• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.675-680
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• 1999

We describe here two cases of anterior tracheoplasty utilizing an autologous pericardial patch. One patient was a 9 year-old female who had a congenital long tracheal stenosis associated with major vascular anomalies including pulmonary artery sling. One-stage correction was done under the support of an extracorporeal membrane oxygenation system. She required a prolonged ventilation support for 10 days postoperatively until the implanted pericardium was fixed to the mediastinal structures. The other patient was a 8 year-old male who had acquired tracheal stenosis following a complicated tracheostomy. By applying additional support over the pericardial patch with the costal cartilage, an endotracheal tube could be removed immediately after the operation. Both patients have been doing well in a postoperative follow-up of over a year, and there have been evidences of growth in the reconstructed trachea.

• Korean Journal of Bronchoesophagology
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• v.10 no.2
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• pp.63-67
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• 2004

Tracheomalacia can be a life threatening upper air way obstructive disease in an infant and vascular rings can be also a major rare cause of tracheoesophageal obstruction. These two rare entities can be combined in one patient because the vascular ring can cause secondary tracheomalacia during development of fetus. The diagnosis of this combination and adequate surgical correction is occasionally difficult. This is a report of an infant who had not diagnosed tracheomalacia associated with vascular ring until 5 months of age because of the prolonged tracheal intubation. The rigid bronchoscopic examination performed under impression of tracheomalacia revealed a concentric tracheal collapse, an unusual bronchoscopic findings of tracheomalacia, which raised a suspicion of the tracheal compression by vascular rings. The 3-D reconstructive DT aortography clearly demonstrated the double aortic arch. The patient was treated surgically by simple division of the left aortic arch and aortopexy with good result. The vascular ring such as double aortic arch should be considered during the diagnosis of tracheomalacia in infants. If the tracheomalacia is associated with vascular ring, simultaneous surgical correction should be performed.

• Korean Journal of Veterinary Research
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• v.44 no.1
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• pp.137-141
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• 2004

The purpose of this study was to compare easiness of application of polypropylene external total ring prosthesis (PPTRP, Group A) with that of polyvinylchloride external total ring prosthesis (PVCTRP, Group B), which were used for surgical correction of tracheal collapse in dogs. PPTRP was made from 3 ml syringe and PVCTRP from the drip chamber of intravenous administration set. Prostheses of group A (n=5) and B (n=5) were placed to cervical trachea in clinically normal 10 dogs, respectively weighing between 4 kg and 6 kg. There were mild coughing and swelling in one to three dogs of both groups for 3 days after surgery. No exercise intolerance was observed in both groups after surgery. There were no different results of clinical signs and radiographic views after surgery between group A and group B. The time (mean${\pm}$SD) to make total ring prosthesis, group A took $23.2{\pm}1.9$ minutes which was remarkably longer than that $(4.6{\pm}0.3)$ of group B. Also, the time to place around trachea, group A required $61.8{\pm}8.8$ minutes and group B $38.4{\pm}8.0$ minutes. Conclusionly, PVCTRP was timesaving and easier to make, fix, and suture than those of PPTRP. PVCTRP may be used alternatively to PPTRP for the tracheal collapse to treat in dogs.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.80-83
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• 2005

A 43-year-old male was admitted to our hospital complaining of dyspnea and wheezing sound at respiration. He had received esophageal exclusion and esophagogastrostomy due to spontanous esophageal rupture 1-year ago. Chest computed tomography revealed esophageal mucocele like that of mediastinal tumor. Trachea is compressed by esophageal mucocele. The operation was performed by resection of thoracic esophagus through right open thoracotomy. Herein we report a case of a tracheal compression by esophageal mucocele after surgical exclusion of the esophagus.

