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Korean J Med. 2014;86(6):755-760. Published online June 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.86.6.755
Insulation-Tipped Diathermic Knife 2를 이용한 중심성 기도 폐쇄 치료 2예
고규한1, 김세중2, 박상훈1, 장세헌1, 유승현1, 구남호1, 이승현1
1한전병원 내과
2분당서울대학교병원 호흡기내과
Two Cases of Central Airway Obstruction Treated with an Insulation-Tipped Diathermic Knife-2
Kyu Han Koh1, Se Joong Kim2, Sanghoon Park1, Se Heon Chang1, Seung Hyun Yoo1, Nam Ho Koo1, Seung Hyeun Lee1
1Department of Internal Medicine, KEPCO Medical Center, Seoul, Korea
2Division of Respiratory and Critical Care Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Corresponding author: Seung Hyeun Lee ,Tel: +82-2-901-3114, Fax: +82-2-901-3254, Email: humanmd04@hanmail.net
Received: August 23, 2013; Revised: October 10, 2013   Accepted: October 14, 2013.
중심성 기도 폐쇄는 양성 혹은 악성 질환과 동반되어 나타날 수 있으며 현재 다양한 기관지경적 치료법이 사용되고 있다. IT knife-2는 소화기 내시경적 시술을 위해 고안된 장비로서 그 안정성과 효용성이 입증되어 국내 의료기관에서 내시경적 점막하 박리술에 널리 사용되고 있다. 저자들은 굴곡성 기관지경과 IT knife-2를 이용하여 진행성 폐암과 방사선 치료 후 발생한 중심성 기도 폐쇄를 가진 두 환자를 성공적으로 치료하였다. 합병증과 예후에 대한 추가적인 연구가 필수적이지만 IT knife-2는 향후 기도 폐쇄의 내시경적 중재적 시술법 중 하나로 고려될 수 있을 것이다.

߽ɾ :기관지경; 중심성 기도 폐쇄; 폐암
Abstract
Central airway obstruction can result from various benign and malignant conditions, and often requires prompt palliation. The efficacies of a variety of bronchoscopic techniques for the treatment of central airway obstruction such as electrocautery, laser, brachytherapy, argon plasma coagulation and cryotherapy have been established. An insulation-tipped diathermic knife-2 (IT knife-2) was initially introduced for gastrointestinal endoscopic submucosal dissection and has been used globally as a safe and effective instrument. However, its use has not been reported for the treatment of endotracheal or endobronchial lesions. Here, we report the case of central airway obstruction in a 65-year-old male due to malignancy and a 52-year-old-female with post-radiation bronchial stenosis that were treated successfully with the IT-knife-2 via flexible bronchoscopy. (Korean J Med 2014;86:755-760)

Keywords :Bronchoscopy, Central airway obstruction, Lung cancer
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