• Title/Summary/Keyword: Tracheal surgery

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Tracheoplasty with Rib Cartilage Flap for Congenital Tracheal Stenosis -A Case Report- (선천성 기관 협착환자에서 늑연골 절편을 이용한 기관성형술 1례)

  • 이형민
    • Journal of Chest Surgery
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    • v.27 no.5
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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.

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Reconstruction of Tracheal Stenosis following Tracheostomy [1 Case Report] (기관절개술후에 발생한 기관협착증에 대한 기관절제 단단문합술치험 1례)

  • Park, Geon-Ju;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.18 no.2
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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.

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Complete Rupture of Cervical Trachea after Compressed Chest Injury in a Child (소아에서 흉부 압박상 후 발생한 경부기관의 완전 파열)

  • Byun, Joung-Hun;Cho, Sung-Ho;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.309-312
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    • 2007
  • Cervical tracheal rupture is one of the rare injuries after blunt chest trauma, and this can be explained by several mechanisms. Early diagnosis and treatment of tracheal rupture after trauma can reduce the mortality and morbidity. We report here on a surgical experienced case of complete rupture of the cervical tracheal that was due to increased intra-tracheal pressure after a compression injury to the chest of an 8 years old child. We also include a review of the literature.

Effectiveness of Endoscopic Dilatation & Silicone Stent Insertion for Tracheobronchial stenoses : Preliminary study (기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고)

  • Lee, Kyong-Soo;Park, Dong-Wook;Kim, Kyu-Hun;Kim, Jae-Wook;Koh, Yoon-Woo;Kim, Do-Jin;Lee, Seung-Won
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.50-55
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    • 2009
  • Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

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Surgical outcomes in dogs with tracheal collapse treated with a novel cross-and-hook braided endoluminal stent

  • Uemura, Akiko;Ozai, Yusuke;Hamabe, Lina;Yoshida, Tomohiko;Tanaka, Ryou
    • Journal of Veterinary Science
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    • v.23 no.3
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    • pp.46.1-46.8
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    • 2022
  • Background: Stenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs. Objectives: To evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs. Methods: The medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically. Results: Twenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs. Conclusions: Compared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse.

A case of tracheal cancer with thyroid invasion (갑상선을 침범한 기관암 환자 1례)

  • Lim, Kang Hyeon;Jeong, Yong Jun;Han, Mun Soo;Lee, Ju Han;Kim, Young Sik;Oh, Kyung Ho;Kwon, Soon Young
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.61-64
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    • 2018
  • Malignant lesion of the trachea predominantly results from direct spread of adjacent tumors, whereas primary tracheal malignancies are rarely observed. Tracheal tumors are usually diagnosed late on account of delayed specific symptoms: dyspnea, stridor, coughing and hemoptysis. Primary tracheal tumors, although very rare, may extend into the thyroid gland and present as a thyroid mass. Surgery, followed by adjuvant radiotherapy, is the treatment of choice. A case of primary tracheal cancer with thyroid invasion is reported, and a review of the literature is presented.

Surgical Management of an Isolated Huge Innominate Artery Aneurysm Causing Tracheal Compression: A Case Report

  • Young Kwang, Hong;Won Ho, Chang;Hong Chul, Oh;Young Woo, Park
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.478-481
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    • 2022
  • The innominate artery is an uncommon site for an aneurysm, and tracheal compression caused by an innominate artery aneurysm is a very rare occurrence. An innominate artery aneurysm can cause catastrophic complications, such as rupture or thromboembolism. The most common surgical approach for open repair is median sternotomy with cardiopulmonary bypass, but cerebral ischemic injury and thromboembolism can occur during surgery. We present the case of a male patient who had an isolated giant innominate artery aneurysm causing tracheal compression, which was successfully managed by surgical repair.