• Journal of Chest Surgery
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• v.50 no.4
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• pp.300-304
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• 2017

A 42-year-old man was diagnosed with cancer of the right lower lung lobe with a posteparterial type of tracheal bronchus, in which the posterior segmental bronchus of the right upper lobe arose from the distal bronchus intermedius. A mass involved the distal bronchus intermedius, requiring a right lower bilobectomy with an additional posterior segmental resection of the right upper lung lobe. Thus, we performed a right lower bilobectomy and sleeve anastomosis of the posterior segmental bronchus of the right upper lobe to the proximal bronchus intermedius, sparing the pulmonary parenchyma of the same lobe.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.487-494
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• 1996

The neurogenic responses of tracheal smooth muscles to electrical field stimulation (EFS) is biphasic, consisting firstly of cholinergic contraction followed by a slow and sustained relaxation. It is well known that a sustained relaxation involves the inhibitory non-adrenergic non-cholinergic systems. This study was done to Investigate the relaxing agents and their action mechanisms by use of an organ bath with plati- ilum . The tracheal smooth muscle relaxation due to EFS was suppressed by L-NAME, the WO (Nitric Oxide) synthase inhibitor, and these effects were reversed by L-arginine, the precursor of NO. Also, L-WAME (HG-nitro-L-arginine methyl ester) increased the basal tension. Nitroprusside, the NO-donor, suppressed the tracheal basal tension greatly. Methylene blue, the inhibitor of guanylate cyclase, decreased EFS-induced relaxations and increa ed basal tension. Forskolin and isoprenaline, which are activators of adenylate cyclase, suppressed tracheal basal tension in the same way as nitroprusside. TEA (tetraethylammonium), the non-specific K'channel blocker, and apamin, the Ca"-activated K'channel blocker, increased tracheal basal tension and EFS-induced relaxations. Our results indicate that Pr3 Is released upon stimulation of the NANC (Won Adrenergic Won Cholinergic) nerves in guinea-pig tracheal smooth muscle and that the release of NO related with the K+ channel, as well as the release of other inhibitory agents< e. g.)VIP (Vasoactive Intestinal Polypeptide), PHI (Peptide Histidine Isoleusine) > mediated via CAMP (cyclic Adenosine Monophosphate) may be Involved In sustained relaxation.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.792-798
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• 1998

Background: There are various tracheal diseseas which cause the obstruction of the trachea: postintubation tracheal stenosis, tracheal cancer, thyroid cancer, endotracheal tuberculosis, et al. Recently surgical resection and reconstruction of the trachea has been adopted as the safe method for tracheal lesions. Materials and methods: We report our experience and results of resection and reconstruction for various obstructive tracheal lesions in 38cases from 1985 to 1996. Length of resection of the trachea was up to 6 cm. Twenty lesions were approached by cervical collar incision, 12 lesions by cervicosternal incision and 4cases needed transthoracic approach. Surgical procedures consisted of resection and tracheotracheal anastomosis in 32 cases, resection and laryngotracheal anastomosis in 6cases and in addition laryngeal release was necessary to release anastomotic tension in 3cases. Results: The complications were 4 minor wound infections, 2 mild suture line granulomas, 1 vocal cord palsy, 2 pneumonias and 1 systemic candidiasis. Two patients who had poor consciousness and pnemonia and one who developed systemic candidiasis were expired after operation. Conclusion: We suggests resection and reconstruction of trachea is optimal procedure for up to 6cm long tracheal lesions. However, for the patients with poor consciousness or poor general conditions would be the conservative treatment preferred to the tracheal reconstruction because of high serious complications and mortalities.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.670-673
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• 2009

A 20 year old woman had developed stenosis at the lower part of the trachea, right main bronchus, and right upper lobe bronchus as a complication of endobronchial tuberculosis. The patient had complained of severe dyspnea. Tracheobronchial stenosis was so extensive that we did reconstruction of the trachea and right bronchus with resection of the lower trachea and right main bronchus and right upper lobectomy. She has been doing well without any respiratory symptoms or complications.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.216-219
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• 2018

We report the case of a 16-year-old male patient who was involved in a traffic accident and transferred to the emergency department with mild chest pain. We initially did not find evidence of tracheal injury on computed tomography (CT). Within an hour after presentation, the patient developed severe dyspnea and newly developed subcutaneous emphysema and pneumoperitoneum were discovered. Abdominal CT showed no intra-abdominal injury. However, destruction of the right main bronchus was identified on coronal images of the initially performed CT scan. Emergency exploratory surgery was performed. The amputated right main bronchus was identified. End-to-end tracheobronchial anastomosis was performed, and the patient recovered without any complications.