• Title/Summary/Keyword: Tracheal surgery

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Evaluation of Tracheal Deviation in Patients with Thyroid Cancer (갑상선 암 환장서 기관지 편이 정도를 평가하는 방법의 연구)

  • Yoo, Young-Sam
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.138-144
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    • 2010
  • Background: Tracheal deviations are encountered frequently in head and neck tumors especially in thyroid cancer. Dyspnea and stridor are symptom calling for surgery. The method of evaluation in tracheal deviation is not well established yet. This paper is aimed to suggest objective tools to evaluate tracheal deviation in relation to cervical vertebra. Material and Method: Ten cases of thyroid cancers were recruited retrospectively. Tracheal inner shadow and shape of cervical vertebra were reconstructed three dimensionally using 3D-doctor to compare position of trachea in relation to vertebral body. Extent of deviation was scored in relation to both lateral borders of vertebral body. Angles between trachea and spinous process were measured in axial CT and compared between study group and control group. Results: Deviation scores were statistically significant between study group (mean=1.1) and control group (mean=0) (p=0.0008). Deviation angles at maximal tumor size in study group (mean=160.3 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0007). Angles at maximal deviation of three dimensional images ages in study group (mean=162.6 Degrees) and deviation angles of control group (mean=177.1 Degrees) were statistically significant (p=0.0089). Conclusion: Tracheal deviation can be evaluated using scoring of three dimensional images and measuring angle between trachea and vertebral spine.

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Tracheoinnominate Artery Fistula after Tracheal Reconstruction (기관 재건술 후 발생한 기관 무명동맥루)

  • 곽영태;신원선;맹대현;이신영;김수철;박주철;김동원
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1288-1291
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    • 1996
  • Tracheoinnominate artery fistula is a rare but a catastrophic complication after tacheostomy or tracheal reconstruction. We experienced one case of tracheoinnominate artery fistula after tracheal reconstruction. The patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. She complained of dyspnea and paroxysmal cough 5 months after tracheostomy and was diagnosed as tracheal stenosis. We performed 4cm of tracheal resection and end to end anastomosis. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and re-reconstruction of trachea. The patient died of bleeding 3 days after the reoperation.

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Formation of an Intestine-Cartilage Composite Graft for Tracheal Reconstruction (기관 재건을 위한 장과 연골의 복합 이식판 개발)

  • Jheon, Sang-Hoon;Lee, Sub;Jung, Jin-Yong;Kong, Jun-Hyuk;Lim, Jeong-Ok;Kim, Yu-Mi;Jin, Chun-Jin;Park, Tae-In;Lee, jae-Ik;Sung, Seok-Whan;Choh, Joong-Haeng
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.474-481
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    • 2004
  • Background: Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and other oncologic conditions but bears. many critical problems compared to other organ transplantations. The purpose of this study was to develop intestine-cartilage composite grafts for potential application in tracheal reconstruction by free intestinal graft. Material and Method: Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chondrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3 kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Result: We identified implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory. Microscopic examinations included special stain s howed absorption of scaffold and cartilage formation even though it was not fully matured. Conclusion: Intestine-cartilage composite graft could be applicable in the future as tracheal substitute and should be further investigated.

Surgical Management of Tracheal and Bronchial Stenosis (기관및 기관지 협착증 환자의 외과적 치료)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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Formation of an intestine-cartilage composite graft for tracheal reconstruction

  • Jheon, Sang-Hoon;Kim, Tae-Hun;Sung, Sook-Whan;Kim, Yu-Mi;Lim, Jeong-Ok;Baek, Woon-Yi;Park, Tae-In
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.107-107
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    • 2003
  • Purpose; Tracheal transplantation is necessary in patients with extensive tracheal stenosis, congenital lesions and many oncologic conditions but bears many critical problems compared with other organ transplantations. The purpose of this study was to make an intestine-cartilage composite graft for potential application for tracheal reconstruction by free intestinal graft. Methods; Hyaline cartilage was harvested from trachea of 2 weeks old New Zealand White Rabbits. Chondrocytes were isolated and cultured for 8 weeks. Cultured chodrocytes were seeded in the PLGA scaffolds and mixed in pluronic gel. Chondrocyte bearing scaffolds and gel mixture were embedded in submucosal area of stomach and colon of 3kg weighted New Zealand White Rabbits under general anesthesia. 10 weeks after implantation, bowels were harvested for evaluation. Results; We could identify implantation site by gross examination and palpation. Developed cartilage made a good frame for shape memory Microscopic examinations include special stain showed absorption of scaffold and cartilage formation even though not fully matured Conclusion; Intestine-cartilage composite graft could be applicable to future tracheal substitute and needs further Investigations.

