• Title/Summary/Keyword: 기관절제술

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Tracheobronchoplasty in the Patient with Right Upper Lobe Squamous Cell Carcinoma Invading Lower Trachea- One case report- (하부기관을 침범한 우상엽 편평상피세포 폐암 환자에서의 기관기관지 성형술-1례보고-)

  • 박승일;정성호;김상필;최인철
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.418-421
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    • 2001
  • 53세 남자 환자가 객혈을 주소로 입워하여 우축 상엽 편평상피세로 폐암으로 진단 받았다. 캄퓨터 단층촬영상 하부 기관에 종양의 침윤이 의심되었다. 우측 하엽과 중엽을 보존하기 위해서 우측상엽과 하부 기관외측을 포함하여 절제하는 기관기관지 성형술 시행하였고, 수술후 우측 폐의 팽창은 완전하였다. 수술 후 1주일째 시행한 기관지 내시경 검사상 우측 중엽과 하엽의 기관지는 뒤틀림 없이 잘 유지되어 있었다. 수술 후 항암치료와 방사선 치료를 받고 현재 환자는 수술 후 1년 7개월 동안 외래 추적관찰 중이다. 저자들은 우측 상엽의 폐암이 기관 하부를 침범한 경우에 우측 기관 소매 전폐절제술의 합병증을 피하고 환자의 폐기능을 보조하면서 침윤된 우측상엽을 포함하여 절제하는 기관기관지 성형술을 시행하여 이에 보고하는 바이다.

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Mediastinoscopic Resection of A Paratracheal Bronchogenic Cyst - A case report - (종격동경을 이용한 기관주위의 기관지성 낭종의 완전절제술 - 1예 보고 -)

  • Cho, Deog Gon;Kang, Chul Ung;Cho, Kue Do;Jo, Min Seop;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.120-123
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    • 2010
  • Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.

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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The Evaluation of Usefulness of the Manufactured DTAB (Double Tilt Angle Board) System (Double Tilt Angle Board (DTAB)의 자체 제작에 관한 유용성 평가)

  • Lee, Joung-Jin;Jang, In-Gi;Kim, Wan-Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.43-51
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    • 2006
  • Purpose: To resolution of A hospital-handmade modification double tilt angle immobilization system (DTAB immobilization system) and to report the clinical results of it. Material and Methods: It was developed in conjunction with the breast board for patients unable to achieve and maintain the desired uncomfortable respiration and position of set-up needed in the treatment of RT (This custom design provides an alternative to accomplishing this desired head angle needed to relax position treatment area, realizing that the lenses totally protected eye-ball out) By using the angled breast board and SBDD(small bowel device), reproducibility of set-up and patient comfort were addressed throughout the simulation, computed tomography planning and treatment process. Results: Usually patients the error range-within 5 mm. When use of Aqua patients error range-within 3 mm. Conclusion: It was constructed in tandem with a unique custom-built double tilt angle board (DTAB). It was designed to eliminate clinical set-up problems with head immobilization and instability during treatment, thus providing for a more comfortable head rest for the patient.

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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.

Trachea Necrosis after Thyroidectomy ; Case Report and Review (갑상선절제술 후 발생한 기도 괴사 ; 증례보고)

  • Choi, Ji Woo;Lee, Jeonghun;Song, Youngpeck;Kim, Chul-Ho;Soh, Euy Young
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.2
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    • pp.109-114
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    • 2014
  • 갑상선절제술은 내분비 외과의사가 하는 수술 중 가장 안전한 수술이지만 수술 중 기도나 식도가 손상 받을 수 있으므로 각별한 주의를 기울여야 한다. 특히 기도 괴사와 같이 생명에 위협을 주는 합병증이 있음을 유념해야 한다. 본 논문은 갑상선 전 절제술과 승모판 치환술을 함께 받은 72세 여성환자가 수술 후 3일만에 기도 괴사가 발생한 케이스이다. 3개의 기관륜에 걸쳐 괴사가 발생되어 있었다. 괴사된 조직을 제거하고, 이후 지속적인 괴사조직에 대한 제거와 치료와 적으로 기관개창술을 시행하고, 자연폐쇄를 유도하여 성공적으로 치료되었다. 비슷한 여러 논문들을 살펴본 결과 기도 괴사를 유발하는 요인으로는 조절되지 않는 기침, 여성, 갑상샘중독 결절, 기도 삽관 시 발생되는 손상, 삽관튜브 커프의 과팽창으로 기도가 장시간 높은 압력으로 압박되었을 때, 적절하기 않은 커프 크기, 삽관튜브 커프의 공기를 빼지 않고 무리하게 움직였을 때, 출혈이 많을 때, 과도한 전기소작으로 인한 손상, 기도로 가는 혈관손상으로 인한 혈액공급의 차단, 감염 등으로 보고 있다. 치료는 기도의 괴사와 감염의 정도에 따라 달라질 수 있다. 일차 봉합술, 일시적 스토마 형성, 일시적 기관조루술, 단단연결술, 기도 스텐트 설치술, 근육피판 재건술, 보존적 치료 등을 시행할 수 있다. 기도 괴사에 대한 위험인자와 치료에 대해서는 아직 확실히 적립되지 않은 상태이다. 드문 합병증이지만 생명을 위협할 수 있는 이러한 합병증에 대해 항상 염두 해 두고 수술 시 신중을 기하고 문제 발생시 신속한 대응을 해야겠다.

Left Lower Lobectomy with Bronchoplasty for Treatment of Tuberculous Bronchial Stricture (좌하엽 절제술 및 기관지성형술을 통한 결핵성 기관지협착의 치료)

  • 윤찬식;정재일;김재욱;이홍섭
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.640-643
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    • 2001
  • A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberclous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.

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A Bronchogenic Cyst Treated by Mediastinoscopy -A case report- (종격내시경을 이용한 기관지성 낭종절제술 치험 1례)

  • 변정욱;김정철
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.789-791
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    • 1996
  • Medstinoscopy has been used in the diagnosis for detection of mediastinal Iymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A 19-year-old male complained of chest disconyortness and dysphagia. A chest roentgenogram showed. the right paratracheal mass. Computed topography findings were consistent with a diagnosis of bronchogenic cyst, and excision of cyst was accomplished via the mediastinoscopy thus avoiding thoracotomy.

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A Case of Vocal Cord Paralysis Following Endotracheal General Anesthesia (삽관마취후의 성대마비 1례)

  • 이계실;차인숙;김광수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.7.3-7
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    • 1982
  • Endotracheal intubation is common practice for either general anesthesia or keeping artificial airway in various conditions. Despite of its great usefulness, however, laryngeal edema, ulceration, and granuloma are occasionally developed following endotracheal intubation as posttraumatic complications. Vocal cord paralysis is also rarely developed. Recently we experienced a case of left vocal cord paralysis with accompanying hoarseness following endotracheal general anesthesia for appendectomy. The symptoms of hoarseness and sore throat developed immediately after the general anesthesia. Periodic check revealed gradual return to normal function of the paralyzed cord with the complete function about 3 months after the anesthesia.

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Clinical Experience of Tracheal Resection after Laser Ablation in a Patient having Tracheal Neurilemoma with Tracheal Stenosis. (기관폐쇄를 동반한 기관 신경초종 환자에 있어 레이져를 이용한 부분절제술후 기관절제술의 경험)

  • 박성민;김광택
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.947-950
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    • 1999
  • Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

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