巻号一覧
51 巻 (2000)
- 6 号 p. 405-
- 5 号 p. 345-
- 4 号 p. 297-
- 3 号 p. 229-
- 2 号 p. 61-
- 1 号 p. 1-
51 巻, 5 号
選択された号の論文の8件中1～8を表示しています
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特集：気道・食道のステント治療
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古川 欣也, 加藤 治文2000 年 51 巻 5 号 p. 345-353
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありTracheobronchial and esophageal stentings for central airway and esophageal stenosis are performed as part of strategies to improve pulmonary functions, dysphagia, and quality of life (QOL) in patients with end-stage lung and esophagus. Most of these patients are inoperable or at high risk because of advanced age and cardiopulmonary failure. Severe complications and degeneration in general condition are likely when invasive surgery is performed in these patients. We review the utility, indications and problems in airway and esophageal stenting for severe endobronchial and esophageal stenosis.
The QOL of all patients improved dramatically after stenting. Nevertheless, when deciding among alternative stents, physicians treating patients with tracheobronchial and esophageal stenosis should give careful consideration to the benefits and possible complication of each stent. Considering the increasing number of elderly patients, deterioration in medical finances and cost effectiveness, stenting for end-stage patients will be an even more essential modality in the 21st century.抄録全体を表示PDF形式でダウンロード (1245K) -
山本 智矢, 福島 淳一, 梅崎 俊郎, 小宮山 荘太郎2000 年 51 巻 5 号 p. 354-364
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありRecent progress in emergency medicine has made it possible to save patients with severe dyspnea using intra-tracheal intubation. Larygotracheal stenosis, however, is frequently experienced in these patients after the airway management. Surgical correction for this stenosis is usually difficult and sometimes needs prolonged and frequent surgical procedures.
In the current paper, surgical correction of laryngotracheal stenosis with conservative treatment and laryngeal stents, such as a keel, T-tube or Core-mold, is detailed together with actual X rays and laryngoscope images. The indication for each stent treatment in various cases is also detailed.抄録全体を表示PDF形式でダウンロード (3536K) -
平林 秀樹, 藤沢 勉, 生野 登, 中島 逸男, 田中 利明, 馬場 廣太郎2000 年 51 巻 5 号 p. 365-369
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありOver a 3-year period in our department, 7 patients underwent stent treatment for a benign stenosis of the pharynx and cervical esophagus. The most common complication of an expandable metallic stent is stent-induced stenosis caused by granulation tissue. The use of expandable metallic stents should be until 2 weeks because of the granulation tissue obstruction at the terminal ends. The through-bougie esophageal prosthesis can be used over 3 years without complication. The authors recommend the through-bougie esophageal prosthesis for cervical esophageal fistula. Esophagus-friendly materials may well include new stents, such as an expandable silicon stent.抄録全体を表示PDF形式でダウンロード (1103K) -
青山 法夫, 南出 純二, 米山 克也, 小泉 博義2000 年 51 巻 5 号 p. 370-376
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありThe purpose of this study was to evaluate the results of esophageal stents implanted in patients with inoperable esophageal carcinoma. From May 1984 to February 2000, 81 patients with inoperable carcinoma of the esophagus were treated by placement of 51 plastic prostheses and 30 metallic stents. The plastic prostheses consisted of 30 silicone stents, 19 polyurethane stents and 2 polyuronide stents in our series. Twenty-nine of the 30 patients treated with metallic stents were treated with Ultraflex (a self-expanding nitinol stent) and one case with Wallstent (a self-expanding stainless steel stent). The overall rate of palliation of dysphagia with the esophageal stents was 86% in our series. The rate of successful palliation for 31 cases with tracheoesophageal fistula was 90%. There were no differences between the plastic prosthesis group and metallic stent group in these rates. The overall median survival time after treatment with stent was 54 days. There was no difference between the stent groups in survival curves by the Kaplan-Meier method. Complaints of sore throat were much more common in the plastic prosthesis group than in the metallic stent group, and that was the only statistically difference between the two groups in terms of complications after the insertion of the stents (p < 0.05). This might have been due to the fact that the metallic stent was slimer than the plastic prosthesis at the insertion point.抄録全体を表示PDF形式でダウンロード (1507K) -
