• Title/Summary/Keyword: trachea stenosis

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Surgical Result of Tracheal Resection and Primary Anastomosis in Tracheal Stenosis (기관 협착증 환자에서 기관 절제 및 단단 문합술의 성적에 대한 고찰)

  • 조성래
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.156-161
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    • 1995
  • Although there are many kinds of method in treatment of tracheal stenosis, tracheal resection and primary anastomosis can be performed for management of various kinds of tracheal stenosis because it is considered the most anatomical ideal therapeutic modality. During a 10-year period we performed 18 tracheal resection on 18 patients with no operative mortality and some morbidity. 13 patients had tracheal stenosis caused by endotracheal intubation [eight patients or tracheostomy [five patients ; and five patients caused by a variety of neoplastic lesions [four primary and one secondary . The length of tracheal stenosis were various from 1.5cm to 5.5cm and site of tracheal stenosis were cervical[17patients and thoracic [one patient . Operative techniques were tracheal resection and primary anastomosis[18 patients and additional procedures were cricoid cartilage reconstruction with costal cartilage [one patient , primary repair of esophagus[one patient and suprahyoid laryngeal release technique[eight patients without any complications. We have eight complications; tracheal restenosis were developed in five patients[growth of grannulation tissue at anastomotic site in three patients, delayed restenosis in two patients , anastomotic disruption in one patient, hoarseness and pneumonia in each of two patients. We managed tracheal complications with T-tube insertion in two patients, permanent tracheostomy in three patients and insertion of Gianturco tracheal stent in one patient, but tracheal stent did not reveal good result because it caused persistent production of sputum. We concluded that it is necessary to access full length of normal trachea including suprahyoid laryngeal release technique to avoid anastomotic tension in tracheal surgery and develope new ideal techniques to manage postoperative tracheal complications, because we suppose tracheal complications are developed due to anastomotic tension.

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Surgical Treatment of Tracheal Stenosis (기관 협착증의 외과적 치료)

  • 최준영;장인석;김종우;김병균;이정은;김성호;이상호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.565-569
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    • 2000
  • Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.

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Surgical treatment of tracheal stenosis due to paratracheal tuberculous lymphadenitis.* (결핵성 임파결절에 의한 기관 협착증 치험 1)

  • 강채규
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.213-217
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    • 1987
  • ; A 15 years old girl was operated due to tuberculous paratracheal lymph node enlargement resulted in marked narrowing of lower part of trachea. She had suffered from sputum expectoration difficulty, which was developed dyspnea and cyanosis. 1st operation was simple removal of enlarged paratracheal lymph node through Rt. thoracotomy but restenosis sign developed 2 months later in spite of Anti-Tbc. medication. 2nd operation was resection of constricted tracheal portion [2.5cm] 8 end to end anastomosis under Extra Corporeal Circulation. Under Extra Corporeal Circulation trachea reconstruction offered many conveniences during operation. Till now, she has been follow up checked for one year, she was very good post-operation state without any restenosis signs.

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A Case of Relapsing Polychondritis (기도협착이 초래된 재발성 다발연골염 1례)

  • 최홍식;김현준;박준호;김진영
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.2
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    • pp.149-153
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    • 1999
  • Relapsing polychondritis is an uncommon disorder of unknown etiology. That involves multisystem characterized by recurrent inflammation, degenerative change of multiple cartilaginous structures. The most common clinical manifestation is an auricular chondritis. Other involving systems are joint, nose, eye, larynx, trachea, aorta, heart and kidney. A 26-year-old man who complained of hoarseness and sore throat was referred to the ENT department from internal medicine department. On initial video-laryngoscopic and radiologic examination, there was no abnormal finding. Treatment with high doses of corticosteroid and methotrexate was not effective. Symptoms were aggrevated with dyspnea. Three months later, on video-laryngoscopic examination, bilateral cord fixation with swelling was noted. The radiologic finding showed subglottic stenosis due to collapse of anterior wall of cricoid cartilage. The condition was managed with tracheotomy. We report a case of relapsing polychondritis involving larynx and trachea with bilateral vocal cord palsy which was managed with tracheotomy.

