 환자 5명중 4명에서 초진시 안와내 종양침윤의 소견이 있었으나 수술시 안와를 보존하였고 그 후 안와 부위의 국소 재발은 없었다. 3. 유도화학요법과 방사선치료만을 받은 5명 모두 6개월 이내에 국소재발하였다. 4. 진행된 악성 부비동암은 수술을 포함한 병용요법으로 좀 더 좋은 치료성적을 얻을 수 있을 것으로 기대된다.

  • PDF