• Title/Summary/Keyword: Tracheo-bronchial

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Clinical analysis of expandble metallic stent in benign tracheal & bronchial disease (양성 기관, 기관지 질환에서 확장성 금속 스텐트 사용에 관한 임상적 고찰)

  • Lee Sung Soo;Kim Do Hyung;Paik Hyo Chae;Lee Doo Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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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.

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Virtual Bronchoscopy for Diagnosis of Tracheo-Bronchial Disease (기관지질환 진단을 위한 가상내시경)

  • Kim, Do-Yeon;Park, Jong-Won
    • The KIPS Transactions:PartB
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    • v.10B no.5
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    • pp.509-514
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    • 2003
  • The virtual bronchoscopy was implemented using chest CT images to visualize inside of tracheo-bronchial wall. The optical endoscopy procedures are invasive, uncomfortable for patients and sedation or anesthesia may be required. Also, they have serious side effects such as perforation, infection and hemorrhage. In order to determine the navigation path, we segmented the tracheo-bronchial wall from the chest CT image. We used the coordinates as a navigation path for virtual camera that were calculated from medial axis transformation. We used the perspective projection and marching cube algorithm to render the surface from volumetric CT image data. The tracheobronchial disease was classified into tracheobronchial stenosis causing from inflammation or lung cancer, bronchiectasis and bronchial cancer. The virtual bronchoscopy is highly recommended as a diagnosis tool with which the specific place of tracheobronchial disease can be identified and the degree of tracheobronchial disease can be measured qualitatively, Also, the virtual bronchoscopy can be used as an education and training tool for endoscopist and radiologist.

Cervical Bronchogenic Cyst (경부 피하조직내에 발생한 기관지성 낭종)

  • Kim Suk-Ju;Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.247-250
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    • 1997
  • Bronchogenic cysts are thought to be uncommon developmental anomalies. They develop from small buds or diverticuli that separate from the foregut in the formation of the tracheo-bronchial tree. They are nearly always located near the tracheal bifurcation; However, these lesions can occur anywhere along the tracheo-bronchial tree. We experienced a case of cervical bronchogenic cyst presenting sorely as an anterior neck mass in a 26-year-old woman. The neck ultrasonography showed as $1.4{\times}1.1cm$ sized hypoechoic lesion with a well-defined margin on the isthmic portion of the thyroid gland. Excision of the mass was carried out. The mass was superfical to the strap muscle and was contained within the subcutaneous tissue in the midline without any connection to the trachea. Grossly, the mass was an oval-shaped cystic lesion which measured 1.5 cm in the greatest diameter. The cyst was filled with thick, yellow, jelly-like material and the inner surface was smooth and glistening. Microscopically, the cyst showed a lining of ciliated columnar epithelium, beneath which was a loose areolar stroma containing plaques of mucous glands and mature cartilage. We thought this cervical bronchogenic cyst appeared to represent an expression of complete aberrent accessory lung bud detachment from the primitive foregut.

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Congenital esophagobronchial fistula associated with esophageal traction diverticulum in adult -Report of one case- (성인의 견인성 식도게실이 동반된 선천성 식도 기관지루 -1예 보고-)

  • 심성보
    • Journal of Chest Surgery
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    • v.24 no.5
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    • pp.510-514
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    • 1991
  • A fistulous communication between an esophageal traction diverticulum and the tracheo-bronchial tree appears to be of rare occurrence. This report reviews the feature of congenital esophagobronchial fistula associated with esophageal traction diverticulum. This 38-year-old male patient suffered from coughing, hemoptysis, fever and chest pain. This patient was taken a diverticulectomy and lobectomy of right lower lobe. Post-operation course was uneventful.

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Result of Secondary Surgery after Primary Surgery for Esophageal Atresia Anomalies (선천성 식도 폐쇄 수술 후 시행한 재 수술의 성적)

  • Im, Soo-Chan;Moon, Suk-Bae;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.105-111
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    • 2007
  • We reviewed the records of 25 patients who were re-operated upon after primary repair of esophageal atresia with or without fistula at the Department of Pediatric Surgery, Seoul National University Children's Hospital, from January 1997 to March 2007. Types of the esophageal atresia anomalies were Gross type A in 5 patients, C in 18, and E in 2. The indications for re-operation were anastomosis stricture (n = 14), tracheo-bronchial remnant (n = 4), persistent anastomosis leakage (n = 3), recurrent tracheo-esophageal fistula (n = 2) and esophageal web (n = 2). The interval between primary and secondary surgery was from 48 days to 26 years 5 months (mean: 2 years and 4 months). Four patients required a third operation. The interval between the second and third operation was between 1 year 1 month and 3 year 10 month (mean: 2 years 5 months). Mean follow up period after last operation was 35 months (1 years-8 years 6 months). The secondary surgery was end-to-end esophageal anastomosis in 15, esophagoplasty in 5, gastric tube replacement in 5. After secondary operation, 6 patients had anastomosis stricture (4 patients were relieved of the symptoms by balloon dilatation, 2 patients underwent tertiary operation). Five patients had leakage (sealed on conservative management in all). Two patients had recurrent tracheo-esophagel fistula (1 patient received chemical cauterization and 1 patient underwent tertiary operation). Currently, only one patient has feeding problems. There were no mortalities. Secondary esophageal surgery after primary surgery for esophageal atresia was effective and safe, should be positively considered when complications do not respond to nonoperative therapy.

