• Title/Summary/Keyword: 근치적 절제

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Surgical Treatment of Synchronous Double Cancer of the Lung and Esophagus - A case report- (폐와 식도에서 동시에 발견된 중복암의 수술적 치료 -1예 보고-)

  • 이재익;우종수;이길수;노미숙;박미경
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.866-869
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    • 2003
  • Less than 2% of patients with primary esophageal cancers have synchronous primary lung cancers and many patients with these synchronous tumors are deemed ineligible for radical resection by surgeons due to the poor prognoses of both the diseases. However, we believe that carefully selected patients could benefit from one stage curative resection for these synchronous tumors. We experienced a case of synchronous double cancer of the lung and esophagus and performed bilobectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the good result of one stage curative resection for these synchronous serious tumors in Korea.

Use of the Stomach as an Esophageal Substitute after Total Pharyngolaryngoesophagectomy for Treating Cervical Esophageal Cancer or Hypopharyngeal Cancer (경부식도암 및 하부인두암에서 근치적 전후두인두식도절제술 후 위를 이용한 재건술의 의의)

  • Lee, Sang-Hyuk;Lee, Sang-Hoon;Yoon, Ho-Young;Kim, Choong-Bai
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.200-205
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    • 2007
  • Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

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Two Cases of Repeated Pancreatectomy for Pancreatic Cancer Developing in the Remnant Pancreas after a Resection of Pancreatic Cancer - Repeated Pancreatectomy of Pancreatic Cancer - (췌장암 절제 후 잔여췌장에 발생한 췌장암에 대한 반복절제를 시행한 2례 - 췌장암의 반복절제 -)

  • Young-Il Kim;Sang Myung Woo;Woo Jin Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.43-47
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    • 2013
  • There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

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Giant Cell Tumor of the Cervical Spine - Case Report - (경추에 발생한 거대 세포종 - 증례 보고 -)

  • An, Ki-Chan;Chung, Kyung-Chil;Kim, Yoon-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.57-62
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    • 2006
  • Giant cell tumors are potentially malignant tumors in vertebrae, affecting frequently difficult to diagnose and are often inoperable. So it will be treated using radiation because of their high recurrence rate and the mechanical compression of spinal cord, but many surgeons described tumors of the vertebra, and the affected vertebral body can be treated using radical or near to total excision, with anteroposterior vertebral fusion or instrumentation of the spine. we report a case of giant cell tumor affecting the third cervical vertebra which caused neck pain and destroyed the vertebra body had treated using radical excison with fusion of posterior arch using instrumentation of the spine together with a literature review.

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Nonfunctional Parathyroid Carcinoma: A Case Report (비기능성 부갑상선암: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.111-116
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    • 2010
  • Parathyroid carcinoma is a rare endocrine malignancy accounting for 0.5% to 4.0% of all cases of hyperparathyroidism and commonly present as hypercalcemia and parathyroid hormone (PTH) elevation. Nonfunctional parathyroid carcinoma does not show symptoms of hyperparathyroidism and only showed a vague indication of being pathologic, even when detected late. The optimal treatment is en bloc resection of the cancer, but frequent local recurrence after surgery has been reported. Adjuvant local treatment such as radiotherapy may improve the likelihood local control in cases with incompletely resected or microscopic residual tumor. The results of this study point to a case of nonfunctional parathyroid carcinoma treated by external beam radiotherapy after en-bloc resection of cancer.

Quality of Life of Long-term Survivors after a Subtotal or a Total Gastrectomy for Gastric Cancer (위암 수술 후 장기생존자에서 위 절제 범위에 따른 삶의 질)

