• 제목/요약/키워드: Tracheal surgery

검색결과 292건 처리시간 0.021초

초냉동 보관된 백서의 동종 기관 이식편의 대망 내 이식에 따른 조직 생육성 및 혈관 형성 (The Viability & Vascularization of the Cryopreserved Rat Tracheal Allografts with Omental Implantation)

  • 김용희;김동관;김규래;박승일
    • Journal of Chest Surgery
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    • 제37권8호
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    • pp.623-631
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    • 2004
  • 배경: 대망의 가장 중요한 성질 중 하나인 혈관 형성 촉진 기능을 이용하여 초냉동 보관된 기관 이식편의 대망 내 이식이 기관 이식편의 생육성이나 혈관 형성에 미치는 영향을 연구하고자 한다. 대상 및 방법: 8주령의 Sprague Dawley rat 수컷의 초냉동 보관된 기관 이식편을 백서의 복강 내 대망에 이식하였다. 연구군은 냉동 보관기간과 대망 내 이식기간에 따라 4개의 군으로 분류하였다(n=52). 이식된 기관 이식편을 획득하여 기관 평활근 및 주변 결합 조직의 섬유화 및 염증 정도, 기관 연골의 석회화 정도, 기관 내 상피세포의 변화 및 연골간 간격에서의 혈관 형성 정도 등을 검사하였다. 결과: 기관 평활근의 염증 정도는 냉동 보관기간이나 대망 내 이식기간에 따라 유의한 차이를 보이지 않았고, 기관 연골의 석회화 정도는 냉동 보관기간과 상관없이 대부분 심하게 진행되어 있었다. 혈관 형성은 기관 이식편의 양끝뿐만 아니라 중간 부위에서도 충분히 이루어져 있었다. 결론: 초냉동 보관된 백서의 장분절 기관 이식편을 2주간 대망 내 이식을 시행한 결과 기관 이식편의 조직 생육성이 적절히 유지되면서 새로운 혈관이 형성되었다. 향후 동종 기관 이식 시 초냉동 보관된 기관 이식편을 대망 내 이식하여 새로운 혈관이 형성된 후 단계적으로 기관 이식을 시행하는 데 도움이 될 수 있다고 생각한다.

주기관 긴 협착증 환자의 수술 치험 (Circumferential Resection and End to End Anastomosis of Mediastinal Trachea for Long Tracheal Stenosis)

  • 유정훈
    • Journal of Chest Surgery
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    • 제25권6호
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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.

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기관 평활근종의 수술적 절제;1례 보고 (Surgical Resection of Tracheal Leiomyoma; A cas report)

  • 심재천
    • Journal of Chest Surgery
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    • 제26권12호
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    • pp.965-968
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    • 1993
  • Primary benign tracheal tumors are exceedingly rare and leiomyoma has the least frequency among them. It is important to recognize early without misdiagnosis such as asthma because it is curable. A 41 year-old female was admitted for dyspnea and choking since November 1991. Under the impression of asthma, she received medication. Symptom was not improved and thus chest CT scan was performed. There was endotracheal tumor mass which was located just above the carina and arose from the right lateral tracheal wall with broad base. We successfully resected the tumor mass including trachea and the defected area of trachea was reconstructed with autologous graft using pericrdium & rib cartilage. During the follow up period, no complication was developed.

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갑상선 종양에 의한 기도협착 치험 -1례 보고- (Circumferential Resection and Direct End to End Anastomosis of Tracheal Stenosis Invaded by Thyroid Carcinoma.)

  • 변형섭
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.389-394
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    • 1988
  • The patient was 22-year old male who had been suffered from labored breathing. Computerized tomography, tracheoscopy, tracheogram disclosed tracheal obstruction by external mass compression on Tl level, which ranged 4.Oem in the length and approximately 4mm in diameter on tracheogram. Under the local anesthesia, tracheostomy was done to prevent intraoperative airway obstruction. And general anesthesia, low collar incision 8z extended median sternotomy was made and nearly total thyroidectomy was performed. After the circumferential resection of the obstructed segment approximately 4cm in length[7 tracheal rings], direct end-to-end anastomosis of trachea was performed. Postoperatively, the patient`s neck was maintained in flexion state to reduce tension of anastomotic site. Postoperatively. medical therapy[Comthyroid k Calcium lactate] and radiotherapy were done. At present, 2-months after operation, he lives well.

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Tracheal Cartilaginous Sleeve in Antley-Bixler Syndrome With W290C Mutation in FGFR2

  • Oh, Jayoung;Kwon, Seong Keun
    • 대한후두음성언어의학회지
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    • 제33권1호
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    • pp.50-53
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    • 2022
  • A case is presented to show tracheal cartilaginous sleeve in Antley-Bixler syndrome, which is the second case to be reported so far. In this patient, W290C mutation in FGFR2, the mutation previously known to cause Pfeiffer syndrome, was newly identified. After receiving tracheostomy, the patient recovered from repetitive respiratory distress, and retrieved normal respiratory function. Thorough airway examination and active surgical management such as tracheostomy is necessary in children with syndromic craniosynostosis, including Antley-Bixler syndrome.