Analysis of Age-related Distribution of the Tracheal Diameter and Cross-sectional Area Among Koreans -Compuerized Tomographic Measurement- (한국인의 연령별 기관 내경 및 단면적 분포에 대한 분석 -흉부전산화단층촬영을 이용한 측정-)

  • Lee, Gun;Kim, Dae-Sik;Moon, Seung-Chul;Koo, Won-Mo;Yang, Jin-Young;Lee, Hyeon-Jae;Lim, Chang-Young;Han, Hyeon;Kim, Kwang-Ho;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.442-447
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    • 1999
  • Introduction: Understanding the normal distribution of the tracheal diameter and crross- sectional area is one of the key elements in the management of various tracheal pathologies or tracheal reconstruction for the patients in growing age. However, data for Korean standard has been lacking. This study was designed to analyze retrospectively the distribution of tracheal diameter and cross-sectional area in young Koreans, which can afford fundamental data for the management of tracheal diseases. Material and Method: Of the patients who underwent computerized tomogram of the chest between May 1996 and August 1998, one hundred six young patients(age range: 0-20 years) were included. Patients with any conditions which might affect the tracheal cross-sectional area or diameter, such as tracheal disease, previous operation, mediastinal tumor, or obstructive lung disease were excluded from the study. Gender distribution was 69 males and 37 females. Tracheal diameters, anterior-posterior and transverse, were measured at the level of the thoracic inlet(level I) and the aortic arch(level II). Types of the trachea were divided into round, oval, or horseshoe shaped on cross-sectional view, and the dimension was calculated by using the equation of A=1/4$\pi$ab(A; area, $\pi$; 3.14, a; anterior-posterior diameter, b; transverse diameter). We analyzed the distribution of the diameter at each level and compared the cross-sectional area with respect to age and gender. A p-value lower than 0.05 wa considered significant. Result: The trachea of patients less than 5 years old were round in shape at both of level I and II, and no differences in cross-sectional area was observed between the levels(p=NS). As the age increased, the trachea become oval in shape at level I while it remained round in shape at level II(p=0.020). The tracheal diameter and cross-sectional area increased as the age increased with a linear correlation(r>0.9). In patients less than 5 years of age, female patients showed larger cross-sectional area than male patients (p=0.020), and it was reversed in patients older than 15 years of age(p=0.002). Conclusion: From the above results, we suggest chest computerized tomogram as a safe and reliable tool in measuring the tracheal diameter and cross-sectional area. We also provide the data as a standard for distribution of the tracheal diameter and cross-sectional area in young Korean population.

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A Case of Tracheal Stent Insertion in Airway Compromise Resulting from Anaplastic Thyroid Cancer (호흡 곤란을 유발한 미분화 갑상선암에서 기관 스텐트 삽입 1예)

  • Nam, Woo joo;Kim, So Yean;Kim, Tae Hwan;Lee, Sang Hyuk
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.47-52
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    • 2017
  • Anaplastic thyroid cancer is a rare disease entity consist 2% of whole thyroid cancer but once diagnosed, it is too fatal to survive. Airway obstruction is a leading cause of death in anaplastic thyroid cancer, which may be caused by both vocal cord palsy, mass effect of the cancer or direct invasion of the cancer itself to the tracheal lumen. Tracheal stent insertion can be a solution for airway compromised cases where surgical excision cannot be performed. The advantage is that the airway problem can be solved without invasive procedure. In this case, we tried expandable tracheal stent insertion for 66 years-old man with anaplastic cancer who visited ER for small amount of hemoptysis and dyspnea. There was severe tracheal narrowing and deviation due to the anaplastic thyroid cancer, ECMO (Extra Corporal Membrane Oxygenation) was used instead of a tracheal intubation for general anesthesia.

Surgical Management of Idiopathic Tracheal Stenosis -Three case reports- (특발성 기관 협착증(Idiopathic Tracheal Stenosis)의 외과적 치험 -3예 보고-)

  • Kim, Hyung-Tae;Choi, Ho;Yoon, You-Sang
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.439-443
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    • 2003
  • A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.