• Journal of Chest Surgery
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• v.30 no.1
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• pp.88-91
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• 1997

Congenital long-segment tracheal stenosis with complex cardiac anomaly has generally been regarded as a fatal disease This report described the successful concomitant repair of unexpected congenital tracheal stenosis and complex cardiac anomaly with the use of edrdiopulmonary bypass. The patient was a 3-month-old girl with coarctation of aorta, V D, and PDA. The presence of tracheal stenosis was not discovered until when difficulty with endotracheal intubation was encountered at operating room. Thus, we decided concomitant repair of both lesions and performed anterior pericardial tracheoplasty combined with one stage repair of coarctation of aorta, VSD, and PDA under the cardiopulmonary bypass. The patient is doing well without any signs of complication at present, 2 years and 1 month after the operation.

• Journal of Chest Surgery
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• v.38 no.11 s.256
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• pp.795-798
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• 2005

The treatment of choice for post-intubation tracheal stenosis is partial tracheal resection and end-to-end ana-stomosis. The surgical treatment of tracheal restenosis that results from unsuccessful repair of post-intubation tracheal stenosis is not easy. Failed reoperation results in permanent tracheostomy and loss of voice. If the first operation fails, about $4\~6$ months of period for resolution of inflammatory reaction, edema, and fibrosis is needed. The exact evaluation of the patient's status is necessary and success rate of reoperation for the appropriate candidates is over $90\%$. We report the results of treatment in two cases of tracheal restenosis that resulted from unsuccessful repair of post-intubation tracheal stenosis with review of literatures.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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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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• v.4 no.1
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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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• v.75 no.2
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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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• v.72 no.6
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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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• v.40 no.12
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• pp.874-877
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• 2007

Airway management is difficult problem in severe tracheal stenosis. A total airway obstruction during the procedure resulted in a fatal outcome. We suggest a tracheostomy assisted with an emergency bypass system as a possible method for avoiding this complication.

• Journal of Chest Surgery
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• v.25 no.6
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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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• v.19 no.3
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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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• v.42 no.2
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• pp.259-262
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• 2009

Surgery on the distal trachea or the carina presents special problems for maintaining the airway and systemic oxygenation. Cardiopulmonary bypass is an alternative method for respiratory support for the patients with these conditions. Percutaneous cardiopulmonary support (PCPS) applied under local anesthesia has recently been used for respiratory support in tracheal surgery and the outcome is satisfactory. We encountered a patient who had severe distal tracheal stenosis after prolonged intubation. We had a gratifying result with performing tracheal resection and repair under the support of PCPS.