• Title/Summary/Keyword: Surgical stent

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Staged Surgical Treatment of Primary Aortoesophageal Fistula

  • Hwang, Sun Hyun;Cho, Jun Woo;Bae, Chi Hoon;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.52 no.3
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    • pp.182-185
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    • 2019
  • Aortoesophageal fistula (AEF) is a rare and potentially fatal disease that causes massive gastrointestinal bleeding. Therefore, early diagnosis and treatment are essential to prevent mortality. Controlling the massive bleeding is the most important aspect of treating AEF. The traditional surgical treatment was emergent thoracotomy, but intraoperative or perioperative mortality was high. We report a case of a patient presenting with hematemesis who was successfully treated by a staged treatment, in which bridging thoracic endovascular aortic repair was followed by delayed surgical repair of the esophagus and aorta.

A Case of Idiopathic Tracheal Stenosis Treated with Tracheal Resection After a Retrievable Stent Insertion (스텐트 삽입술 후 수술적 절제술로 치료한 특발성 기관 협착증 1예)

  • Lee, Hyoung-No;Cho, Hye-Jin;Lee, Jong-Woo;Shin, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Choi, Ho;Lee, Ki-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.450-456
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    • 2002
  • Idiopathic tracheal stenosis is a type of benign stenosis that possesses specific characteristics but is of unknown origin. It is a rare disease characterized by extensive fibrosis of a portion of trachea, and predominantly found in women. The lesion presents as circumferential fibrotic stenosis that usually occurs at upper trachea and the subglottic larynx, but lower trachea may also be involved. Diagnosis is made from the clinical characteristics accompanide by compatible pathologic features and by exclusion of other etiologies. Conservative management such as laser resection, dilatation and stent insertion can be tried initially, but surgical resection is recommended for definitive treatment due to frequent restenosis and maintenance problems of conservative approach. We report a case of idiopathic tracheal stenosis treated with tracheal resection and anastomosis followed by insertion of a retrievable stent for immediate relief of airway obstruction.

Treating a Ruptured Ascending Aorta with an Endovascular Stent Graft (상행 대동맥 파열에서 혈관내 스텐트 그라프트를 이용한 치료)

  • Kim, Gwan-Sic;Lee, Taek-Yeon;Kim, Joon-Bum;Lee, Seung-Hyun;Kim, Hee-Jung;Cho, Won-Chul
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.92-95
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    • 2010
  • Endovascular stent grafting is regarded as a promising alternative approach to open surgical repair for treating various aortic diseases in high risk patients. We report here on a case of a 79-year-old female who underwent endovascular stent-graft insertion in the ascending aorta for treating a complicated ascending aortic rupture that occurred secondary to radiation necrosis during the treatment of recurrent breast cancer.

A Case of Tracheal Stent Insertion in Airway Compromise Resulting from Anaplastic Thyroid Cancer (호흡 곤란을 유발한 미분화 갑상선암에서 기관 스텐트 삽입 1예)

  • Nam, Woo joo;Kim, So Yean;Kim, Tae Hwan;Lee, Sang Hyuk
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.47-52
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    • 2017
  • Anaplastic thyroid cancer is a rare disease entity consist 2% of whole thyroid cancer but once diagnosed, it is too fatal to survive. Airway obstruction is a leading cause of death in anaplastic thyroid cancer, which may be caused by both vocal cord palsy, mass effect of the cancer or direct invasion of the cancer itself to the tracheal lumen. Tracheal stent insertion can be a solution for airway compromised cases where surgical excision cannot be performed. The advantage is that the airway problem can be solved without invasive procedure. In this case, we tried expandable tracheal stent insertion for 66 years-old man with anaplastic cancer who visited ER for small amount of hemoptysis and dyspnea. There was severe tracheal narrowing and deviation due to the anaplastic thyroid cancer, ECMO (Extra Corporal Membrane Oxygenation) was used instead of a tracheal intubation for general anesthesia.

A Case of Postpneumonectomy Syndrome Treated with Endobronchial Stent (기관지 스텐트 삽입으로 치료한 전폐절제술후 증후군 1예)

  • Jeong, Seong-Hyun;Cho, Hye-Jin;Lee, Hyoung-No;Lee, Hyung-Sook;Sheen, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Won, Jae-Hwan;Park, Kyung-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.325-331
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    • 2002
  • Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.