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Subglottic transection of larynx with right pneumothorax One case Report (외상후 발생한 성문하후두의 완전절단 치험 1례)

  • 김학제
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.812-816
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    • 1985
  • In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

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Extended Sleeve Lobectomy for Tuberculous Bronchial Stenosis - A case report- (결핵성 기관지 협착에 대한 확대 소매 폐엽절제술 - 1예 보고 -)

  • Kim, Dae-Hyun;Kwak, Young-Tae;Choi, Cheon-Woong;Yoo, Ji-Hong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.793-796
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    • 2010
  • Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.

Anesthetic Management of Corrective Operation of Tracheal Stenosis (기관절개후에 발생한 기관협착증 마취례)

  • Park, Dae-Pal
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.155-157
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    • 1987
  • A 25 years old male patient was experienced Trough method operation to correct of Tracheal stenosis following Tracheostomy. After admission, a No.3 Magill plastic portex tube had been placed in the previous tracheostomy opening. Stenotic narrowing portion was noted low trachea (about 3.5cm above carina) Despite of narrowing of the lesion, anesthetic course was uneventful with oxygen, halothane and non depolarized muscle relaxant by controlled respiration. Postoperative coures were also favorable With adequate respiratory cares and blood gas analyzed.

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Surgical Repair of Tracheal Stenosis with Tracheoesophageal Fistula Induced by Prolonged Endotracheal Intubation - Report of A Case - (기관삽관에 의한 기관협착및 기관 식도루: 수술치험 1례)

  • 허강배
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.581-587
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    • 1992
  • Tracheoesophageal fistula[TEF] is a rare but life-threatening lesion that may occur from ventilation with a cuffed tube. It occurs most frequently when an inlying esophageal tube is also being used-usually for feeding purposes. The mechanism of injury appears to be pressure experted on the tracheal wall by the cuff, which then compresses the "party wall" of the trachea and esophagus against the foreign body that lies in the esophagus. The patient was 32 years old female who had been receiving a treatment of respiratory failure induced by postoperative sepsis with assist ventilator and nasogastric tubal feeding. Sudden attack of abdominal gas distention and massive drainage of gas through N-G tube were developed during assist ventilation in that patient, so we diagnosed as tracheal stenosis with a tracheoesophageal fistula induced by prolonged endotracheal intubation We performed tracheal reconstruction and primary closure of perforated esophagus after weaning ventilator. The postoperative course was uneventiful.eventiful.

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Tracheal Compression by Xhronic Dissecting Aeurysm(TYpe B) -A Case Report- (기관지 압박을 초래한 만성 해리성 대동맥류(Type B) -임상적 치험 1례-)

  • 송정근
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.328-331
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    • 1995
  • A 42-year-old Marfan female had a chronic dissection of the descending aorta[Type B and the aneurysmal expansion of the descending aorta caused compression of the trachea resulting in respiratory distress which mimicked bronchial asthma. The patient has been successfully managed by resection and replacement of the aneurysm in the descending aorta. The operation could be done without the aid of the partial cardiopumonary bypass. As the patient had been prepared by unilateral axillo-bifemoral by-pass using prosthetic graft 8mm in diameter 10days prior to the main operation.

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Retrievable Nitinol Stent for Treatment of Tuberculous Tracheobronchial Stenosis -A case report- (결핵성 기관-기관지 협착에서 제거형 니티놀 스텐트 삽입요법 -1례-)

  • Chung, Bong-Kyu;Kim, Kwang-Taik;Park, Sung-Min;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.107-111
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    • 2000
  • Although a tracheal stent can be an option for inoperable tracheal stenoses there still are some troublesome side effects including overgranulation from foreign body irritation restenosis and patient's discomfort associated with the procedure. We report a successful case of a retrievable stent made of self-expandable 'shape memory' metal and polyurethane in a 24 year old female patient with respiratory distress and tight stenosis in the trachea and left main bronchus, The stent was inserted following a balloon dilatation and was successfully removed on the 7th days after the procedure. She regained a normal active life without any repiratory symptoms and a follow-up of 8 months showed satisfactory results.

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