気管・気管支異物，とくに開胸手術と死亡例を中心として

SURGICAL REMOVAL OF THE FOREIGN BODIES IN TRACHEA AND BRONCHI

　Ⅰ．はじめに

　気管気管支異物は，気管支鏡法（以下，上気管支鏡法および下気管支鏡法を含む）で摘出できる場合が殆どであり，ことに重篤なかつ乳幼児でもventilation bronchoscopeの発達により，異物の侵した気道を経由して摘出する機会が多くなつてきた。

　しかし，膨化しやすいピーナッツなどの植物性異物では，気管支が閉塞するばかりでなく，異物が組織の中に陥入していき，気管支鏡法での摘出は困難となり，さらに低酸素血症が高度な場合などでは窒息死することもあり，きわめて重大な問題である。

　Among 31 cases with foreign bodies in the trachea and bronchi, surgical removal was performed in 5 cases. Bronchotomy was performed in 4 urgent cases showing no irreversible changes in the lungs and bronchi. Three of them had unsuccessful bronchoscopic procedure and one showed poor risk for bronchoscopic procedure. Lobectomy was performed in a case with long-standing foreign body which produced a lung abscess secondarily. The postoperative courses of these 5 cases were uneventful.

　When bronchoscopic removal of foreign bodies is unsuccessful, surgical removal by thoracotomy should be performed promptly.