• 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.

• Journal of Chest Surgery
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• 제38권11호
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• pp.795-798
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• 2005

기관 삽관 후에 발생한 기관 협착에 대한 근본적 치료는 기관 부분 절제 및 단단 문합이다. 기관 협착에 대한 성공적이지 못한 교정으로 인해 발생하는 기관의 재협착에 대한 수술 치료는 쉽지 않다. 재수술이 실패할 경우 환자는 평생 기관절개 상태 및 목소리 소실을 안고 살아야 한다. 첫 번째 수술이 실패했을 경우 염증반응, 부종, 섬유화가 해소될 때까지 약 $4\~6$개월을 기다린 후 재수술을 시행해야 한다 환자의 상태에 대한 정확한 평가가 필요하며 일단 재수술의 후보자로 선정되면 재수술의 성공률은 $90\%$ 이상이다. 저자들은 기관 삽관으로 인해 발생한 기관 협착에 대해 성공적이지 못한 교정 후 발생한 기관의 재협착 2예에 대한 치험을 문헌 고찰과 함께 보고하는 바이다.

• 대한기관식도과학회지
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• 제1권1호
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• pp.101-108
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• 1995

From 1988 to 1995, 59 patients with laryngotracheal stenosis were operated with resection of stenotic segment and end to end anastomosis in Seoul national university. Among these patients, 36 were tracheal stenosis, 17 were combined lesion of subglottis and trachea and 5 were subglottic stenosis. The success of procedure was determined by stoma closure or decannulation and an overall 89.8% success rate was achieved following 165 procedures. The success rate showed correlation with severity of stenosis and the number of procedures done was related to the site of stenosis. There was no mortality and granulation formation, unilateral vocal cord palsy were the common complication of end to end procedures.

• Journal of Chest Surgery
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• 제4권1호
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• pp.51-54
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• 1971

37 years old female was admitted with chief complaints of dyspnea on exertion and hemoptysis. Past history and family history were non-contributory. Physical examination showed Grade III systolic murmur at the apex, which transmitted to the back. E. K. G. and X-ray findings were compatible with the mitral insufficiency. With small size of Beall mitral valve, mitral valve replacement was done under the cardia-pulmonary bypass using hemodilution technic. Patient was tracheotomized after operation and assisted respiration was done for four weeks. Postoperatively, all signs were fine and patient walked around the ward without any difficulty, but she was in psychotic state. On postoperative 60th day, she complained of sudden dyspnea and on chest film, tracheal stenosis was found and recannulation of the tracheal tube was made. Thereafter, she was quite fine until postoperative 110th day when she, by berself, removed the tracheal cannula and died of asphyxia. Autopsy findings of the valve showed no thrombosis, no variance of the valve, and good endothelization of the valve cuffs. Asphyxia, due to removal of the tracheal connula by herself under psychotic state, was considered to be the cause of death in this patient who had tracheal stenosis after tracheostomy.

• Tuberculosis and Respiratory Diseases
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• 제75권2호
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• pp.79-82
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• 2013

Tracheal Stenosis after Tracheostomy Treated Successfully with Papillotome Electrocautery A 39-year-old woman presented with symptoms of dyspnea. Ten years previously, she had received a tracheostomy because of the decision to not continue taking an anticonvulsant drug. Presently, chest computed tomography showed diffuse stenosis and focal web at the cervical trachea. We performed bronchoscopy and found a two-thirds reduction of the upper trachea due to the web-like fibrotic stenosis. Papillotome electrocautery removed the stenotic lesion. Endobronchial electrocautery is a valuable tool with potential for therapy of an endobronchial obstructing airway lesion. We report this case to introduce the successful treatment with papillotome electrocautery.

• Tuberculosis and Respiratory Diseases
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• 제72권6호
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• pp.486-492
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• 2012

Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

• Journal of Chest Surgery
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• 제40권12호
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• pp.874-877
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• 2007

고도의 기관 협착에서 기도 확보는 어려운 문제이며, 시술 중의 기도 폐쇄는 치명적인 결과를 초래할 수 있다. 이에 응급 체외 순환기를 이용한 기관절개술을 하나의 방법으로 제시하는 바이다.

• Journal of Chest Surgery
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• 제25권6호
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• pp.588-592
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• 1992

Recently we have experienced one case of long tracheal stenosis which developed after pulmonary tuberculosis. The patient was 32 years old woman, 165cm in height. She complained severe dyspnea and headache. We could hear the inspiratory wheezing sound and stridor without stethoscope. Preoperative tracheogram and chest CT scan showed long tracheal stenosis from the posterior portion of clavicular head to the upper portion of carina and right main bronchus. Under the general anesthesia, the stenotic segment, about 7.5cm, was resected and end to and anastomosis was performed successfully through the right anterolateral thoracotomy and supraclavicular collar incision. Her postoperative course was uneventful and the patient has remained well till now.

• Journal of Chest Surgery
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• 제19권3호
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• pp.470-474
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• 1986

In the treatment of the acute respiratory failure, ventilatory support with endotracheal intubation or tracheostomy is a life saving procedure in many cases but the development of postintubation tracheal stenosis is a very serious complication. Recently we have experienced one case of postintubation tracheal stenosis which occurred in the region of cuff site. Preoperative tracheogram showed a concentric stricture 3.0 cm in length located 4.0 cm proximal to the carina. Under the general anesthesia, the stenotic segment was resected and end-to-end anastomosis was performed successfully through the right posterolateral thoractomy. Her postoperative course was uneventful and the patient has remained well till now.

• Journal of Chest Surgery
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• 제42권2호
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• pp.259-262
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• 2009

기관 및 폐문부 수술 시 기도확보가 어려운 경우나 폐실질 질환을 동반하여 저산소증 등이 우려될 경우 심폐보조장치의 도움을 받을 수 있다. 국소마취 하에 시행할 수 있는 경피적 심폐보조장치는 고전적인 심폐보조장치를 대신하여 기관호흡으로 호흡유지가 힘든 환자에게 안전하고 손쉽게 적용할 수 있다. 저자들은 고도의 하부 기관협착 환자에서 경피적 심폐보조장치를 이용한 호흡보조 하에 기관절제 및 단단 문합술을 성공하였기에 보고하는 바이다.