• Title/Summary/Keyword: 경부절제

Search Result 164, Processing Time 0.026 seconds

Esophageal Reconstruction for Hypopharyngeal Stricture After Severe Corrosive Injury (부식성 하인두 협착시 식도재건술)

  • 변정욱;구본일
    • Journal of Chest Surgery
    • /
    • v.30 no.1
    • /
    • pp.48-54
    • /
    • 1997
  • Between 1987 and 1995, eleven patients with severe chronic corrosive stenosis of the hypopharynx and esophagus underwent surgical restoration of digestive continuity at Inje University Seoul Palk Hospital. There were 7 male and 4 female patients aged from 21 to 47 years (mean, 34 years). The caustic material was acid in 6 patients and alkali in 5 patients. The esophagus was reconstructed using the right colon In 9 and left colon in 2. The cervical approach and the side of proximal anastomosis depended on the status of the pyriform slnus of the hypopharynx. In the neck, J-formed incision was made along the sternocleidomastoid muscle. The sternohyoid and thyrohyoid muscles were divided transversely to expose the thyroid cartilage. Hypopharyngeal opening for proximal anastomosis was made by reverse triangular formed resection of the thyroid cartilage after elevation of perichondrium. Immediately after operation, dysphagia and aspiration into trachea were common, so training of swallowing was required. Feeding gastrostomy was usually maintained for 3 months until restoration of swallowing function was confirmed . There was graft necrosis in 3 patients, who were treated with jejunal free graft. Revisional procedures for stenosis of cervical anastomosis in B patients consisted of widening of pharyngocecostomy site in 2 and resection of adhesive band in one. Return of normal swallowing assuring normal nutrition was obtained in 10 of 11 cases.

  • PDF

A Case of Malignant Hemangiopericytoma in Face (안면부에 발생한 악성 혈관외피세포종 1례)

  • Chang Hang-Seok;Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.14 no.1
    • /
    • pp.99-102
    • /
    • 1998
  • 혈관외피세포종(Malignant hemangiopericytoma)은 난원형의 혈관외피세포(pericyte)들로 구성된 매우 드문 혈관종의 일종으로 대개 사지 및 후복막에 발생되며, 안면부와 경부에도 약 25%가량의 발생율이 보고되어 있다. 성별 발생빈도의 차이는 없고 $20{\sim}50$대에서 호발하며, 종양은 대부분 서서히 성장하고 경계가 명확한 무통성의 고형 종괴로 나타난다. 악성과 양성의 구별은 조직학적 소견과 주변 조직으로의 침습, 원격전이 여부 등을 고려하여 판단하지만, 양성으로 진단된 경우에도 수년 내에 재발 및 원격전이가 나타나는 경우가 다수 보고되므로 악성과 양성의 감별이 매우 어렵고. 양성인 경우에도 악성 잠재성이 존재하는 것으로 알려졌다. 치료는 수술적 완전절제가 유일한 방법이나 절제가 불완전한 경우는 수술 후 외부 방사선 조사를 한다. 항암제 투여는 효과면에서 논란이 있지만, 원격전이나 수술과 방사선 치료가 실패한 경우 시행할 수 있다. 저자들은 최근 안면부에 발생한 악성 혈관외피세포종 환자 1예를 치험하였기에 보고하는 바이다.

  • PDF

Tracheal Myoepithelioma (기관에 발생한 근상피종)

  • 김성철;김진국;이재웅;김관민;심영목;김호중;한정호
    • Journal of Chest Surgery
    • /
    • v.31 no.2
    • /
    • pp.194-197
    • /
    • 1998
  • Myoepithelioma is a benign tumor composed of sheets and islands of various proportion of spindle, plasmacytoid, epitheloid, and clear cells. We are reporting of a 38-year-old woman with an extremely rare neoplasm of the trachea, myoepithelioma. The patient had an right neck mass and diagnosed presumptively as the thyroid tumor with tracheal invasion. Resection and anastomosis of the trachea with partial thyroidectomy was done. The tumor was a well circumscribed mass with solid growth pattern and composed of spindle and epitheloid cells, which were positive for S-100 protein and smooth muscle actin. In electron microscopy, a large amount of microfilaments in the cytoplasm and layers of basement membrane-like materials in the intercellular spaces were observed, which are characteristics of myoepithelioma. Patient has been well for 8 months postoperatively.

  • PDF

Composite Graft Reconstruction of Esophagus for Double Primary Cancer of Larynx & Esophagus (후두암과 식도암의 이증원발성 종양에서의 합이식술을 이용한 식도 재건술)

  • I Hoseok;Song Dong Seop;Kim Su Wan;Shim Young Mog
    • Journal of Chest Surgery
    • /
    • v.38 no.11 s.256
    • /
    • pp.791-794
    • /
    • 2005
  • After esophagectomy, the stomach is used most commonly for the method of reconstruction. However, the stomach may not be large enough to be reached the site of anastomosis when it is above the pharynx. We experienced a double primary cancer of the lower esophagus and the larynx. Total laryngectomy and total esophagectomy were done with cervical pharyngojejunogastrostomy for reconstruction. Free jejunal graft is interposed between the oropharyngeal stump and the stomach is pulled-up. We could restore the alimentary track without tension at the anastomotic site and obtain sufficient blood supply.

