• Journal of Chest Surgery
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• 제33권4호
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• pp.320-323
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• 2000

This case describes a tracheal stenosis complicated by endobronchial truberculosis. A 50-year-old female with progressive dyspnea was referred to us for the management of long segmental tracheal stenosis. Treatment modalities for tracheal stenosis include open surgical resectin and reconstruction, mechanical dilation, laser resection, and placement of an airway prosthesis. The following is a report of a successful treatment of a long segmental tracheal stenosis through a tracheal augmentation and the use of al Bovine pericardium. This technique may provide a relief from tracheal stenosis.

• Journal of Chest Surgery
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• 제48권4호
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• pp.231-237
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• 2015

Surgical procedures on the trachea have only been undertaken within the past 50 years. Knowing the unique blood supply of the trachea and how to reduce tension on any anastomosis are key to a successful outcome. Tracheal conditions requiring surgery usually present with shortness of breath on exertion, and preoperative evaluation involves computed tomography and rigid bronchoscopy. Tracheal resection and reconstruction can be safely performed with excellent outcomes by following a well-described technique.

• 대한기관식도과학회지
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• 제8권1호
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• pp.66-70
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• 2002

In patient with lung cancer, the resection margin of right main bronchus was invaded by tumor intraoperatively. So we performed tracheal reconstruction with autologous pericardium after resection of lower trachea including carina. Postoperatively, the patient discharged well and followed up for 5 months without any evidence of tumor recurrence or restenosis.

• Journal of Chest Surgery
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• 제18권2호
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• pp.345-351
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• 1985

Tracheal stenosis is due to tracheostomy or prolonged intubation. Development of tracheal stenosis following tracheostomy is very serious complication. In recent practice, tracheostomy has became more popular because of increased occasions of major and minor traumas. At the Dept. of thoracic surgery, Chonbuk national university hospital, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Chest X-ray revealed the narrowing of trachea at cervicothoracic junction due to previous tracheostomy. We resected the narrow segment & tracheal reconstruction was performed with an excellent result in postoperative periods. Postoperative air tracheogram did not reveal demonstrable narrowing of air filled trachea.

• Journal of Chest Surgery
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• 제31권8호
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• pp.792-798
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• 1998

배경: 기관의 폐쇄 질환은 기관 삽관과 기관 절개술에 의한 협착, 기관 종양, 갑상선 종양, 기관내 결핵등 다양한 질환이 원인이 될 수 있는데 최근 이런 기관 질환에 대해 병변 부위를 완전히 절제한 후 단단 문합 술을 시행하여 좋은 결과를 얻고 있다. 대상 및 방법: 이에 저자들은 1985년에서 1996년까지 38명의 기관 폐쇄 병변에 대해 실시한 기관 절제 및 재건술의 성적과 결과를 분석하였다. 기관 절제 길이는 2 cm이하에서 6 cm까지 다양하였으며, 수술 방법은 경부 횡절개 22례, 경부 및 부분 흉골 정중절개 12명, 우측 흉부절개 를 4례에서 시행하였으며, 기관 병변 주위를 완전 절제한후 32명의 환자에서 기관 단단 문합술을, 6명의 환자에게 윤상연골 절제가 동반된 후두 기관 문합술을 시행하였다. 이중 3명에서 봉합부 장력을 감소시키기 위해 후두 분리가 필요하였다. 결과: 합병증으로 창상 감염 4례, 문합 부위 육아종 증식 2례, 성대 마비 1례, 폐렴 2례, 전신성 캔디디아시스 1례가 발생하여 그중 수술전 의식이 명료하지 않아서 수술후 T-tnbe 삽입이 필요하였던 2명 환자가 폐렴에 의해, 외상에 의해 전신성 캔디디아시스가 발생한 1례가 사망하였다. 결론: 이상의 성적으로 6 cm 까지의 기관 병변에서 기관 절제가 재건술로 좋은 결과를 얻을 수 있었으나 의식 상태나 전신상태가 나쁜 환자에서의 기관절제와 재건술은 수술후 합병증 및 사망률이 높으므로 보존적 치료가 좋을 것으로 사료된다.

