Abstract
A 55-year-old man had received home oxygen therapy for five years for progressive emphysema, and was admitted to our hospital with severe and progressive difficulty in breathing. Dynamic chest computed tomogra phy and bronchofiberscopy revealed 80 percent stricture from the trachea to the bilateral main bronchi. He was diagnosed with grade 3 tracheobronchomalacia using Johnson's classfication, and span plasty with a ringed PTFE was planned. We cut a ringed PTFE with a diameter of 12mm and length of 2.5cm. After dividing the prosthesis longitudinally, its curve was spread. The rings were cut in various portions to fit the membranous portion of the trachea and bronchi. We first sutured the reinforcement to the edge of the cartilaginous rings with 4-0 PSD-II. It was then sutured in a similar fashion at the proximal, distant and central points of the membranous portion. This process was repeated every 2 or 3 cm from the trachea at the apex down to the bilateral main bronchi. His symptoms were markedly improved postoperatively and he could leave the hospital. Postoperative dynamic chest computed tomography and bronchofiberscopy revealed good preservation of tracheal caliber throughout.