Preoperative Evaluation and Significance of Carotid Resection in Advanced Cervical Metastatic Cancer (진행된 경부 전이암에서 경동맥 절제를 위한 술전검사와 절제술의 의의)

  • Cho Jung-Il;Kim Young-Mo;Choi Won-Suk;Choi Sang-Hak;Han Chang-Joon
    • Korean Journal of Head & Neck Oncology
    • /
    • v.17 no.1
    • /
    • pp.13-18
    • /
    • 2001
  • Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

  • PDF

Mediastinal Cavernous Hemangioma (상대정맥에 발생한 해면상 혈관종 -1례 보고-)

  • 김동원;이재영;배철영;신원선;맹대현;곽영태;이신영
    • Journal of Chest Surgery
    • /
    • v.31 no.1
    • /
    • pp.69-72
    • /
    • 1998
  • Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4$\times$5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

  • PDF

Report of eight cases of thyroglossal duct cyst and fistula (갑상선 설관낭종 및 설관루)

  • 김교완;김종훈;김중강
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1977.06a
    • /
    • pp.10.1-10
    • /
    • 1977
  • The authors have experienced 8 cases of the thyroglossal duct cysts and fistula which were diagnosed and treated surgically in the Dept. of Otolaryngology, Taegu Presbyterian Hospital during the period of last 2 years. 1. Age distribution showed at age 2∼10 years old (4 cases), and 10∼30 years old (3 cases); The youngest age of 2, and the oldest age of 42. 2. The form of disease revealed as cystic form (7 cases) and fistula form (1 case). 3. Operating procedure were excision of thyroglossal duct cyst with partial removal of hyoid bone. 4. Sex distribution 7 in female and 1 in male. 5. Histologic examination revealed as stratified squamous epithelial lining were 7 cases, its cell composed with plasma cells lymphocytes. No epithelial lining is 1 case. 6. Post-operative complications were not developed in all cases.

  • PDF

Reconstruction of the Defect after Resection of Tonsillar Carcinoma Using Pectoralis Major Myocutaneous Flap (편도암 수술후 대흉근피판을 이용한 결손부위의 재건)

  • Choi Eun-Chang;Lee Jeong-Joon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.11 no.1
    • /
    • pp.41-46
    • /
    • 1995
  • The pectoralis major myocutaneous flap represents a major contribution to head and neck cancer reconstruction. Its advantages are improved viability, one-stage reconstruction, and carotid protection. The oropharyngeal defect especially tonsillar area reveals valley shaped one with loss of a wide mucosal area. Using pectoralis major myocutaneous flap to this defect is sometimes difficult due to its natural figure of bulkiness. This article reviews our experience with patients undergoing 14 pectoralis major myocutaneous flap in carcinoma of the tonsillar area. Complications and their incidences were I total loss, 3 marginal loss, 2 minor seperation of suture, I wound infection and 2 hematoma. Most of the complications did not require a second procedure for reconstruction. Bulkiness of the flap and gravity force to the upper suture line were thought to be causes of the complications. Modification of the flap design with bilobular figure was useful to reduce its bulkiness at the folding area. More stable suture around hard palate was needed to overcome seperation of the suture.

  • PDF

Results of Pharyngocolostomy in Intractable Caustic Pharyngeal Stricture (난치성 식도협착에서의 인두-대장 문합술의 결과)

  • 박충규;심영목;김진국;김관민
    • Journal of Chest Surgery
    • /
    • v.32 no.6
    • /
    • pp.561-566
    • /
    • 1999
  • Background: It is not easy to surgically correct caustic pharyngeal strictures and a lot of effort is required to restore normal swallowing after the surgery. The authors reviewed the course in patients who underwent pharyngocolostomy. Material and Method: From August 1995 to March 1998, 6 patients with caustic stricture underwent esophageal reconstruction surgery. The time of injury to the replacement of the esophagus was from 3 months to 2 years and 4 months. The left colon was used in all patients. The surgical route was used under the sternum in 5 patients and through the esophageal hiatus in 1 patient. In the cervical anastomoses, the cervical pharyngocolic anastomosis was performed on the left pyriform sinus after a partial resection of the thyroid cartilage in 3 patients and on the posterolateral aspect of the inferior pharyngeal constrictor in 3 patients. Result: Postoperative complications consisted of a dysphagia in 3 patients and left vocal cord palsy in 1 patient. There was no cervical anastomotic stricture. Revisional procedures consisted of an esophageal dilation and free jejunal graft in 1 patient, supraglottic scar band resection in 1 patient, and colonic mucosal resection in 1 patient. Swallowing training was required in the 3 patients with dysphagia. Restoration of normal swallowing was obtained in all patients between the 9th and the 303rd day. Conclusion: Pharyngocolostomy is a satisfactory method of treatment for patients with intractable caustic stricture. Pharyngocolojejunostomy is an effective alternative for esophagocologastrostomy in cases where gastric outlets are involved.

  • PDF

Brachiocephalic Venous Aneurysm Mimicking Metastatic Cervical Lymphadenopathy in a Patient with Gastric Cancer: A Case Report (위암 환자에서 경부 전이성 림프절로 오인될 수 있는 팔머리정맥류: 증례 보고)

  • Min Jung Ryu;Jae-Kwang Lim;Hoseok Lee
    • Journal of the Korean Society of Radiology
    • /
    • v.81 no.4
    • /
    • pp.933-938
    • /
    • 2020
  • Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After follow-up chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.