• Journal of Chest Surgery
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• 제15권1호
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• pp.73-76
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• 1982

For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, among the variable complications following tracheostomy, the tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. At the Dept. of thoracic surgery, CAFGH, we have experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 2.5 cm segmental narrowing 5 cm below the tracheostoma. Before recon-struction, we tried to dilate the stenotic segment for about 2 months, but the result was not satisfactory to relieve dyspnea. So, we resected the narrowed segment and tracheal reconstruction was performed with an excellent result in postoperative periods till now.

• Journal of Chest Surgery
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• 제27권4호
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• pp.324-327
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• 1994

Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

• Journal of Chest Surgery
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• 제30권6호
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• pp.636-640
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• 1997

기관 식도루의 발생은 대개 카프 주변의 압력에 의한 기관후벽의 궤양 및 괴사에 의한 식도와의 누공 발생에 의하여 생긴다. 본 교실에서는 23세의 여자 환자에서 심폐소생술을 위한 기관삽관후 12일째 발견한 기관식도루 1예를 치험 하였다. 기관식도루는 자연 치유가 드물어 수술로서 교정을 시행하여야 하며 진단 즉시 수술해야 하는 것이 원칙이나 본 예에서는 환자의 전신 상태가 쇠약하여 수술을 지연하였으며 기관 재건술후 재건 부위는 양호하였으나 위루관 제거부위 누출에 의한 복막염 및 패혈증으로 사망한 1예를 보고한다.

• 대한기관식도과학회지
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• 제8권1호
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• pp.22-28
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• 2002

Background and Objectives : The aim of the this study is to determine the efficacy of an external prosthesis made of ringed Polytetrafluoroethylene to prevent Postanastomotic stenosis after surgical correction of extensive tracheal defects in rabbits. Materials and Methods : Thirty rabbits were used, divided into two groups of 15 animals each. Group A rabbits underwent resection of six-ring segments of the cervical trachea and tracheal end-to-end anastomosis. The Procedure used in group B was similar to that used in group A. but the tracheal anastomosis was supported by an external ringed polytetrafluoroethylene prosthesis. After six months, rabbits were killed and tracheas were resected and then compared the postanastomotic tracheal stenosis using morphometry. Results : Anteroposterior diameter, transverse diameter, cross sectional area and intra luminal perimeter of trachea was greater in group B than group A. Also inflammatory changes of mucosa and submucosa were greater in group A than group B. Conclusion : A ringed PTFE as a external stent was effective to prevent tracheal stenosis resulting from the extensive tracheal resection and tracheal reconstruction in rabbits.

• 대한기관식도과학회지
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• 제16권2호
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• pp.131-137
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• 2010

Background: Montgomery T-tube is widely used to maintain airway in many cases. Market-available tubes are not always fit to the trachea of each patient and need some modification such as trimming. Complications do happen in prolonged use like tracheostomy tubes. To overcome above limitations, we designed custom-made T-tube using CT data with the aid of 3D reconstruction software. Material and Method: Boundaries were extracted from neck CT data of normal person and processed by surface rendering methods. Real laryngotracheal model and tracheal inner surface-mimicking tube model were made with plaster and rubber. The main tube was designed by accumulation of circles or simple closed curves made from boundaries. Stomal tube was made by accumulation of squares due to limitation of software. Measurement data of tracheal lumen were used to custom-made T-tubes. Tracheal lumen residing portion (vertical limb) was made like circular cylinder or simple closed curved cylinder. Stomal portion (horizontal limb) was designed like square cylinder. Results: Custom made T-tube with cylindric vertical limb and horizontal limb of square cylinder was designed. Conclusion: CT data was helpful in making custom made T-tube with 3D reconstruction technique. If suitable materials are available, commercial T-tube can be printed out from 3D printers.