• Journal of Chest Surgery
• /
• v.31 no.12
• /
• pp.1243-1246
• /
• 1998

Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.2
• /
• pp.61-64
• /
• 2007

Treatment choice for primary pulmonary sarcoma is complete surgical resection. A 69 year old man developed dyspnea due to left lung atelectasis. There was endobronchial tumor completely obstructing the left main bronchus. The tumor was resected completely by main bronchial resection via a left thoracotomy incision, and diagnosed as leiomyosarcoma. Bronchoscopy and computed tomography in 6 months after operation, there was no evidence of recurrence.

• Journal of Chest Surgery
• /
• v.8 no.2
• /
• pp.149-152
• /
• 1975

In spite of great advances in surgical treatment during past several decades, surgery of the trachea failed to develop correspondingly, partly because of relative rarity of the tracheal lesions and partly because of difficulties in surgical technique and anesthesia. Surgical diseases of the trachea are largely obstructions due to neoplasm or cicatrical stenosis and tracheal malacia. The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tubes, has produced, apparently with increasing frequency, tracheal stenosis, tracheomalized tracheal erosion. Surgery is presently the only reasonable way to treat stenotic lesions of the tracheobronchial tree. In the case of tumors, the current trend has been that of radical excision. Primary end-to--end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, for decades it was believed that a maximum of four tracheal rings only might be excised and primary healing achieved with safety. A great variety of procedures, developed by numerous investigations and directed at tracheal substitution, have almost invariably met with discouraging results. A meticulous study done by Grillo and associates on autopsy specimens has shown that an average 6.4cm of mediastinal trachea can be safely resected by full mobilization of the right lung and transplantation of the left main bronchus into the bronchus intermedius. Recently, we experienced a case of successful resection of a tumor of the tracheal carina and primary tracheo-left main bronchial anastomosis at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul. The patient, a 29-year-old man, was admitted to the hospital with complaints of dyspnea and cough. On admission, chest film showed hydropneumothorax on the right. After closed thoracostomy, hydropneumothorax disappeared, but hazy densities, developed in the right middle and lower lung fields, resisted to treatment. Bronchoscopy uncovered irregular tumor covering the carina and the right main bronchus, and biopsy indicated well differentiated squamous Cell carcinoma. Operation was performed on July 2, 1975. A right postero-lateral thoracotomy was used. Excision involved the lower trachea, the carina, the left main bronchus and the right lung. This was followed by direct anastomosis between the trachea and the left main bronchus. Bronchography was done on 17th postoperative day revealed good result of operation without stricture at the site ofanastomosis. About one month after the operation symptoms and signs of bronchial irritation with dyspnea developed, and these responded to respiratory care. On 82nd postoperative day, sudden dyspnea developed at night and the patient expired several hours later. Autopsy was not done and the cause of death was uncertain.

• Journal of Chest Surgery
• /
• v.32 no.8
• /
• pp.761-764
• /
• 1999

The glomus tumor is a distinctive benign neoplasm with a small painful nodule, occurs most commonly in extremities but may be found elsewhere in the body. Its occurrence in the trachea or lung parenchyme has been recognized with extreme rarity and there has not been any report, to our knowledge, of its occurrence in the main bronchial glomus tumor. We report a case of a glomus tumor in the left main bronchus in a 67-year-old man who was presented with blood-tinged sputum and dyspnea, which was completely relieved by surgical resection.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.817-821
• /
• 1985

Benign tumor of the lung are relatively uncommon and leiomyoma among these is one of the rarest tumors. Because of salient features as well as the location of the leiomyoma, which led to the destruction of the lung and subsequent pneumonectomy, the importance of early diagnosis should be emphasized. Recently, authors experienced a leiomyoma of left main stem bronchus with complete atelectasis of the lung, resected with left thoracotomy and transverse bronchotomy in a 58 year old male. The tumor resected was composed of dense interlacing spindle cells by hematoxilin-eosin and also trichrome stains. At repeated bronchoscopic examination postoperatively, one and three months later, there was no evidence of any residual or recurrent tumors. For the universal rarity of the leiomyoma in the bronchus or lung and also there is no report in the reviews of the Journal of Korean Thoracic and Cardiovascular Surgery since volume one, 1968, authors report a case with the foreign literature reviews.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.3
• /
• pp.179-182
• /
• 2022

Foreign body (FB) aspiration remains a serious health problem, particularly in children. The complications due to occlusion by FB or related to procedures for removal can lead to morbidity and mortality. Most of the FBs are located in the unilateral bronchus, however, the organic FB can be multiple or bilaterally located when children chewed the FB. Here, we present a case of successful retrieval of bilateral bronchial FBs. Preoperatively, FB in the left main bronchus was diagnosed, however, FB of the right upper bronchus was not definitive on X-ray and CT scan. During the rigid bronchoscopy, occult FB in the right upper bronchus was detected and successfully removed.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.1
• /
• pp.61-66
• /
• 2012