The accuracy evaluation of digital surgical stents according to supported type (디지털 수술용 가이드의 지지타입에 따른 정확도 평가)

  • Lee, Junyoun;Yoon, Minho;Park, Taeseok;Chun, Inkon;Yun, Kwidug
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.8-16
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    • 2018
  • Purpose: The purpose of this study is to evaluate the accuracy of surgical stent according to the supported type. Materials and methods: 5 sets of dental models which have tooth supported edentulous area and tooth-tissue supported edentulous area were made. Dental model were scanned with model scanner, and CBCT was taken. CT data and model scan data were overlapped using In2Guide software, implant were virtually planned in the software. Surgical stents are fabricated by 3D printing. The implant fixture were installed using the surgical stent, CBCT were retaken. CBCT before surgery and after surgery were overlapped, and the differences (angle difference, coronal difference, apical difference) were evaluated using statistical analysis. Results: In the assessment of the accuracy of surgical guides according to arch type, there are no statistically significant differences between maxilla and mandible. In the case of support type, tooth supported stents showed lower angle difference and length difference than tooth-tissue supported stents, which are statistically significant. Conclusion: Arch type does not affect the accuracy of surgical stents. But tooth support stents are more accurate than tooth-tissue support stents in the case of angle and length difference.

Surgical Study in Treatment of the Tracheal Stenosis (기관협착증 치료에 대한 외과적 고찰)

  • 지청현
    • 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.

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A Comparative Study of Stenting versus Surgical Bypass in Gastric Outlet Obstruction Caused by Gastric Cancer (위암 날문부 폐쇄 환자에게 시행한 치료의 비교고찰: 위-공장 우회술과 금속성 자가팽창성 스텐트 삽입술)

  • Jo, Seung-Jin;Yoon, Ki-Young;Choi, Kyung-Hyun;Park, Moo-In;Park, Seun-Ja;Ko, Ji-Ho;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.82-87
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    • 2007
  • Purpose: In gastric cancer patients with gastric outlet obstruction, there are several complications such as malnutrition and vomiting. Palliative enteral stenting is a less invasive procedure as compared with a gastrojejunostomy. The aim of this study was to determine whether there was a significant difference between patients that undergone palliative enteral slanting and patients that had received a bypass gastrojejunostomy. Materials and Methods: One hundred patients underwent palliative entering stenting and 3f patients were subjected to a surgical bypass gastrojejunostomy. We reviewed the medical records of the patients with gastric outlet obstruction secondary to far advanced gastric cancer that were diagnosed using a gastrofibroscope, UGI and abdominal CT, and were admitted to our institution between January 2000 and August 2006. The outcome of stent placement for gastric outlet obstruction was compared with palliative gastrojejunostomy during the same period. We excluded patients with recurrent gastric cancer and double cancer from this study. Results: There were significant differences between the group of patients that underwent slanting and the group of patients that received a gastrojejunostomy regarding the age of patients ($67{\pm}12$ vs. $57{\pm}9$, P<0.001) but not between the sex of the patients (M : F, 2 : 1 vs. 2 :1, P=0.637). The most common complication of stenting was tumor ingrowth (16/100, 16%) and the second most common complication was stent migration (14/100). Failure of the procedure occurred in only three patients. Twenty-three patients underwent re-slanting and one patient required open conversion with a gastrojejunostomy. The median time to the first meal was $4{\pm}2$ days in the stent group of patients and $6{\pm}2$ days in the gastrojejunostomy group of patients (P=0.001). The median postoperative hospital stays were 9 days in the stent group of patients and 15 days in the gastrojejunostomy group of patients (P=0.003). The mean survival periods were 11 months in the stent group of patients and 10 months in the gastrojejunostomy group of patients (P=0.937). Conclusion: There were no significant differences In the mean survival rates. An earlier first meal and a shorter hospitalization stay were found in the slanting group of patients compared to the bypass gastrojejunostomy group of patients. However, re-slanting was a concern due to tumor ingrowth and stent migration.

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Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report- (정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.364-368
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    • 2004
  • Congenital pulmonary vein stenosis is a rare anomaly and related to high mortality due to progressive pulmonary hypertension and heart failure in infancy. Aggressive anti-failure medication and surgical treatment is recommended. Surgical options are balloon dilatation, endovascular stent, pneumonectomy, lung transplantation, patch grafting, and sutureless repair. We report a case of congenital pulmonary vein stenosis with normal anatomical connection successfully treated with sutureless technique and using pulmonary vasodilators, such as Sildenafil, lloprost and iNO postoperatively.

Perforated Afferent Loop Syndrome in a Patient with Recurrent Gastric Cancer: Non-Surgical Treatment with Percutaneous Transhepatic Duodenal Drainage and Endoscopic Stent (재발된 위암 환자에서 발생한 천공성 수입각 증후군의 비수술적 치료)

  • Song Kyo Young;Son Chang Hee;Park Cho Hyun;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.4 no.3
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    • pp.176-179
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    • 2004
  • Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

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