• Journal of Chest Surgery
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• 제27권5호
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• pp.407-412
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• 1994

Congenital long-segment tracheal stenosis which involves nearly entire trachea and carina is very rare disease, but leads to life threatening obstruction in infancy and childhood. Symptoms are ranged from stridor and wheezing to severe cyanosis and respiratory failure. Routine chest X-ray is somewhat helpful to diagnose it, but definitive diagnosis can be made by bronchoscopy or tracheogram for severely narrowed tracheal lumen.Recently, we experienced a case of congenital tracheal stenois, type 1 by Cantrell classification with carinal involvement. After costal cartilage was designed as oval shaped flap and covered with pericardium, anterior and posterior augmentation was done with prepared costal cartilage.This patient died of respiratory failure at 13 days postoperatively, probably due to sustaining obstruction in association in with failure to make a sufficient widening at carinal level.Important issues in the management of congenital tracheal stenosis are rapid diagnosis, selection of appropriate surgical procedure, and detailed anesthetic schedule.In the future, more biocompatible material and more effective surgical procedures should be studied to reduce the surgical mortality and morbidity of the complicated tracheal stenosis.

• Journal of Chest Surgery
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• 제30권8호
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• pp.833-837
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• 1997

선천성 기관 협착증은 아주 드문 질병이지만 영아나 유소아에 있어서 치명적인 질병이다. 하부기관을 침습한 선천성 기관 협착 환아 2명에게 Peter Goldstraw가 고안한 슬라이드 기법을 이용하여 기관 성형술을 시행하였다. 기관 성형술은 기관 협착부위 중앙을 절단한 후 협착 부위의 상하를 종 절개하여 서로 문합했다. 증례 1은 현재 건강한 상태이다. 증례 2는 술후 4일째 문합부위 파열로 사망하였다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.834-838
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• 1989

Tracheal stenosis is being encountered more frequently as ventilatory support and cuffed tubes are increasingly used for treatment of respiratory failure. We experienced 13 cases of tracheal stenosis treated surgically at department of Thoracic and Cardiovascular Surgery, school of medicine, Kyung Hee university during the 4 years. The causes of tracheal stenosis were prolonged endotracheal intubation 5 cases, tracheostomy 3 cases, tracheal tumor 2 cases, thyroid tumor 1 case and congenital double aortic arch 1 case. The methods used to manage the tracheal stenosis were tracheal resection % end to end anastomosis 8 cases, 2 cases of subglottic stenosis were underwent primary laryngotracheal anastomosis, Lt. aortic arch division 1 case, and stent insertion 2 cases. In two cases, who had 6 cm in length of tracheal stenosis, we were underwent tracheal resection k end to end anastomosis with supralaryngeal release procedure. Postoperative courses were uneventful except one case with tracheal tumor.

• 대한기관식도과학회지
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• 제1권1호
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• pp.82-93
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• 1995

Three-dimensional reconstruction of computed tomographic image(3D CT) is a well-established imaging modality which has been investigated in various clinical settings. It is commonly performed in case of congenital or developmental abnormalities, and traumatic fracture of skull and face that requires reconstruction of osseous structure. However reporting the 3D CT in laryngeal or tracheal stenosis is rare and its results are obscure. The authors performed 3D CT in six cases of tracheal stenosis and found diagnostic value of 3D CT. A Comparision of diagnostic information obtained from plain X-ray, 2D CT and 3D CT has performed in total six cases of tracheal stenosis. Surgical treatment of the tracheal stenosis was following in these cases : tracheal end to end anastomosis In 1 case, laryngotracheal end to end anastomosis in 2 cases. 3D CT information was compared with operative finding. In two of six cases, satisfactory information was not obtained from 3D CT in evaluating an exact stenosis of trachea. Future, it will be helped in evaluating of tracheal stenosis by 3D CT.