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (extranodal MZL) is a distinct subgroup of non-Hodgkin's lymphoma. Pulmonary extranodal MZL is a rare entity and accounts for less than 0.5% of primary pulmonary malignancies. Only a few cases of simultaneous occurrence of lung cancer and pulmonary extranodal MZL have been reported. A 60-year-old woman was referred to our hospital with a pulmonary nodule. She was diagnosed with lung adenocarcinoma by percutaneous needle biopsy. The protrusions into the left main bronchus were found by accident while performing bronchoscopy during lung cancer evaluation. The bronchial lesions were diagnosed as extranodal MZL. Although the patient underwent surgical resection for the lung adenocarcinoma, the pulmonary extranodal MZL was left untreated; it was monitored during follow-up visits. To our knowledge, this is the first report of synchronous lung adenocarcinoma and primary extranodal MZL of the main bronchus.

• Tuberculosis and Respiratory Diseases
• /
• v.38 no.4
• /
• pp.340-346
• /
• 1991

Tuberculous tracheobronchitis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus and recognized as one of the most common and serious complication of pulmonary tuberculosis. It had been a diagnostic challenge in prebronchoscopic era and since 1968, fiberoptic bronchoscopy has been accepted as a safe and valuable diagnostic procedure of tuberculous tracheobronchitis. Now, it remains a troublesome therapeutic problem due to its sequelae such as bronchostenosis, bronchiectasis and bronchial deformity. The authors analyzed the clinical features, radiological findings and bronchoscopic findings with pathologic and bacteriologic study on 61 cases of tuberculous tracheobronchitis and following results were obtained. 1) The peak incidence was in the fourth decade and male to female ratio was 1:3.4. 2) The most common symptom was cough (86.9%) and followed by sputum (49.2%), dyspnea (27.9%), fever (19.8%), weight loss (11.5%), hemoptysis (6.6%), hoarseness (6.6%) and chest discomfort (3.3%) and localized wheezing was heard in 18%. 3) In chest X-ray, consolidation with collapse was observed in 70.5%, and followed by consolidation only (18.0%), mediastinal node enlargement (8.2%), cavitary lesion (6.6%), suspicious hilar mass (3.3%) and miliary lesion (1.6%) and there was no abnormal findings in 4.9%. 4) Bronchoscopy showed hyperplastic lesion in 67.2%, mucosal lesion (18.0%), ulcerative lesion (9.8%) and stenotic lesion (4.9%). The most common site of bronchial lesion was right upper bronchus (36.1%) and followed by right main bronchus (34.4%), left main bronchus (29.5%), left upper bronchus (16.4%), right middle bronchus (8.2%), right lower bronchus (6.6%) and left lower bronchus (3.3%). 5) Chronic granulomatous inflammation with or without caseation necrosis on microscopic examination was confirmed in 69.7%, bronchial washing AFB stain was positive in 34.1%, prebronchoscopic sputum AFB stain was positive in 88.1% and postbronchoscopic sputum AFB stain was positive in 30.1%.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.3
• /
• pp.467-471
• /
• 1996

We report a case of a 20-year-old woman who presented with fever, dry cough and pulmonary consolidation at the left upper lobe on chest radiograph. Fiberoptic bronchoscopy revealed obstruction of the left upper lobar bronchus with exophytic mass and multiple nodular protruding lesions at the left main bronchus. Endobronchial actinomycosis was confirmed by demonstration of sulfur granule through the bronchoscopic biopsy of nodular lesion. Intravenous administration of penicillin G followed by oral tetracycline therapy for 5 months resulted in complete recovery of symptoms which had been present for 3 months prior to therapy. Infiltrative consolidation on the chest X-ray disappeared and all the lesions shown by bronchoscopy were nearly normalized after 6 months only to remain small nodular remnants at the left main bronchus. Endobronchial actinomycosis should be included in the differential diagnosis of endobronchial mass.

• Journal of Chest Surgery
• /
• v.24 no.6
• /
• pp.533-540
• /
• 1991

We have performed 14 single lung transplantation in mongrel dogs transplanting the left lung exclusively from December 1989 to January 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantation[group I ] and a Euro Collins solution in the remaining 7 transplantations[group II ] as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5 - 0 prolene and the pulmonary artery was anastomosed using 6 - 0 prolene. The bronchus was anastomosed next with 4 - 0 Vicryl interruptly and covered with a greater omentum which had been prepared previously. In group I the three dogs died at eleven hours, 5 days, and 14 days, postoperatively and the remaining four doings were killed at 5 days, 5 days, 6 days, and 12 days, respectively. In group II the two dogs died during the operation, one dog died at 6 hours, two dogs died at 6 days postoperatively. Two dogs were killed at 5 days, and 7 days. No significant difference was noted between the two groups in survival time, lung infiltration of transplanted lungs, and perfusion defects in perfusion lung scans. Of the 8 dogs which died naturally, the causes of death were as follows: 2 cases of sepsis, 2 cases of ventricular fibrillations, 2 cases of malnutrition, and 2 cases of respiratory failures.