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A Case of Tracheal Cancer Arising 3 Years after Radiation Therapy for Laryngeal Cancer (후두암에 대한 방사선 치료 3년 후 기관암이 발생한 환자 1례)

  • Yum, Gunhwee;Oh, Kyung Ho;Choi, Jung Woo;Kwon, Soon Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.2
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    • pp.110-113
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    • 2018
  • Tracheal cancer is rare and accounts for approximately 0.03% of all malignancies. Because of atypical symptoms, tracheal cancer can be misdiagnosed as obstructive lung disease, or tumors of thyroid or lung. Among patients of previous head and neck cancer, other primary cancer may accompany which called "econd primary cancer". We report a case of patient with tracheal cancer 3 years after definite radiation therapy of laryngeal cancer with a review of related literatures.

A Case of Tracheal Granuloma Removal using Potassium-Titanyl-Phosphate Laser (Potassium-Titanyl-Phosphate 레이저를 이용하여 제거한 기관 육아종 1예)

  • Hong, Ji Song;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.92-95
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    • 2020
  • Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.

Delayed Detection of a Penetrating Tracheal Foreign Body (수상 후 10년이 지나 발견된 기관 내 이물질)

  • Jang, Woo-Sung;Kim, Young-Tae;Kim, Joo-Hyun;Kang, Chang-Hyun
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.384-387
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    • 2007
  • The finding of a tracheal penetrating injury that's caused by a foreign body is rare in adulthood. A 42-year-old man had experienced penetrating trauma due to a glass fragment 10 years ago. He presented with blood tinged sputum and dyspnea on exertion, and this had developed 1 year previously. Chest CT scan and bronchoscopy revealed a foreign body crossing the tracheal lumen and the object arose from outside of the trachea; this was all associated with airway edema. We removed the foreign body, which was a 5cm length of glass fragment, and we repaired the tracheal defect using a simple primary suture. The postoperative course of the patient was uneventful and he is now being followed up at the outpatient department; he has had no additional symptoms.

Management of Permanent Tracheostomal Stenosis by Tracheal Advancement Flap (기관전진피판술을 이용한 영구기관 개구협착의 치료)

  • Choi, Jong-Ouck;Min, Hun-Ki;Choi, Geon;Jung, Kwang-Yoon;Kim, Young-Ho;Park, Chan;Lee, Byeong-Ki
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.136-141
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    • 1995
  • Tracheostomal stenosis after total laryngectomy is a distressing complication which con-tributes significantly to both psychosocial and physical morbidity according to nature and severity in laryngectomee. Sternal stenosis will compromise not only optimal air exchange, crust formation but also the ability to clear tracheobronchial secretion, so pneumonia and atelectasis will develop. Having a number of procedure recommended for correction of such stenosis with limited results. We developed new technique which is based on tracheal advancement flap had been ap-plied to 12 patients, successfully. We think that total or partial tracheal advancement flap technique Is useful for widening the stoma and advantages of this method are following. 1. Simple technique. possible under local anesthesia 2. Healthy tracheal ring facilities width control 3. Less chance of refractory scar stenosis 4. Tracheoesophageal shunt can be constructed after the partial advancement flap.

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An Experimental Study for the Prevention of Postanastomotic Tracheal Stenosis using PTFE (Polytetrafluoroethylene) in Tracheal Surgery (기관문합수술에서 PTFE(Polytetrafluoroethylene)를 이용한 협착방지에 대한 실험연구)

  • 이석열;이길노;고은석
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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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.

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