초록접수 현황
| 15F-031 | 구연 발표 |
Outcomes of Extracorporeal Membrane Oxygenation Support During Surgery for the Critical Airway Stenosis
Yeong Dae Kim, M.D.¹, Hoseok I, M.D.¹, Do Hyung Kim M.D.², Jeong Su Cho, M.D.¹, Bong Soo Son, M.D.², Seon Hee Kim, M.D.¹, Seunghwan Song, M.D.¹
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea¹, Departments of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea²
Background : We report our strategy and experience of extracorporeal membrane oxygenation(ECMO) support during surgery for severe airway stenosis.
Methods : Between April 2012 and March 2015, nine patents underwent airway operation supported by ECMO. The causes of surgeries were tracheal stenosis(n=6), tracheal malasia(n=1), primary tracheal tumor(n=1), and external tracheal compression by mediastinal mass(n=1). Surgeries were tracheal resection and end to end anastomosis(n=4), tracheostomy(n=1), tracheal ballooning(n=1), carinal plasty(n=1), tracheoplasty(n=1), and mediastinal mass debulking(n=1).
Results : All ECMO supports were successful for gas exchange. ECMOs in six cases were weaned off intraoperatively. In the other three cases, ECMOs were maintained postoperatively until the patient stabilized. Median extracorporeal support time was 145min(range:86min-12690min). There was one hospital death on postoperative day 33 due to multiorgan failure after carinaplasty for malasia. Median ICU stay was two days(range:1day-61days) and median hospital stay was 33 days(range: 9days-303days). Mean follow up time was 17.1± 10.8 months. There were two re-interventions which were balloon tracheoplasty and revision of permanent tracheostomy. There were two late deaths. One is due to pneumonia during chemotherapy for mediastinal lymphoma and the other is due to sudden collapse by recurred airway stenosis. Overall survival rate were 76.2% and 63.5% in 1 year and 2 years, respectively.
Conclusion : In our experiences, extracorporeal membrane oxygenation is considered as a feasible and safe method for ciritical airway surgery and its midterm outcome is favorable.
Methods : Between April 2012 and March 2015, nine patents underwent airway operation supported by ECMO. The causes of surgeries were tracheal stenosis(n=6), tracheal malasia(n=1), primary tracheal tumor(n=1), and external tracheal compression by mediastinal mass(n=1). Surgeries were tracheal resection and end to end anastomosis(n=4), tracheostomy(n=1), tracheal ballooning(n=1), carinal plasty(n=1), tracheoplasty(n=1), and mediastinal mass debulking(n=1).
Results : All ECMO supports were successful for gas exchange. ECMOs in six cases were weaned off intraoperatively. In the other three cases, ECMOs were maintained postoperatively until the patient stabilized. Median extracorporeal support time was 145min(range:86min-12690min). There was one hospital death on postoperative day 33 due to multiorgan failure after carinaplasty for malasia. Median ICU stay was two days(range:1day-61days) and median hospital stay was 33 days(range: 9days-303days). Mean follow up time was 17.1± 10.8 months. There were two re-interventions which were balloon tracheoplasty and revision of permanent tracheostomy. There were two late deaths. One is due to pneumonia during chemotherapy for mediastinal lymphoma and the other is due to sudden collapse by recurred airway stenosis. Overall survival rate were 76.2% and 63.5% in 1 year and 2 years, respectively.
Conclusion : In our experiences, extracorporeal membrane oxygenation is considered as a feasible and safe method for ciritical airway surgery and its midterm outcome is favorable.
책임저자: Seunghwan Song
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
연락처 : Seunghwan Song, Tel: 051-240-7267 , E-mail : ong77.sh@gmail.com
