• 대한두경부종양학회지
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• 제26권1호
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• pp.27-29
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• 2010

Tracheostomal stenosis after total laryngectomy is brothersome problem to surgeon and patient. To prevent tracheostomal stenosis, tension around the tracheostoma must be released. Advancement flap, V-Y inset and Z-plasty were suggested as solution to tracheostomal stenosis. But such methods need elevation of superior flap and it is very difficult when the patients received radiotherapy and has high change of developing pharyngocutaneous fistula. We suggested new stomaplasty technique which named "Modified Fish-Mouth Technique" that does not need to elevate superior skin flap.

• 대한기관식도과학회지
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• 제4권2호
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• pp.165-170
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• 1998

Background and Objectives : Decannulation failure may result from factors such as inadequate ability 0 clear secretion, mucosal induration, granulation tissue, restenosis, tracheal wall depression and vocal cord palsy. We were to evaluate the effectiveness of surgical treatment on the basis of site and type of stenosis. Materials and Method : A series of 44 cases of decannulation difficulty between 1993 and 1997 were reviewed. The following data were collected on each of these patients : primary disease, indication for tracheostomy, site of stenosis, endoscopic findings of stenosis, surgical techniques used for treatment. Results : Primary diseases were 30 head trauma, 4 neck injury, 10 other diseases. Indication for tracheostomy were 37 prolonged intubation, 4 emergency tracheostomy, 3 laryngeal trauma. Endoscopic findings of stenosis were 24 granulation tissue, 16 laryngotracheal collapse, 4 combined with granulation tissue and collapse. Site of stenosis were 3 glottic, 9 subglottic, 24 stomal, 1 substomal, 7 mixed. 22 of 24 cases were decannulation using endoscopic treatment. Conclusion : The most common cause of failed decannulation was sternal granulation tissue. The most effective treatment of granulation tissue was endoscopic technique.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1987년도 제21차 학술대회 연제순서 및 초록
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• pp.17.1-17
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• 1987

근래 기관내 삽관을 통한 보조호흡술의 발달과 각종 사고로 인한 경부외상의 증가로 인하여 기관협착증이 속발되는 빈도가 높아지는 경향을 보이고 있다. 기관협착증은 관강의 협소 및 관내 분비물의 저류로 인하여 심각한 호흡곤란을 초래하게 된다. 이러한 기관협착을 치료하기위하여 관강을 증폭시키고, 효율적인 기도점막으로 환원시키기란 쉽지 않다. 최근 3년간 본 교실에서 급성 기관협착 4례(기관외상 2례. 막성협착 2례), 만성 기관협착 6례(stomal stenosis 2례, cuff stenosis 1례, mixed stenosis 3례)에 대하여 기관륜의 재배열(2례), T-tube stenting(5례), 이개연골편을 이용한 기관성형술(1례), 협착부의 제거 및 단단문합술(2례) 등으로 각각 치료한 경험을 문헌고찰과 함께 보고하는 바이다.

• 성인간호학회지
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• 제19권4호
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• pp.634-643
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• 2007

Purpose: This study was performed to investigate the type and frequency of end colostomy-related complications and to identify the risk factors for those complications. Methods: Retrospective analysis of medical records was made in 708 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005. The type was divided into stomal and peristomal complications: stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retraced stoma, stenosis, and hyperplasia; peristomal complications did peristomal varix, peristomal hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplasia, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage and pyoderma gangrenosum. Results: For stomal complications, hyperplasia was most common(9.0%). For peristomal complications, irritant contact dermatitis was developed in 17.4%. Sex and BMI were risk factors for irritant contact dermatitis, hyperplasia, peristomal hernia, flat stoma, and retracted stoma. Conclusion: Teaching for preventing irritant contact dermatitis such as proper pouching and peristomal skin protection, and for comprehensive weight control should be emphasized on self care program for ostomates, while ostomy care nurse should take a careful consideration of preoperative ostomy site marking in female obese patients.

• Advances in pediatric surgery
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• 제8권1호
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• pp.11-15
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• 2002

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation, Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required, Sigmoid loop colostomy is preferred whenever possible.

• Journal of Chest Surgery
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• 제14권4호
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• pp.339-344
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• 1981

Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.

• 대한두경부종양학회지
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• 제16권1호
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• 대한두경부종양학회지
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• 제3권1호
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• pp.55-63
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• 1987

A retrospective investigation of 52 cases of carcinoma of the larynx, who underwent total laryngectomy $\bar{c}\;or\;\bar{s}$ neck dissection at Pusan National University Hospital from 1978 to 1985, was performed. The results obtained were as follows: 1) There were 32 glottic(62.7%), 18 supraglottic(35.3%) and 1 subglottic(2.0%) carcinoma. 2) In stage grouping, stage ill was the most(64.7%) and then stage II, stage IV, stage I in order. 3) Overall rate of cervical metastasis was 29.4%. In glottic carcinoma, 0% of $T_1,\;40%\;of\;T_2,\;18%\;of\;T_3\;and\;25%\;of\;T_4$. In supraglottic carcinoma, there was 0% of $T_1,\;29%\;of\;T_2,\;56%\;of\;T_3\;and\;50%\;of\;T_4$. 4) The incidence of postoperative complication was 31.4% and stomal stenosis was the most(13.7%) 5) There were 8 cases of local recurrence and 3 cases of distant metastasis(2 cases in lung, 1 case in esophagus) among 40 cases which were able to follow up. 6) 3 year estimated survival rate for glottic and supraglottic carcinoma were 73.3 % and 85.7% respectively.