  • Lee, Seung-Soo;Han, Sung-Won;Jeong, Hye-Yeon;Song, Jye-Won;Chung, Ho-Young;Yu, Wan-Sik
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.34-39
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    • 2010
  • Purpose: The aim of this study was to compare quality of life of long-term survivors after a subtotal or a total gastrectomy for gastric cancer. Materials and Methods: The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and QLQ-STO22 questionnaire were used to assess quality of life of 166 patients on their 5th annual follow-ups after gastrectomy for gastric cancer. One hundred twenty-six patients underwent a subtotal gastrectomy and 40 patients a total gastrectomy. Results: The subtotal gastrectomy group revealed a trend to have better quality of life in functional scales (physical, role, emotional, cognitive and social), fatigue, pain, dyspnea, diarrhea and financial difficulties. The total gastrectomy group showed a trend to have better quality of life in the global health status and quality of life, nausea and vomiting, insomnia, appetite loss and constipation. In all scales of the EORTC QLQ-STO22, the subtotal gastrectomy group had a trend to have better quality of life. However these did not reach the statistical significance. Conclusion: Surgeons may not limit the extent of resection concerning long-lasting poor quality of life. Oncologically sound resection is recommended.

The Impact of Preoperative Chemotherapy on the Surgical Management of Unresectable Gastric Cancer (수술 전 항암요법이 절제 불가능한 위암 환자의 수술에 미치는 영향)

  • Yoon, Sam-Youl;Kim, Min-Gyu;Oh, Sung-Tae
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.269-274
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    • 2009
  • Purpose: There have been reported that preoperative chemotherapy for treating noncurative gastric cancer could increase the R0 resection rate by downstaging the gastric cancer. Yet there have been only rare reports about the effect of preoperative chemotherapy on performing surgery for noncurative gastric cancer. Our study was designed to analyze our experiences with these effects. Materials and Methods: We retrospectively analyzed 46 patients who had undergone gastrectomy after chemotherapy between December 2001 and January 2009. The patients' preoperative condition, the operative findings and the postoperative clinical coursed were analyzed. Results: Preoperative chemotherapy was performed for a mean of 4.4 cycles. Four patients showed a level of ANC below 1,500 (${\mu}/L$) and above a 10 percentile weight loss, respectively. For an operation, we found fibrosis or fixation between the tumor and the adjacent organs in 29 patients, and 4 of the 13 patients who underwent resection with another organ were documented to have invasion by tumor. Forty one patients underwent curative resection. Ten patients developed postoperative complications. There was no mortality at postoperative 60 days. Conclusion: We assumed that preoperative chemotherapy had little effect on the patient preoperatively, and it had some effect on down-staging pathologically. Preoperative chemotherapy didn't increase the postoperative complication rate.

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Bone Metastasis after a Curative Resection for Gastric Cancer (위암의 근치적 절제술 후 발생한 골 전이)

  • Kim Jin Jo;Song Kyo Young;Chin Hyung Min;Kim Wook;Chun Hae Myung;Park Cho Hyun;Park Seung Man;Park Woo Bae;Lim Keun Woo;Kim Seung Nam
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.23-28
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    • 2005
  • Purpose: Bone metastasis is not a common event in patients with gastric cancer. Therefore, most studies of bone metastasis in such patients have been in the form of case reports, so the clinical features of the bone metastasis are not well understood. To clarify metastatic patterns, the efficacy of radiation or chemotherapy, and the prognosis, we analyzed 29 cases of patients with bone metastases after curative surgery for gastric cancer. Materials and Methods: Twenty-nine (29) gastric cancer patients with bone metastasis who underwent curative resection from January 1989 to December 2002 at the Departments of Surgery, Kangnam St. Mary's Hospital and Our Lady of Mercy's Hospital, The Catholic University of Korea, were analyzed. Results: Nineteen (19) patients were males and, 10 patients were females. The mean age of the patients was $53\pm12$ years. There were more Borrmann type-3 and type-4 cancers and more undifferentiated histologic types. Most of the original cancers were stage III or IV. The most frequently involved bone was the spine. Treatment after recurrence was done in 16 patients ($55.2\%$). The median survival time after recurrence of the patients who received treatment was seven (7) months ($0\∼75$ months in range), which was significantly longer than that of the patients who did not received treatment (P=0.019). However, there was no difference according to the treatment modality (P=0.388). Conclusion: Bone metastasis after a curative resection of gastric cancer tends to occur in Borrmann type-3 and type-4 cancers, cancers with undifferentiated histology and, in stage III/IV disease. The prognosis of bone metastasis is dismal, and aggressive treatment is the only way to prolong survival.

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