Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Jejunal Free Graft for Complicated Corrosive Esophageal Stricture

유리공장이식편을 이용한 합병된 부식성 식도협착의 재건술

  • I Hoseok (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee Sungsoo (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital) ;
  • Shim Young Mog (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 이호석 (성균관대학교 의과대학 흉부외과학교실, 삼성서울병원 흉부외과) ;
  • 이성수 (성균관대학교 의과대학 흉부외과학교실, 삼성서울병원 흉부외과, 아주대학교 의과대학 흉부외과학교실, 아주대학교병원 흉부외과) ;
  • 심영목 (성균관대학교 의과대학 흉부외과학교실, 삼성서울병원 흉부외과)
  • Published : 2005.06.01
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Abstract

The management of failure of colonic graft or corrosive stricture with impaired colonic circulation continues to be a challenge to surgeons. We present four cases of complicated corrosive esophageal stricture, which were successfully treated using jejunal free graft. As the initial surgical treatment, three patients underwent colonic interposition, and one underwent Whipple's procedure due to panperitonitis. Ore patient underwent transposition of jejunal free patch graft, two underwent interposition of jejunal free graft, and one underwent esophagojejunocolojejunostomy using jejunal free graft. All patients did not show dysphagia after long term follow-up. Complex esophageal reconstruction with jejunal free graft was performed successfully and long term functional outcome was good.

부식성 식도협착의 재건수술시 대장의 혈액순환이 나쁜 경우 또는 대장치환술 후 허혈성 부전이 나타난 경우 가장 적합한 재건장기로는 유리공장이식편을 들 수 있다. 복잡하게 합병된 부식성식도협착 환자에서 유리공장이식편을 이용하여 식도재건술을 시행한 4예를 보고하고자 한다. 일차식도재건술로서 4예 중 3예는 대장치환술을, 1예는 장천공에 의한 복막염으로 Whipple's 술식 및 공장루설치술을 받았다. 1예는 인두대장문합부의에 유리공장첩포 이식을, 2예는 대장이식편 부전 부위에 유리공장이식편 치환을 받았다. 1예는 대장의 일부와 유리공장이식편을 이용하여 인두공장대장공장문합술을 시행하였다. 수술 후 문합부위 누출로 인한 재수술이 1예 있었다. 장기추적 관찰상 모두 연하곤란이 없었다. 여러 가지 원인으로 인하여 합병된 식도재건술이 필요하여 유리공장이식편을 사용했던 경우 만족할 술 후 이환율과 연하기능을 보였다.

Keywords

References

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