• 제목/요약/키워드: Tracheal surgery

검색결과 292건 처리시간 0.025초

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

  • 이형민
    • Journal of Chest Surgery
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    • 제27권5호
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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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기관절개술후에 발생한 기관협착증에 대한 기관절제 단단문합술치험 1례 (Reconstruction of Tracheal Stenosis following Tracheostomy [1 Case Report])

  • 박건주;김공수
    • Journal of Chest Surgery
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    • 제18권2호
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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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소아에서 흉부 압박상 후 발생한 경부기관의 완전 파열 (Complete Rupture of Cervical Trachea after Compressed Chest Injury in a Child)

  • 변정훈;조성호;조성래
    • Journal of Chest Surgery
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    • 제40권4호
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    • pp.309-312
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    • 2007
  • 흉부 압박상에 의한 경부 기관의 파열은 매우 드물게 발생하며, 여러 가지 기전에 의해 설명되고 있다. 기관 손상을 받은 많은 환자는 병원에 도착하기 전에 사망하기 때문에 빠른 진단에 의한 치료는 예후를 결정하는 데 매우 중요하다. 교통사고에 의한 흉부 압박상으로 호흡곤란을 주소로 내원한 8세의 남아에서 발생한 경부 기관의 완전파열 1예를 조기 진단하여 수술치험하였기에 문헌고찰과 함께 보고하는 바이다.

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

  • 이경수;박동욱;김규훈;김재욱;고윤우;김도진;이승원
    • 대한기관식도과학회지
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    • 제15권1호
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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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    • 제23권3호
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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.

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

  • 임강현;정용준;한문수;이주한;김영식;오경호;권순영
    • 대한두경부종양학회지
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    • 제34권2호
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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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    • 제55권6호
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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.

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

  • 이건;김대식;문승철;구원모;양진영;이헌재;임창영;한헌;김광호;선경
    • Journal of Chest Surgery
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    • 제32권5호
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    • pp.442-447
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    • 1999
  • 서론: 성장기에서 기관의 성장양상에 관한 이해는 수많은 기관질병의 관리나 선천성 기관협착증에서 기관 성형술 등에서 매우 중요한 지표가 된다. 그러나 이에 관한 국내의 연구례가 거의없는 실정이다. 본 연구는 한국인 소아에서 기관의 내경과 단면적을 후향적으로 분석하여 기관질환의 치료에 기초자료를 제공하고자 한다. 대상 및 방법: 1996년 5월부터 1998년 8월까지 흉부전산화 단층촬영을 시행한 0세부터 20세까지 106명의 환자를 대상으로 하였는데 기관의 내경이나 단면적에 영향을 줄 수 있는 기관질환, 과거에 개흉술을 받은 경우, 종격동 종양, 폐쇄성 폐질환이 있는 경우는 본 연구에서 제외시켰다. 남자가 69명, 여자가 37명이었으며 기관의 종단내경과 횡단내경은 흉부유입부와 대동맥궁 부위에서 각각 측정하였다. 기관의 형태는 각 부위의 단면에서 원형, 타원형, 말발굽형으로 구분하였으며 단면적은 A = 1/4$\pi$ab (A: 단면적, $\pi$: 3.14, a: 종단내경, b: 횡단내경)의 공식으로 계산하여 각 부위의 내경과 연령 및 성별에 따른 단면적을 비교 분석하였다. 통계처리에서 p값이 0.05이하일 때 통계적 의미가 있는 것으로 간주하였다. 결과: 5세이하에서는 level I과 II 모두에서 기관의 형태가 원형을 이루고 있었으며 두 부위간의 단면적의 차이는 없었다. 성장함에 따라 level I의 형태는 타원형으로 변해가는 반면 level II에서는 그대로 원형을 유지하고 있었으며 level I의 단면적이 level II 보다 크다(p=0.020). 기관의 내경과 단면적은 성장함에 따라 직선관계로 증가한다는 것이 확인되었고(r>0.9), 5세이하의 소아에서는 여자가 남자보다 기관의 단면적이 크고 (p=0.020) 15세가 넘으면 반대로 남자가 더 크다 (p=0.002). 결론: 이상의 결과에서 흉부전산화 단층촬영은 기관의 내경과 단면적을 측정하는데 있어 안전하고 확실한 방법이며 성장기의 한국인에서 기관의 내경과 단면적에 대한 지표가 되고자 한다.

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

  • 남우주;김소연;김태환;이상혁
    • 대한두경부종양학회지
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    • 제33권1호
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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.

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

  • 김형태;최호;윤유상
    • Journal of Chest Surgery
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    • 제36권6호
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    • pp.439-443
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    • 2003
  • 특별한 원인 없이 하부후두나 상부기관의 협착이 나타날 수 있는데, 이를 특발성 기관 협착증(Idiopathic Tracheal Stenosis)이라 한다. 이러한 특발성 기관 협착증는 젊은 여성에게 나타나는 성대하부의 원형섬유성 협착을 보이는 드문 질병이다. 이에 대한 치료는 질병의 원인이나 경과가 밝혀지지 않아 보존적 원칙에 따르는 것이 일반적이었으나, 최근 들어 외과적인 절제와 재건술이 많이 시행되고 있으며 좋은 결과를 보고하고 있다. 3예 모두 여성 환자로 호흡곤란을 주소로 내원하였고, 2예는 기관지천식 진단하에 수년간 내과적 치료를 받은 병력이 있었다. 모든 환자에 있어서 경부 및 흉부 전산화단층촬영과 기관지내시경으로 기관 협착증을 진단하였고, 협착의 위치에 따라 성문하 협착(Subglottic Stenosis) 2예는 경부 칼라 절개술을 통하여 성문하 절제(Subglottic resection)를 시행하였고 기관 원위부 협착 1예는 우측 후외측 개흉술을 통하여 기관절제 및 단단 문합을 시행하였으나 문합부의 감염에 의한 재협착으로 기관내 스텐트 삽입 후 경부 칼라절개와 정중흉골절개로 모든 기관을 노출한 재수술로 성공적인 치료를 하였기에 보고하는 바이다.