—特に高度気道狭窄における複数個のステント留置 (combination stenting) について—宮澤 輝臣, 宮津 由香, 児玉 美千世, 岩本 康男2000 年 51 巻 5 号 p. 377-381
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありFurther implantation of the same stent and/or additional implantation of a different stent are sometimes needed during therapeutic bronchoscopy. Therefore, combination stenting has been performed using a rigid bronchoscope as an emergency procedure in 23 patients with life-threatening tracheobronchial stenosis (11 lung cancers, 9 esophageal cancers, 1 colon cancer, 1 relapsing polychondritis, and 1 von Recklinghausen's disease). This treatment has been performed with combination stents of many types (19 Dumon stents including 6 Dumon Y-stents, 47 Ultraflex stents, 1 Dynamic stent, and 2 Covered Wallstents). Symptomatic relief of dyspnea was achieved in 87% of the patients. Due to the diffuse narrowing of the airway extending along the trachea into the mainstem bronchi and beyond, in one patient seven stents had to be implanted, six stents in one patients, five stents in one patient, and four in two others. Due to stenosis with fistula, in one patient three stents had to be implanted, and two in four others. Combination stenting should be considered in some cases. This procedure seems to be indicated in certain complicated situations, e.g., long stenosis, bilateral bronchial stenoses, and stenosis with fistula.抄録全体を表示PDF形式でダウンロード (1513K)
原著
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平海 晴一, 田渕 圭作, 北尻 真一郎2000 年 51 巻 5 号 p. 382-386
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありFish bone foreign bodies impacted in the aerodigestive tract are a common ENT emergency. In most cases, fish bones are impacted within the oral cavity or oropharynx and easily identified and removed. But in some cases, they are impacted more caudally or deeply into the mucosa and diagnoses based on inspection alone are impossible. In such cases, radiological investigations are needed.
Plain-film radiology is used frequently, but it is not very sensitive and cannot show the inflammatory changes around the fish bone. We show the efficiency of computed tomography (CT) scanning in diagnosing fish bones in the aerodigestive tract, and propose the use of CT scanning for screening in cases of fish bone impaction with prolonged pain or dysphagia.抄録全体を表示PDF形式でダウンロード (961K) -
佃 朋子, 工藤 典代2000 年 51 巻 5 号 p. 387-392
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありTracheostomy was performed in 65 patients during a 9-year period (1990-1999) at our hospital, of which thirty cases were infants. Their causative diseases were neuromuscular disorders (31 cases), multiple anomaly (16 cases), laryngo-tracheal disorders (9 cases) and other disorders (9 cases). Complications after surgery occured in 31 cases, and the most common complications were tracheal or stomal granulation. One case suffered from bleeding from the tracheo-innominate artery fistula. Regarding progress and prognosis, we could close the tracheal stoma in 15 cases, and 9 cases died. Eight of these died due to an aggravation of their primary disease.抄録全体を表示PDF形式でダウンロード (577K)
症例報告
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藤井 守, 井口 郁雄, 綾田 展明, 小野田 友男2000 年 51 巻 5 号 p. 393-396
発行日: 2000/10/10
公開日: 2009/01/27
ジャーナル 認証ありA 30 year-old woman, who had been an out-patient of neurology department because of anorexia nervosa for 13 years, consulted at our department complaining of neck and throat pain, lasting for 3 days, induced by strain. Neck swelling was unclear on inspection but palpation revealed subcutaneous emphysema in the whole neck region. Mediastinal emphysema was also observed on plain X-ray film and CT scan. Both emphysemas were thought to be caused by increasing air-way pressure due to strain and loss of elasticity of the alveolar tissue, which was believed to be caused by the low nutritional state of the patient's anorexia nervosa. She was treated with rest and prophylactic antibiotics. Though the emphysemas subsided uneventfully, liver dysfunction due to the anorexia nervosa progressed. The patient was transferred to the internal medicine ward to treat this dysfunction after the emphysemas had disappeared.抄録全体を表示PDF形式でダウンロード (633K)
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