부식성 상부식도 협착증에서 하인두-장 문합에 의한 식도재건술

Esophageal Reconstruction by Hypopharyngointestinal Anastomosis in Corrosive Upper Esophageal Stricture

  • 박재길 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 이선희 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 장윤희 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 진웅 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 곽문섭 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 김세화 (가톨릭의과대학 여의도성모병원 흉부외과) ;
  • 천성원 (가톨릭의과대학 여의도성모병원 일반외과)
  • Park, Jae-Kil (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Lee, Sun-Hee (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Chang, Yun-Hee (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Jin, Ung (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Kwack, Moon-Sub (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Kim, Se-Wha (Dept. of Thoracic & cardiovascular Surgery, St. Mary's Hospital, Catholic University Medical College) ;
  • Chun, Sung-Won (Dept. of General Surgery, St. Mary's Hospital, Catholic University Medical College)
  • 발행 : 1998.09.01

초록

대상 및 방법: 저자들은 1995년 8월부터 1997년 1월까지 상부 식도를 포함한 광범위한 부식성 협착증 환자 7례에서 하인두-결장문합에 의한 식도재건술을 시행하였다. 결과: 연령은 20세에서 63세까지 였으며 7례중 6례가 여성이었다. 부식제는 6례에서 강산이었고 1례는 알칼리 용액이었으며, 부식제 연하후 식도재건까지의 기간은 6개월에서 50년이었다. 식도재건 방법으로 4례에서는 하인두- 우결장-공장문합을 시행하였으며, 3례에서는 하인두-우결장-위문합을 시행하였다. 수술사망례는 없었고 7례중 1례에서 만 문합부 협착으로 수차례의 식도 확장술을 받았으며, 6례에서는 경구섭식에 문제가 없어 전례에서 관찰기간중에 4kg 내지 13kg의 체중증가 소견을 보였다. 결론: 결론적으로 상부식도 협착증에서의 하인두-결장 문합술은 유효하고 안전한 술식이라고 할 수 있다.

Material and Method: Esophageal reconstruction by the hypopharyngointestinal anastomosis was done in 7 patients of corrosive upper esophageal stricture at St. Mary's Hospital from August 1995 to January 1997. Result: There were one male and six female patients ranging from 20 to 63 years of age. The causative agents were acid in 6 patients and alkali in 1 patient. The esophageal reconstruction was made by hypopharyngcolojejunostomy in 4 patients and hypopharyngocologastrostomy in 3 patients. There were no operative mortalities. One patient developed anastomotic stenosis but others were free from dysphagia. All gained 4 kg to 13 kg of body weight during the follow-up period. Conclusion: In this experience right colon and terminal ileum including ileocecal valve was revealed as a good substitute for the esophagus and the esophageal reconstruction by hypopharyngocologastro (jejuno)stomy seems to be a satisfactory method with acceptable morbidity and mortality in corrosive upper esophageal stricture patient.

키워드

참고문헌

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