• Title/Summary/Keyword: Rigid bronchoscopy

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Airway Stenting in Tracheobronchial Diseases : Silastic stenting (기도질환에서 실리콘 기도스텐트 치료)

  • Kim, Ho-Joong
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.5-8
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    • 2004
  • Stenosing airway disease is classified as intraluminal obstruction, extrinsic compression, and malacia by the anatomical site of the lesion. Stenting therapy is indicated for symptomatic relief of life-threatening dyspnea caused by the last two types. Airway stents are made with metal mesh and/or silicone rubber, and currently more than 20 kinds of stent are available. Among many kinds of silicone stent, the Dumon stent is mostly widely used for benign and malignant airway stenoses, but general anesthesia and rigid bronchoscopy are needed for insertion. It can be removed when the stenosing airway disease subsides completely. In many clinical studies, most patients $(85-90\%)$ improved immediately after stenting, and procedure-related mortality was low $(<3\%)$ in experienced centers. Stent displacement, mucus impaction, and granulation tissue formation are potential complications. Stenting is one of many effective therapeutic modalities for stenosing central airway disease. Careful patient selection, experiences, and continuous development of new technology will bring better results.

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Usefulness of Photodynamic Therapy in the Management of Early Central Lung Cancer: A Report of Three Cases

  • Lee, Jong Hoo;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.338-344
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    • 2009
  • In photodynamic therapy, a chemical photosensitizer is activated by light of a specific wavelength., Photodynamic therapy has been combined with bronchoscopy in patients who are ineligible for surgical resection in order to treat patients with early central lung cancer. Here, we describe 3 patients with early central lung cancer who were treated effectively using photodynamic therapy. Our experience shows that this approach is a useful modality in the therapy of these types of tumors.

Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

Congenital Tracheomalacia Associated with Esophageal Atresia (선천성 식도폐쇄에서 발생한 선천성 기관연화)

  • Han, Seok-Joo;Jung, Eun-Joo;Kim, Se-Heon;Yoon, Choon-Sik;Shim, Kyu-Dae;Nam, Yong-Taek;Kim, Jai-Eok;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.161-165
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    • 2002
  • This is a case of tracheomalacia associated with esophageal atresia. An 11-month-old- male boy presented with a life-threatening apneic spell after correction of esophageal atresia (Gross type C). After complete exclusion of the other possible causes of the apneic spell, the presumptive diagnosis of tracheomalacia was made with fluoroscopy and 3-dimensional chest CT. The final diagnosis was made with rigid bronchoscopy under spontaneous respiration. The aortopexy was performed with intraoperative bronchoscopic examination. The postoperative period was unremarkably uneventful. The patient was discharged 9 days after the aortopexy and has remained well to date (5 months after the aortopexy).

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A Case of Endobronchial Urokinase for Relief of Bronchial Obstruction by Blood Clots (좌측 주기관지 피덩이를 우로키나아제 기관내 국소주입으로 제거한 1예)

  • Choi, Jung;Lee, Sa Ra;Kwak, Choong Hwan;Pae, Hyun Hye
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.297-302
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    • 2003
  • Background : Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occurred.

Surgical Treatment of Tracheal Tumors [9 cases] (원발성 기관종양의 수술치험 9례 보고)

  • 이두연
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.792-799
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    • 1985
  • Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

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Removal of a Bronchial Foreign Body by Bronchoscopic Cryotherapy: A Case Study

  • Kim, Hyoyeon;Byun, Gwanghyun;Lee, Sang Joon;Woo, Seung Hoon
    • Medical Lasers
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    • v.10 no.1
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    • pp.55-59
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    • 2021
  • A foreign body in the airway can be a potentially life-threatening event. The diagnosis and treatment of foreign bodies in the airway are a challenge for otolaryngologists. Despite the improvements in medical care and public awareness, approximately 3,000 deaths occur each year from foreign body aspiration. A high degree of vigilance is required to ensure prompt treatment and avoid the complications of foreign body aspiration. The author encountered a case of a 77-year-old female patient who had aspirated an unknown foreign body that was fixed in her main bronchus. An initial attempt was made to remove it with a flexible bronchoscope but failed due to the patient's hypoxemic state during the procedure. Under general anesthesia, a rigid bronchoscopic examination was performed, but it was difficult to approach the object due to the bronchus curvature. Instead, a cryotherapy instrument of bronchoscopy was applied. The foreign body was frozen and removed to the carina, where a laryngoscope and laryngeal forceps were used to remove it.

A Case of Tracheal Capillary Hemangioma in an Adult (성인의 기관에 발생된 모세관 혈관종)

  • Kim, Hye-Jeong;Bae, So-Young;Sung, Young-Kyung;Song, Song-Yi;Jeon, Kyeong-Man;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Han, Joung-Ho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.5
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    • pp.385-388
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    • 2010
  • Capillary hemangioma of the trachea is an extremely rare benign tumor in adults. We present the case of a 28-year-old woman with hemoptysis owing to a tumor of the proximal trachea. The tumor was removed by rigid bronchoscopy. The resulting specimens showed capillary hemangioma without any signs of malignant transformation. This presentation is the first case in Korea. Although tracheal capillary hemangioma is a rare disease, we should consider it as a possible cause of hemoptysis in the young adult.

Serious Complications after Self-expandable Metallic Stent Insertion in a Patient with Malignant Lymphoma

  • Cho, Sung Bae;Cha, Seon Ah;Choi, Joon Young;Lee, Jong Min;Kang, Hyeon Hui;Moon, Hwa Sik;Kim, Sei Won;Yeo, Chang Dong;Lee, Sang Haak
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.31-35
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    • 2015
  • An 18-year-old woman was evaluated for a chronic productive cough and dyspnea. She was subsequently diagnosed with mediastinal non-Hodgkin lymphoma (NHL). A covered self-expandable metallic stent (SEMS) was implanted to relieve narrowing in for both main bronchi. The NHL went into complete remission after six chemotherapy cycles, but atelectasis developed in the left lower lobe 18 months after SEMS insertion. The left main bronchus was completely occluded by granulation tissue. However, the right main bronchus and intermedius bronchus were patent. Granulation tissue was observed adjacent to the SEMS. The granulation tissue and the SEMS were excised, and a silicone stent was successfully implanted using a rigid bronchoscope. SEMS is advantageous owing to its easy implantation, but there are considerable potential complications such as severe reactive granulation, stent rupture, and ventilation failure in serious cases. Therefore, SEMS should be avoided whenever possible in patients with benign airway disease. This case highlights that SEMS implantation should be avoided even in malignant airway obstruction cases if the underlying malignancy is curable.

A Case of Pulmonary Mucormycosis Presenting as an Endobronchial Mass (기관지내 종괴로 발현된 폐모균증 1례)

  • Hwang, Jung-Hye;An, Chang-Hyeok;Yun, Jong-Wook;Roh, Gil-Hwan;Ham, Hyeong-Suk;Kang, Eun-Hae;Suh, Gee-Young;Jeong, Man-Pyo;Kim, Ho-Goong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.633-638
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    • 2000
  • Pulmonary mucormycosis is an opportunistic infection in patients with severe underlying illness such as immunocompromised diseases or uncontrolled diabetes mellitus. While patients with leukemia and lymphoma usually present with diffuse parenchymal disease, diabetic patients usually have a localized endobronchial disease involving central airways. We report upon a case of pulmonary mucormycosis in diabetes mellitus patient presenting as an endobronchial mass, which was cured with antifungal therapy, rigid bronchoscopic mass removal and right pneumonectomy.

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