• Journal of Chest Surgery
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• 제30권1호
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• pp.88-91
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• 1997

복잡 심 기 형을 동반한 선천성 기관협착증은 일반적으로 치명적 인 질환으로 간주되고 있다. 본 논문에서는 수술전에 예상하지 못한 선천성 기도 협착을 동반한 복잡 심기형 환자에서, 체외순환하에 동시 교정술을 성공리에 수행하였기에 보고하고자 한다. 환아는 3개월된 여자로 대동맥 교약증, 심실중격결손증 및 동맥관 개존증의 진단으로 전신마취 유도 후 예상치 못한 기관내 삽관의 어려움으로 선천성 기도협착이 있음을 알게 되었고, 자가심낭을 이용한 전방 기관 성형술 및 대동맥 교약증, 심실중격결손증 및 동맥관개존증의 일차 완전 교정술을 체외순환 하에 동시에 시행하게 되었다. 환아는 술후 2년 1개월이 지난 현재 합병증의 증상없이 순조로운 술후경과를 보이고 있다.

• Clinical and Experimental Pediatrics
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• 제45권5호
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• pp.669-672
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• 2002

저자들은 출생 후 수 시간 뒤에 발생한 호흡 곤란을 주소로 내원한 환아에서 우연히 발견된 기관의 석회화와 양측 조롱박 구멍 협착증을 진단하고 비강 내에 스텐트를 위치시키는 수술로서 호흡 곤란 등의 증상 호전된 환아를 보고하는 바이다.

• Journal of Chest Surgery
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• 제38권8호
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• pp.583-588
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• 2005

선천성 기관 협착증은 드문 질환이며, 장분절성 기관 협착은 아주 치명적이다. 신생아나 영아에서 심한 호흡 부전이 발생하고 복합 심기형이 동반되면 수술 교정이 쉽지 않다. 선천성 심기형을 동반한 장분절성 기관 협착으로 인공 호흡기 이탈이 불가능한 2.6 kg 체중의 어린 영아 1예와 신생아 1예에 서 기관성형술을 시행하였다. 심실중격결손증 수술 후 미만성 기관 협착이 발견된 어린 영아는 기관 절제술 및 좌측 주 기관지로의 확장 문합술을 시행받았으며, 미만성 근위부 기관 협착과 팔로사징을 동반한 신생아는 활주 기관성형술과 팔로사징 완전 교정술을 동시에 시행받았다. 두 환아 모두 술후 컴퓨터 단층 촬영에서 양호한 결과를 보였으며, 현재 증상 없이 건강한 상태이다.

• Advances in pediatric surgery
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• 제7권1호
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• pp.54-58
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• 2001

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

• Journal of Chest Surgery
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• 제35권2호
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• pp.149-152
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• 2002

저자들은 이중 기관기관지 스텐트를 성공적으로 거치하여 상당히 긴 부분에 걸쳐 협착이 있는 환아에서 환기유지를 할 수 있었던 증례를 보고한다. 생후 1개월된 환아가 출생 시부터 시작된 빈호흡과 이산화탄소저류를 주소로 응급실로 내원하였다. 술전 흉부단층촬영에서 폐동맥 슬립과 진성성대 직하부부터 양측주기관지 입구에 이르는 상당히 긴 부분에 걸쳐 미만성 기관협착을 확인하였다. 수술소견에서 양측 주기관지의 입구는 3m미만이었으며 기관지협탁부위는 완전환형기관연골이었다. 체외순환 상태에서 좌폐동맥을 잘라 주폐동맥으로 재이식하고 자가심낭편을 이용하여 기관을 확대성형하였다. 그러나, 기관내 육아조직의 성장과 이식한 자가심낭편의 호기시 운동성 폐쇄에 의해 여전히 이산화탄소저류와 호흡곤란은 지속되었다. 이 문제를 해결하기 위해 기관스텐트를 기관내에 거치하였으나, 여전히 양측 주기관지 입구의 협착으로 인해 호흡곤란 증세가 해결되지 않았다. 결국 이중 기관기관지 스텐트를 삽입하여 기도폐쇄를 해결할 수 있었다.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2003년도 제3차 추계학술대회
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• pp.107-107
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• 2003

Purpose; Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and many oncologic conditions but bears many critical problems compared with other organ transplantations. The purpose of this study was to make an intestine-cartilage composite graft for potential application for tracheal reconstruction by free intestinal graft. Methods; Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chodrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel. Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Results; We could identify implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory Microscopic examinations include special stain showed absorption of scaffold and cartilage formation even though not fully matured Conclusion; Intestine-cartilage composite graft could be applicable to future tracheal substitute and needs further Investigations.