• 대한기관식도과학회지
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• 제1권1호
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• pp.101-108
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• 1995

From 1988 to 1995, 59 patients with laryngotracheal stenosis were operated with resection of stenotic segment and end to end anastomosis in Seoul national university. Among these patients, 36 were tracheal stenosis, 17 were combined lesion of subglottis and trachea and 5 were subglottic stenosis. The success of procedure was determined by stoma closure or decannulation and an overall 89.8% success rate was achieved following 165 procedures. The success rate showed correlation with severity of stenosis and the number of procedures done was related to the site of stenosis. There was no mortality and granulation formation, unilateral vocal cord palsy were the common complication of end to end procedures.

• Journal of Chest Surgery
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• 제14권4호
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• pp.339-344
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• 1981

Eight patients underwent tracheal resection and reconstruction for tracheostomy and postintubation injuries from 1971 to early 1981. The ages ranged from 12 years to 59 years. The patients had 7-cuff stenosis and one stomal lesion in whom intubated long. Four male and four female patients were treated. Cervical approach was used in one, cervicomediastinal in 3 and transthoracic in four. The longest length of resection extended to 4 cm in whom cervico-upper half mediastinal incision and neck flexion were applied. Techniques for obtaining tension-free anastomosis included cervical flexion or division of the inferior pulmonary ligament and mobilization of the right hilum. Concurrent tracheostomy was not needed in all. There was one death at the end of emergency operation from anesthetic accident. Granulations at the anastomosis line, necessitating bronchoscopy, were noted in two and the lesion did not recurred after removal. No restenosis or other complications occurred during long follow-up.

• Journal of Chest Surgery
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• 제28권3호
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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.

• Journal of Chest Surgery
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• 제26권8호
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• pp.664-666
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• 1993

A technique for insertion of a long silicone T-tube in patient with critical stenosis and high-risk resection and primary anastomosis of long segment of the distal trachea is presented. It was not easy to insert a long T-tube by existing methods because of flexibility of a T-tube and tightness of stenosis. So we used a silastic endotracheal tube and guiding wire as stylet of a T-tube. During insertion, ventilation was normally maintained through the lumen of endotracheal tube. This provided rapid relief from airway obstruction and asphyxation and is a easy, safe and effective method to restore patency of the major airways.

• Journal of Chest Surgery
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• 제32권10호
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• pp.951-953
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• 1999

Leiomyoma is extremely rare benign tumor of the trachea. A case of leiomyoma of the trachea is described in a 36-year-old man. The patient had a brief history of asthma-like symptoms. Computed tomography of the chest revealed the ovoid lower trachea mass, which was occupying about 80% of the tracheal lumen. At fiberoptic bronchoscopy highly vascularized round mass was seen on the membranous portion of the lower trachea. The tumor was excised by segmental sleeve resection and end-to-end anastomosis of the trachea was performed. Postoperative course was uneventful and bronchoscopic findings showed clear healing of the anastomotic site.

• 대한기관식도과학회지
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• 제15권2호
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• pp.81-86
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• 2009

A 57 year old human immune virus(HIV)-positive male presented with a progressive dyspnea for 6 months. Chest CT showed multiple polypoid masses arising from upper tracheal wall. Bronchoscopic examination revealed that multiple large cauliflower-like polypoid tumors was obstructing tracheal lumen. They were diagnosed as multiple squamous papillomas and were removed by Nd:YAG laser photocoagulation and rigid bronchoscopic treatment. The tumors were histologically diagnosed as squamous papilloma infected with human papilloma virus(HPV) type 6 and 11 in in-situ hybridization. Rigid bronchoscopy might be safer and more efficient than flexible bronchoscopy for the treatment of multiple tracheal papillomatosis obstructing tracheal lumen because of easy establishment of airway patency and direct use of rigid bronchoscope itself for tumor resection.

• Journal of Chest Surgery
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• 제8권2호
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• pp.149-152
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• 1975

In spite of great advances in surgical treatment during past several decades, surgery of the trachea failed to develop correspondingly, partly because of relative rarity of the tracheal lesions and partly because of difficulties in surgical technique and anesthesia. Surgical diseases of the trachea are largely obstructions due to neoplasm or cicatrical stenosis and tracheal malacia. The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tubes, has produced, apparently with increasing frequency, tracheal stenosis, tracheomalized tracheal erosion. Surgery is presently the only reasonable way to treat stenotic lesions of the tracheobronchial tree. In the case of tumors, the current trend has been that of radical excision. Primary end-to--end reconstruction of the trachea has been generally recognized as the ideal method of repair following resection. However, for decades it was believed that a maximum of four tracheal rings only might be excised and primary healing achieved with safety. A great variety of procedures, developed by numerous investigations and directed at tracheal substitution, have almost invariably met with discouraging results. A meticulous study done by Grillo and associates on autopsy specimens has shown that an average 6.4cm of mediastinal trachea can be safely resected by full mobilization of the right lung and transplantation of the left main bronchus into the bronchus intermedius. Recently, we experienced a case of successful resection of a tumor of the tracheal carina and primary tracheo-left main bronchial anastomosis at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul. The patient, a 29-year-old man, was admitted to the hospital with complaints of dyspnea and cough. On admission, chest film showed hydropneumothorax on the right. After closed thoracostomy, hydropneumothorax disappeared, but hazy densities, developed in the right middle and lower lung fields, resisted to treatment. Bronchoscopy uncovered irregular tumor covering the carina and the right main bronchus, and biopsy indicated well differentiated squamous Cell carcinoma. Operation was performed on July 2, 1975. A right postero-lateral thoracotomy was used. Excision involved the lower trachea, the carina, the left main bronchus and the right lung. This was followed by direct anastomosis between the trachea and the left main bronchus. Bronchography was done on 17th postoperative day revealed good result of operation without stricture at the site ofanastomosis. About one month after the operation symptoms and signs of bronchial irritation with dyspnea developed, and these responded to respiratory care. On 82nd postoperative day, sudden dyspnea developed at night and the patient expired several hours later. Autopsy was not done and the cause of death was uncertain.

• Journal of Chest Surgery
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• 제28권6호
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• pp.633-636
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• 1995

Leiomyoma of the trachea is a rare benign tumor. A case of leiomyoma of the thoracic trachea is described in a 46-year-old woman. The patient complained of productive cough, dyspnea and blood-tinged sputum since July 1993. Plain chest radiographs were not helpful, but computed tomography of the chest showed an intraluminal tracheal mass just above the carina. Fiberoptic bronchoscopy revealed a broad based, nodular mass rising from the posterior tracheal wall, just above the carina. The tumor was excised by sleeve resection and end-to-end anastomosis of the trachea was performed. The patient`s postoperative course was uneventful. She was discharged on the 20th postoperative day.

• 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.

• Journal of Chest Surgery
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• 제26권12호
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• pp.965-968
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• 1993

Primary benign tracheal tumors are exceedingly rare and leiomyoma has the least frequency among them. It is important to recognize early without misdiagnosis such as asthma because it is curable. A 41 year-old female was admitted for dyspnea and choking since November 1991. Under the impression of asthma, she received medication. Symptom was not improved and thus chest CT scan was performed. There was endotracheal tumor mass which was located just above the carina and arose from the right lateral tracheal wall with broad base. We successfully resected the tumor mass including trachea and the defected area of trachea was reconstructed with autologous graft using pericrdium & rib cartilage. During the follow up period, no complication was developed.