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Compamative Study of Tracheal Anastomotic Techniques. (기관 문합 수기의 비교 실험)

  • 송원영;이연재
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1219-1224
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    • 1997
  • Although several reports were presented recently about bronchial arterial revascularization in clinical lung transplantation, one factor peculiar to the lung transplantation is the ischemia of the donor bronchus. Poor bronchial healing occurs frequently following clinical lung transplantation and this has been major cause of mortality and morbidity. There have been many attempts to solve bronchial anastomotic complications. Telescoping technique, one of those attempts, was advocated by San Antonio Group recently. This experiment was per(armed to evaluate the effect of telescoping anastomotic technique upon th healing of the tracheo-bronchial anastomosis. We used rabbits(weighing about 800 g) as experimental animal. Method: Resection of middle one third of cervical trachea and reanastomosis was performed by simple interrupted anastomotic technique in Group 1(n=15) and by telescoping anastomotic technique in Group 2(n= 15). Result: Anastomotic sites in the telescoping technique group showed significant increase of fibrosis in the early postoperative days(< Sdays) and remarkable band-like fibrous union compared to the simple interrupted group.

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Bronchogenic cysts treated with the transcervical approach (경부절게를 통한 기관지원성낭종 치료)

  • Song, Jong Hoon;Hong, Ki Hwan;Hong, Yong Tae;Kim, Eun Ji
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.75-79
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    • 2017
  • Bronchogenic cysts are congenital malformations of the bronchial tree, a type of bronchopulmonary foregut malformation. The presentation of the bronchogenic cyst is variable, making pre-operative diagnosis difficult. They aremostly asymptomatic orarefound incidentally when the chest is imaged. They can present as lower neck massesor mediastinal masses that may enlarge. They cause mass effect due to local compression and may result in tracheo-bronchial obstruction leading to air trapping and respiratory distress. The treatment is somewhat controversial, and in general,these lesions are treated using the transcervical or transbronchial approach. When these cysts arelocalized in the upper mediastinum, it may be possible to removethemusing the transcervical approach. In our three cases, the patientscomplained of mild dysphagia, foreign body sensation, and dyspnea. We report three cases of a large bronchogenic cyst in the lower neck and the upper mediastinum treated using the transcervical approach.

Tracheal Reconstruction Using Femoro-Femoral Bypass -A Case Report- (우측 소매 전폐 적출술 후 발생한 기관 협착증의 체외 순환을 이용한 수술치험 1례)

  • 최필조
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.324-327
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    • 1994
  • Resection and reconstruction of distal trachea or carina have posed tremendous technical challenges for surgeons. Successful outcome depends on thorough preoperative evaluation, careful anesthetic management,strict attention of surgical technique and postoperative care. We report a successful case of revision of tracheal stenosis using femoro-femoral bypass on a 13~year-old boy. The patient complained severe dyspnea about I month following right sleeve pneumonectomy. Preoperative CT scan and intraoperative bronchoscopy showed pin-point tracheal stenosis at a tracheo-bronchial anastomosis site about 1.2cm in length.At operation the lesion was severely adhesed and the lumen was nearly obstructed. The stenotic segment was resected and direct end-to-end anastomosis was done under femoro-femoral bypass for adequate oxygenation. The patient was discharged at postop. 16 days without specific complications and has continued to do well.

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A Case of Intractable Tracheitis Treated by Heat-Moisture Exchangers in a Total Laryngectomized Patient (열가습 여과기로 치료한 후두전적출 환자의 난치성 기관염 1예)

  • Koo, Beom Mo;Moon, Seong Kyu;Kim, Seung Woo
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.87-91
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    • 2020
  • The tracheostomy directs external air into the airway tract. This process causes mucosal dryness, irritation and inflammation in the tracheo-bronchial tree. In order to prevent such problems, several methods are applied; ointment application, humidification and careful suction etc. The heat-moisture exchanger (HME) is commercially sold device that assists heating and humidification of the inhaled air. The authors experienced successful treatment outcome of intractable tracheitis caused by repetitive and vigorous intra-tracheal suction by applying HME in a total laryngectomized patient. We report an interesting and didactic case with a brief literature review.