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Insulation-Tipped Diathermic Knife 2를 이용한 중심성 기도 폐쇄 치료 2예

Two Cases of Central Airway Obstruction Treated with an Insulation-Tipped Diathermic Knife-2

  • Koh, Kyu Han (Department of Internal Medicine, KEPCO Medical Center) ;
  • Kim, Se Joong (Division of Respiratory and Critical Care Medicine, Seoul National University Bundang Hospital) ;
  • Park, Sanghoon (Department of Internal Medicine, KEPCO Medical Center) ;
  • Chang, Se Heon (Department of Internal Medicine, KEPCO Medical Center) ;
  • Yoo, Seung Hyun (Department of Internal Medicine, KEPCO Medical Center) ;
  • Koo, Nam Ho (Department of Internal Medicine, KEPCO Medical Center) ;
  • Lee, Seung Hyeun (Department of Internal Medicine, KEPCO Medical Center)
  • 투고 : 2013.08.23
  • 심사 : 2013.10.14
  • 발행 : 2014.06.01

초록

중심성 기도 폐쇄는 양성 혹은 악성 질환과 동반되어 나타날 수 있으며 현재 다양한 기관지경적 치료법이 사용되고 있다. IT knife-2는 소화기 내시경적 시술을 위해 고안된 장비로서 그 안정성과 효용성이 입증되어 국내 의료기관에서 내시경적 점막하 박리술에 널리 사용되고 있다. 저자들은 굴곡성 기관지경과 IT knife-2를 이용하여 진행성 폐암과 방사선 치료 후 발생한 중심성 기도 폐쇄를 가진 두 환자를 성공적으로 치료하였다. 합병증과 예후에 대한 추가적인 연구가 필수적이지만 IT knife-2는 향후 기도 폐쇄의 내시경적 중재적 시술법 중 하나로 고려될 수 있을 것이다.

Central airway obstruction can result from various benign and malignant conditions, and often requires prompt palliation. The efficacies of a variety of bronchoscopic techniques for the treatment of central airway obstruction such as electrocautery, laser, brachytherapy, argon plasma coagulation and cryotherapy have been established. An insulation-tipped diathermic knife-2 (IT knife-2) was initially introduced for gastrointestinal endoscopic submucosal dissection and has been used globally as a safe and effective instrument. However, its use has not been reported for the treatment of endotracheal or endobronchial lesions. Here, we report the case of central airway obstruction in a 65-year-old male due to malignancy and a 52-year-old-female with post-radiation bronchial stenosis that were treated successfully with the IT-knife-2 via flexible bronchoscopy.

키워드

참고문헌

  1. Wood DE, Liu YH, Vallieres E, Karmy-Jones R, Mulligan MS. Airway stenting for malignant and benign tracheobronchial stenosis. Ann Thorac Surg 2003;76:167-172. https://doi.org/10.1016/S0003-4975(03)00033-X
  2. Ernst A, Feller-Kopman D, Becker HD, Mehta AC. Central airway obstruction. Am J Respir Crit Care Med 2004;169:1278-1297. https://doi.org/10.1164/rccm.200210-1181SO
  3. Chhajed PN, Somandin S, Baty F, et al. Therapeutic bronchoscopy for malignant airway stenoses: choice of modality and survival. J Cancer Res Ther 2010;6:204-209. https://doi.org/10.4103/0973-1482.65250
  4. Morris ML, Tucker RD, Baron TH, Song LM. Electrosurgery in gastrointestinal endoscopy: principles to practice. Am J Gastroenterol 2009;104:1563-1574. https://doi.org/10.1038/ajg.2009.105
  5. Noppen M, Meysman M, D'Haese J, Schlesser M, Vincken W. Interventional bronchoscopy: 5-year experience at the Academic Hospital of the Vrije Universiteit Brussel (AZ-VUB). Acta Clin Belg 1997;52:371-380. https://doi.org/10.1080/17843286.1997.11718603
  6. Smith EL, Hann DM, Ahles TA, et al. Dyspnea, anxiety, body consciousness, and quality of life in patients with lung cancer. J Pain Symptom Manage 2001;21:323-329. https://doi.org/10.1016/S0885-3924(01)00255-X
  7. Amjadi K, Voduc N, Cruysberghs Y, et al. Impact of interventional bronchoscopy on quality of life in malignant airway obstruction. Respiration 2008;76:421-428. https://doi.org/10.1159/000152832
  8. Ono H, Hasuike N, Inui T, et al. Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer 2008;11:47-52. https://doi.org/10.1007/s10120-008-0452-0
  9. Hyun JJ, Chun HJ, Keum B, et al. Weblike stenosis due to gastroesophageal reflux disease, treated with an insulation-tipped diathermic knife-2 (IT-2). Endoscopy 2010;42(Suppl 2):E110. https://doi.org/10.1055/s-0029-1243946
  10. Sasada S, Kawahara K, Kusunoki Y, et al. A new electrocautery pleural biopsy technique using an insulated-tip diathermic knife during semirigid pleuroscopy. Surg Endosc 2009;23:1901-1907. https://doi.org/10.1007/s00464-008-0263-8

피인용 문헌

  1. High grade anorectal stricture complicating Crohn's disease: endoscopic treatment using insulated-tip knife vol.14, pp.3, 2014, https://doi.org/10.5217/ir.2016.14.3.285