기관절개술후 종격동기관 협착증에 대한 기관절제 단단 문합술 (Circunferential resection and direct end to end anastomosis of mediastinal trachea on a post tracheostomy stenosis)

  • 김세화;박희철;이홍균
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.495-502
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    • 1980
  • A 37 year old male patient was suffered from severe labored breathing caused by post tracheostomy stenosis, which was localized at the mediastinal trachea [cuffed tracheal stenosis] and ranged 1.5 cm in length and approximately 3 ram. in diameter on tracheogram. After dilation of tracheal stenosis with dilator, endotracheal intubation was tried for induction of anesthesia and control of respiration during operation. A tube was placed just beyond the tracheal stenosis without respiratory difficulty. Under the endotracheal anesthesia, circumferential resection of the mediastinal trachea containing the stenosis, approximately 2 cm in length [4 tracheal rings}, was carried out and primary direct end to end anastomosis was performed with interrupted submucosal sutures [3-0 Dexon] and mobilization of trachea Postoperative tracheostomy was not performed. The patient was completely relieved from dyspnea immediately after operation. Post-operative convalescence was entirely uneventful and at present, about 3 months after operation, he is now conducting a usual life. From the literature and our experience, the etiology and treatment of post-tracheostomy stenosis were discussed.

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실험동물 잡견 기도의 장기간 보존을 위한 냉동 보관법의 효과 (The Effect of Cryopreservation to Maintain Long-term Storage on Canine Trachea)

  • 성숙환;박성희
    • Journal of Chest Surgery
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    • 제24권5호
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    • pp.438-444
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    • 1991
  • This study was designed to evaluate the viability of canine trachea after cryopreservation for two months. Eight cervical tracheal rings were resected in three dogs and both ends were anastomosed. The resected tracheal segments were cryopreserved and stored in liquid nitrogen at -196oC for two months. Two months later, the cryopreserved segments were thawed. Half of each segment was implanted into the abdomen of its donor animal and the other half was cultured in tissue media. Two weeks later, the animal was sacrificed. The native cervical trachea was removed to serve as a control and the abdominally implanted trachea was removed for study. At that time, both specimens were also cultured in tissue media. Tracheal epithelial viability was assessed histologically by using an inverted microscope. The epithelial cells were confirmed immunohistochemically using monoclonal antibodies against cytokeratin and epithelial membrane antigen. Control and cryopreserved segments showed good, viable epithelial cells, but the implanted segments showed slightly depressed viability. We conclude that canine tracheal epithelium can survive after cryopreservation for two months, but the implanted trachea will be slightly damaged by ischemia before revascularization, even if omental wrapping is used.

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좌측 수상 전폐 적출술에 의한 선양 낭포암 치험 1례 (Surgical Treatment of Adenoid Cystic Carcinoma by Left Tracheal Sleeve Pneumonectomy)

  • 김동원
    • Journal of Chest Surgery
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    • 제27권5호
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    • pp.413-417
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    • 1994
  • Adenoid cystic carcinoma usually grows in the trachea or near its bifurcation and causes obstruction of the air way. We recently experienced a 33 year-old male patient who had adenoid cystic carcinoma in the left main bronchus with the chief complaint of productive cough. On the bronchoscopy, the mass obstructed the left main bronchus completely and had nodularity and increased vascularity.The trachea was shifted to the left side and the lower lobe of the left lung was atelectatic on chest X-ray and computed axial tomogram.He underwent left tracheal sleeve pneumonectomy and lymph node dissection through bilateral thoracotomy. At first,we attempted left tracheal sleeve pneumonectomy through the left thoracotomy,however, it was very difficult to perform carinoplastic procedure after sleeve resection of 2.5cm of distal trachea and 1cm of proximal right main bronchus including whole left lung because of poor operative field and difficulty in the anastomosis of the right main bronchus to the distal end of the trachea without tension.Therefore after radical resection of the left lung we made right thoracotomy,through which we could anastomosed the distal trachea and right main bronchus with 4-0 PDS interrupted suture after mobilization of the right hilum without difficulty. The tumor was confirmed to be adenoid cystic carcinoma with metastasis to subcarinal lymph node histopathologically. Postoperative course was uneventful but he needed two bronchoscopic procedure to clear distal airway of the retained bronchial secretion. He was discharged at 14 days after operation with complete recovery.

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기관상관후 발생한 기관식도루의 교정 1 례 (Tracheoesophageal Fistula Due to Endotracheal Intubation: a case Report of Requiring Tracheal Reconstruction)

  • 신원선;곽영태
    • 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.

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스텐트 삽입술 후 수술적 절제술로 치료한 특발성 기관 협착증 1예 (A Case of Idiopathic Tracheal Stenosis Treated with Tracheal Resection After a Retrievable Stent Insertion)

  • 이형노;조혜진;이종우;신승수;오윤정;박광주;황성철;최호;이기범
    • Tuberculosis and Respiratory Diseases
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    • 제53권4호
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    • pp.450-456
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    • 2002
  • 심한 호흡부전을 보인 특발성 기관 협착증 환자에서 풍선 확장술 및 기관 스텐트 삽입술을 시행하여 호흡을 안정시킨 후 수술적 절제 및 문합술을 시행하였다.