• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.6-7
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• 1981

With the improvement of living standard and educational level of the people, there is an increasing awareness about the dangers of toxic substances and lethal drugs. In addition to the above, the governmental control of these substances has led to a progressive decrease in the accidents with corrosive substances. However there are still sporadic incidences of suicidal attempts with the substances due to the unbalance between the cultural development in society and individual emotion. The problem is explained by the fact that there is a variety of corrosive agents easily available to the people due to the considerable industrial development and industrialization. Salzen(1920), Bokey(1924) were pioneers on the subject of the corrosive esophagitis and esophageal stenosis by dilatation method. Since then there had been a continuing improvement on the subject with researches on various acid(Pitkin, 1935, Carmody, 1936) and alkali (Tree, 1942, Tucker, 1951) corrosive agents, and the use of steroid (Spain, 1950) and antibiotics. Recently, early esophagoscopic examination is emphasized on the purpose of determining the way of the treatment in corrosive esophagitis patients. In order to find the effective treatment of such patients in future, the authors selected 96 corrosive esophagitis patients who were admitted and treated at the ENT department of Severance hospital from 1971 to March, 1981 to attempt a clinical study. 1. Sex incidence……male: female=1 : 1.7, Age incidence……21-30 years age group; 38 cases (39.6%). 2. Suicidal attempt……80 cases(83.3%), Accidental ingestion……16 cases (16.7%). Among those who ingested the substance accidentally, children below ten years were most numerous with nine patients. 3. Incidence acetic acid……41 cases(41.8%), lye…20 cases (20.4%), HCI……17 cases (17.3%). There was a trend of rapid rise in the incidence of acidic corrosive agents especially acetic acid. 4. Lavage……57 cases (81.1%). 5. Nasogastric tube insertion……80 cases (83.3%), No insertion……16 cases(16.7%), late admittance……10 cases, failure…4 cases, other……2 cases. 6. Tracheostomy……17 cases(17.7%), respiratory problems(75.0%), mental problems (25.0%). 7. Early endoscopy……11 cases(11.5%), within 48 hours……6 cases (54.4%). Endoscopic results; moderate mucosal ulceration…8 cases (72.7%), mild mucosal erythema……2 cases (18.2%), severe mucosal ulceration……1 cases (9.1%) and among those who took early endoscopic examination; 6 patients were confirmed mild lesion and so they were discharged after endoscopy. Average period of admittance in the cases of nasogastric tube insertion was 4 weeks. 8. Nasogastric tube indwelling period……average 11.6 days, recently our treatment trend in the corrosive esophagitis patients with nasogastric tube indwelling is determined according to the finding of early endoscopy. 9. The No. of patients who didn't given and delayed administration of steroid……7 cases(48.9%): causes; kind of drug(acid, unknown)……12 cases, late admittance……11 cases, mild case…9 cases, contraindication……7 cases, other …8 cases. 10. Management of stricture; bougienage……7 cases, feeding gastrostomy……6 cases, other surgical management……4 cases. 11. Complication……27 cases(28.1%); cardio-pulmonary……10 cases, visceral rupture……8 cases, massive bleeding……6 cases, renal failure……4 cases, other…2 cases, expire and moribund discharge…8 cases. 12. No. of follow-up case……23 cases; esophageal stricture……13 cases and site of stricture; hypopharynx……1 case, mid third of esophagus…5 cases, upper third of esophagus…3 cases, lower third of esophagus……3 cases pylorus……1 case, diffuse esophageal stenosis……1 case.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.407-416
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• 1992

Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1366-1372
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• 1996

Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.622-626
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• 2005

Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.664-666
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• 1993

A technique for insertion of a long silicone T-tube in patient with critical stenosis and high-risk resection and primary anastomosis of long segment of the distal trachea is presented. It was not easy to insert a long T-tube by existing methods because of flexibility of a T-tube and tightness of stenosis. So we used a silastic endotracheal tube and guiding wire as stylet of a T-tube. During insertion, ventilation was normally maintained through the lumen of endotracheal tube. This provided rapid relief from airway obstruction and asphyxation and is a easy, safe and effective method to restore patency of the major airways.

• Journal of Chest Surgery
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• v.17 no.3
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• pp.492-496
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• 1984

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. We experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 4.0 cm segmental narrowing below the tracheostoma. Before reconstruction, we tried to T-tube cannulation, but the result was not satisfactory. So we resected the narrowed segment and tracheal reconstruction was performed with uneventful result.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.409-412
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• 1993

We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

• Journal of Chest Surgery
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• v.24 no.8
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• pp.765-772
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• 1991

Between 1985 and 1990, 41 patients underwent treatment of the tracheal stenosis. Nineteen patients underwent resection and end-to-end anastomosis including three cases of the subglottic stenosis. Other patients had had treatment such as LASER therapy, bronchoscopic removal, insertion of the Montgomery silastic T-tube or stent insertion Nineteen patients which underwent resection and end-to-end anastomosis were excellent result from three years to sixth months. Other patient were followed at OPD for the other complication or restenosis. There were no hospital death but one patient was managed by bronchoscopic removal of the granulation tissue and other one patient had underwent reoperation for the dehiscence at the anastomotic site.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.939-941
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• 1995

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis.A 19-month-old male was presented an appearence of underdevelopment and mild dehydration state due to persistent vomiting since 5 months after his birth. Esophagogram revealed an abrupt narrowing of lower esophagus with dilatation above it. The operation method was aesection of esohageal stenosis and end to end anastomosis through left seventh thoracotomy. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.33 no.4
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• pp.320-323
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• 2000

This case describes a tracheal stenosis complicated by endobronchial truberculosis. A 50-year-old female with progressive dyspnea was referred to us for the management of long segmental tracheal stenosis. Treatment modalities for tracheal stenosis include open surgical resectin and reconstruction, mechanical dilation, laser resection, and placement of an airway prosthesis. The following is a report of a successful treatment of a long segmental tracheal stenosis through a tracheal augmentation and the use of al Bovine pericardium. This technique may provide a relief from tracheal stenosis.