• Journal of Chest Surgery
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• 제43권6호
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• pp.793-796
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• 2010

기도에 발생하는 결핵의 후유증으로 종종 원위부 기관이나 주 기관지에 미만성 협착이 발생한다. 기관지 협착이 주 기관지에만 존재할 경우 기관지 소매 절제술로 치료할 수 있는데, 협착의 길이가 2cm 이내일 경우 기관지 소매 절제술을 시행하기에 좋은 대상이 된다. 그러나 협착의 길이가 긴 경우에는 기관지 소매 절제술을 시행하기 어렵거나 또는 불가능할 수 있어 전폐젤제술 또는 기관지내시경적 치료를 시행하기도 한다. 확대 소매 폐엽절제술은 기관지 성형술을 이용하여 한 개 이상의 폐엽을 절제하는 수술 방법으로 주로 국소적으로 진행된 폐암에서 전폐절제술을 피하기 위하여 시행되었다. 저자들은 기도 결핵의 후유증으로 우측 주 기관지, 중간 기관지, 우중엽 기관지 및 우하엽 기관지에 심한 협착이 존재하는 환자에 대해 확대 소매 폐엽절제술을 시행하여 좋은 치료 결과를 보인 증례를 문헌고찰과 함께 보고한다.

• Journal of Chest Surgery
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• 제42권5호
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• pp.670-673
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• 2009

기관지내 결핵을 앓아오던 20세 여자 환자가 기관하부와 우측 수기관지, 우측 상엽 기관지 협착이 발생하였다. 이로 인하여 환자는 심한 호흡곤란을 호소하였다. 협착이 광범위하여 하부 기관, 우측 주기관지 및 우상엽 절제술 후 기관 및 주기판지 재건슬을 시행하였다. 4년이 지난 현재까지 별다른 합병증 없이 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제20권1호
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• pp.177-181
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• 1987

For the treatment of bronchial stenosis due to trauma, inflammatory and neoplastic lesion, bronchoplastic procedure in the interest of preservation of lung tissue are relatively new developments in the field of thoracic surgery. We reported on case of bronchoplasty using to pericardial patch for the treatment of bronchial stenosis due to chronic inflammation. The patient was 26 years old female and chief complaint was respiratory difficulty. Bronchogram revealed diffuse stenosis of left main bronchus about 4cm and especially, at just below the carina marked narrowing of lumen and fine serration in the wall. At the time of operation, longitudinal incision was made at left main bronchus about 5cm and reconstructed bronchus using to pericadial patch at membranous compartment of bronchus. The postoperative course was uneventful and post-operative follow up bronchography showed that improvement of bronchoplastic segmented region.

• 대한기관식도과학회지
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• 제10권2호
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• pp.17-21
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• 2004

Background Insertion of tracheal stent in the treatment of benign tracheal & bronchial disease has increased since the introduction of expandable metallic stent. Material & Methods : Between Jan, 1995 and Feb. 2004, eight patients who had benign tracheo-bronchial disease underwent insertion of expandable metallic tracheal stent. We retrospectively analyzed stent insertion indications, complications, and following the result. Results : Surgical indications were post-intubation tracheal stenosis (1 case), tracheal stenosis following tracheal surgery (2 cases), tracheo-esophageal fistula (2 cases), broncho-pleural fistula(1 case), left main bronchus stenosis following bronchoplasty (1 case), and left main bronchus stenosis due to mediastinal repositioning (1 case). Expandable metallic tracheal stent was inserted in five patients to resolve dyspnea caused by airway obstruction, and to prevent recurrent pneumonia in three patients. The complication developed in 6 patients $75\%$; 3 cases of distal stenosis due to growth of granulation tissue, and one case each of tearing of posterior membrane, aggravation of tracheo-esophageal fistula, and airway partial obstruction due to stent migration. The stent was removed in 5 patients and tracheal surgery (tracheal resection and end to end anastomosis with primary repair of esophagus, pericardial patch tracheo-bronchoplasty, tracheal repair and omental wrapping) was performed in 3 patients. Conclusion Insertion of self expandable metallic stent in benign tracheo-bronchial disease is an effective means of relieving dyspnea for only a short period, and it did not increase the long term survival. Better means of treatment of benign tracheo-bronchial stenosis in necessary.

• Journal of Chest Surgery
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• 제28권2호
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• pp.201-205
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• 1995

Most of the patient with endobronchial tuberculosis have some degree of bronchial stenosis. however, a part of bronchial stenosis need aggressive treatment for the patency because of severe symptoms. The self-expendable metallic stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. We experienced a successful left wedge pneumonectomy on a 29-year-old woman with obstruction of left main bronchus due to complication of the bronchial stent. She had inserted self-expendable metallic stents on left main bronchus of the tuberculous bronchial stenosis two times. There was no specific postoperative complication.

• Journal of Chest Surgery
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• 제25권11호
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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

• Journal of Chest Surgery
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• 제35권2호
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• pp.149-152
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• 2002

저자들은 이중 기관기관지 스텐트를 성공적으로 거치하여 상당히 긴 부분에 걸쳐 협착이 있는 환아에서 환기유지를 할 수 있었던 증례를 보고한다. 생후 1개월된 환아가 출생 시부터 시작된 빈호흡과 이산화탄소저류를 주소로 응급실로 내원하였다. 술전 흉부단층촬영에서 폐동맥 슬립과 진성성대 직하부부터 양측주기관지 입구에 이르는 상당히 긴 부분에 걸쳐 미만성 기관협착을 확인하였다. 수술소견에서 양측 주기관지의 입구는 3m미만이었으며 기관지협탁부위는 완전환형기관연골이었다. 체외순환 상태에서 좌폐동맥을 잘라 주폐동맥으로 재이식하고 자가심낭편을 이용하여 기관을 확대성형하였다. 그러나, 기관내 육아조직의 성장과 이식한 자가심낭편의 호기시 운동성 폐쇄에 의해 여전히 이산화탄소저류와 호흡곤란은 지속되었다. 이 문제를 해결하기 위해 기관스텐트를 기관내에 거치하였으나, 여전히 양측 주기관지 입구의 협착으로 인해 호흡곤란 증세가 해결되지 않았다. 결국 이중 기관기관지 스텐트를 삽입하여 기도폐쇄를 해결할 수 있었다.

• Tuberculosis and Respiratory Diseases
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• 제45권2호
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• pp.416-420
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• 1998

저자들은 기관지결핵의 후유증으로 좌주기관지 협착이 있었던 환자가 이상성 기류유량곡선을 보인 후 금속스텐트 삽입후 교정되었다가 스텐트 삽입 2개월 후부터 육아종형성에 따른 좌주기관지의 재협착이 나타나 다시 기류유량곡선상 이상성 기류유량곡선을 보인 증례를 경험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.286-288
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• 2015

Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

• 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.