• Korean Journal of Bronchoesophagology
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• v.10 no.1 s.19
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• pp.41-45
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• 2004

Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

• 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.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.101-104
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• 2003

One of major problem in endotracheal intubation for general anesthesia is intrathoracic tracheal obstruction induced by tumor such as, intrathoracic goiter and malignant lymphoma etc. Small amount of secretion or hemorrhage and mild tracheal edema may cause aggravation of tracheal obstruction during endotracheal intubation. Also, it is too difficult to perform the emergency tracheostomy in middle tracheal obstruction. We tried to perform femorofemoral cardiopulmonary bypass without endotracheal intubation for induction of general anesthesia in case of middle tracheal obstruction and We reported with review of literature.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.194-197
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• 1998

Myoepithelioma is a benign tumor composed of sheets and islands of various proportion of spindle, plasmacytoid, epitheloid, and clear cells. We are reporting of a 38-year-old woman with an extremely rare neoplasm of the trachea, myoepithelioma. The patient had an right neck mass and diagnosed presumptively as the thyroid tumor with tracheal invasion. Resection and anastomosis of the trachea with partial thyroidectomy was done. The tumor was a well circumscribed mass with solid growth pattern and composed of spindle and epitheloid cells, which were positive for S-100 protein and smooth muscle actin. In electron microscopy, a large amount of microfilaments in the cytoplasm and layers of basement membrane-like materials in the intercellular spaces were observed, which are characteristics of myoepithelioma. Patient has been well for 8 months postoperatively.

• Journal of Chest Surgery
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• v.32 no.10
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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.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.100-104
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• 1995

Posterior mediastinal goiter extending to carotid sheath posteriorly is rare. Recently we experienced two cases of posterior mediastinal goiter presenting dyspnea due to tracheal compression. The one was a 48-year-old female with mediastinal tumor shadow on chest roentgenogram . The other was a 54-year-old female with palpable mass on neck and huge mediastinal mass. These masses were resected completely through the right posterolateral thoracotomy and median sternotomy respectively. The postoperative courses were uneventful.

• Tuberculosis and Respiratory Diseases
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• v.77 no.5
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• pp.215-218
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• 2014

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.75-78
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• 2003

Primary adenoid cystic carcioma of trachea is rare, with an incidence of only 0.2 per 100,000 persons per year. When all series of the tracheal carcinomas are combined, adenoid cystic carcinoma is the second most common tumor only to squamous cell carcinoma in incidence. Most patients have wheezing or stridor, dyspnea, hemoptysis, and cough as symptoms. Treatment options include surgery alone, radiation therapy alone, or a combination of both. The recommended surgical option is primary tracheal resection and reconstruction. Recently, we experienced a case of adenoid cystic carcinoma in 45 year old female patient who was treated tracheal tumor resection and end-to-end anastomosis of the trachea, so we report this case with the literatures.

• Journal of Chest Surgery
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• v.28 no.6
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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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• v.27 no.5
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• pp.413-417
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• 1994

Adenoid cystic carcinoma usually grows in the trachea or near its bifurcation and causes obstruction of the air way. We recently experienced a 33 year-old male patient who had adenoid cystic carcinoma in the left main bronchus with the chief complaint of productive cough. On the bronchoscopy, the mass obstructed the left main bronchus completely and had nodularity and increased vascularity.The trachea was shifted to the left side and the lower lobe of the left lung was atelectatic on chest X-ray and computed axial tomogram.He underwent left tracheal sleeve pneumonectomy and lymph node dissection through bilateral thoracotomy. At first,we attempted left tracheal sleeve pneumonectomy through the left thoracotomy,however, it was very difficult to perform carinoplastic procedure after sleeve resection of 2.5cm of distal trachea and 1cm of proximal right main bronchus including whole left lung because of poor operative field and difficulty in the anastomosis of the right main bronchus to the distal end of the trachea without tension.Therefore after radical resection of the left lung we made right thoracotomy,through which we could anastomosed the distal trachea and right main bronchus with 4-0 PDS interrupted suture after mobilization of the right hilum without difficulty. The tumor was confirmed to be adenoid cystic carcinoma with metastasis to subcarinal lymph node histopathologically. Postoperative course was uneventful but he needed two bronchoscopic procedure to clear distal airway of the retained bronchial secretion. He was discharged at 14 days after operation with complete recovery.