• Title/Summary/Keyword: 내시경 절제

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Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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The Role of Colonoscopy in Children with Hematochezia (소아 선혈변에서 대장 내시경 검사의 역할)

  • We, Ju-Hee;Park, Hyun-Suk;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.155-160
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    • 2011
  • Purpose: This study was performed to evaluate the role of colonoscopy in children with hematochezia. Methods: We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010. Results: The mean age of the patients was $6.0{\pm}4.4$ (7 days~17.8 years) years. The male to female ratio was 2.2:1. The duration between the 1st episode of hematochezia and colonoscopy was $4.9{\pm}12.1$ months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found. Conclusion: The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

Innovative Techniques for thoracic sympathectomy: Experience of 654 patients for essential hyperhidrosise (흉부 교감신경절 절제에 대한 수술기법의 변화)

  • 문동석;이두연;김해균
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.703-710
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    • 1998
  • We treated 654 patients with simultaneous bilateral sympathectomy for essential hyperhidrosis from March 1989 to September 1997(354 males and 300 females). The exposure afforded by thoracoscopy is actually superior to that seen at the time of either thoracotomy or axillary thoracotomy. The use of single-lumen intubation with alternating partially collapsed lung by CO2 inflation resulted in shorter anesthesia, shorter operative time, and shorter hospitalization. 2-mm extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective one in the treatment of hyperhidrosis by experienced surgeons. The modification on our technique of thoracoscopic sympathectomy as described allowed us to significantly improve our previous results. A majority of the patients were relieved, and over 95% were satisfied initially.

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Surgical Treatment of Bronchoesophageal Fistula in Adult (성인 식도 기관지루의 외과적 치료)

  • 곽영태;김동원
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.67-72
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    • 1996
  • Bronchoesophageal fistula is a rare clinical entity whether congenital or acquired in adult. We experinced 8 cases of bronchoesophageal fistula and performed surgical correction from 1991 to 1994. Of the 8 patients, 5 patients were male and three were female aging from 21 to 61 years(mean 44.12$\pm$14.62 years). Seven of 8 patients had congenital bronchesophageal fistula and the other one had acquired bronchoesophageal fistula. According to the classification of Braimbridge and Keith, 4 cases were belonged to type I and 3 cases were type II . The diagnosis was confirmed by esophagogram in six patients, by bronchoscopy and bronchogram in two patients, and in one patient, the fistula was discovered i cidentally during operation. All patients received astulectomy and concomitant procedures were applied as follows ; 4 diverticulectomy, 4 right lower lobectomy, 1 bilobectomy, 1 left lower lobectomy and 1 wedge resection of left lower lobe. All but one patient were discharged without any complication and have been in good condition.

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Mucoepidermoid Carcinoma of The Bronchus in a 10-Year-Old Child -A Case Report- (10세 소아에서 발생한 기관지 점막표피양 종양의 수술체험 -1례 보고-)

  • 윤석원;김동관;박창률;박승일
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.760-763
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    • 2002
  • Mucoepidermoid cancer of the bronchus in childhood is extremely rare. These tumors generally produce symptoms of airway obstruction, often misdiagnosed as unresolved tuberculosis. Distant metastasis is an uncommon finding of this malignancy, therefore complete surgical resection is treatment of choice. The prognosis of these tumors correlates with the histologic grade of the tumor. We report our clinical experience of mucoepideromoid cancer in a 10-year-old child who visited our hospital with symptoms of recurrent cough and fever. The patients underwent successful removal of tumor by bilobectomy via thoracotomy after bronchoscopic biopsy.

Tracheobronchoplasty in the Patient with Right Upper Lobe Squamous Cell Carcinoma Invading Lower Trachea- One case report- (하부기관을 침범한 우상엽 편평상피세포 폐암 환자에서의 기관기관지 성형술-1례보고-)

  • 박승일;정성호;김상필;최인철
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.418-421
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    • 2001
  • 53세 남자 환자가 객혈을 주소로 입워하여 우축 상엽 편평상피세로 폐암으로 진단 받았다. 캄퓨터 단층촬영상 하부 기관에 종양의 침윤이 의심되었다. 우측 하엽과 중엽을 보존하기 위해서 우측상엽과 하부 기관외측을 포함하여 절제하는 기관기관지 성형술 시행하였고, 수술후 우측 폐의 팽창은 완전하였다. 수술 후 1주일째 시행한 기관지 내시경 검사상 우측 중엽과 하엽의 기관지는 뒤틀림 없이 잘 유지되어 있었다. 수술 후 항암치료와 방사선 치료를 받고 현재 환자는 수술 후 1년 7개월 동안 외래 추적관찰 중이다. 저자들은 우측 상엽의 폐암이 기관 하부를 침범한 경우에 우측 기관 소매 전폐절제술의 합병증을 피하고 환자의 폐기능을 보조하면서 침윤된 우측상엽을 포함하여 절제하는 기관기관지 성형술을 시행하여 이에 보고하는 바이다.

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Soft Tissue Implantation of Thyroid Adenomatous Hyperplasia after Endoscopic Thyroid Surgery:Report of a Case (내시경 갑상선 절제술 후에 발생한 갑상선 선종성 과형성증의 연조직 착상 1예)

  • Lee, Yong-Sang;Yoon, Ji-Sup;Nam, Kee-Hyun;Chung, Woong-Youn;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.46-49
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    • 2007
  • Soft tissue implantation of thyroid tissue is a very rare event. Needle tract implantation of thyroid carcinoma after fine-needle aspiration (FNA) biopsy has been occasionally reported, but implantation of benign thyroid tumor tissue is extremely rare. Rupture of thyroid tissues during surgery or trauma may cause the thyroid tissue to be implanted and result in multiple palpable nodules in soft tissue of the neck. Several reports have shown the possibility of implantation of normal or hyperplastic thyroid tissues in soft tissue. We herein report a case of implantation of adenomatous hyperplastic tissue in the neck along the trochar and previous operation site after endoscopic thyroid surgery, which was successfully treated by complete excision.

Gastric Extramedullary Plasmacytoma in a Dog (개의 위에서 발생한 골수외 형질세포종)

  • Chae, Woong-Joo;Kwon, Do-Hyoung;Kwon, Jin-A;Kim, Jae-Hoon;Jung, Joo-Hyun
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.356-359
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    • 2012
  • An eight-year-old, spayed female Shih-tzu, weighing 3.2 kg with a history of chronic intermittent vomiting and unknown pain for four months was referred. In ultrasonography, a small round hypoechoic mass was identified in the gastric wall. Gastric endoscopy showed a solitary raised mass with smooth surface in the pyloric antrum. Surgical resection was performed. Histopathologic findings with immunohistochemical studies showed extramedullary plasmacytoma in the gastric submucosal and muscle wall layer. The patient recovered normally without any complications. The tumor has not been re-occurred after surgical removal, to date.

A case of echinostomiasis with ulcerative lesions in the duodenum (십이지장 궤양을 동반한 호르텐스극구흡충 감염증례)

  • 채종일;홍성태
    • Parasites, Hosts and Diseases
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    • v.32 no.3
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    • pp.201-204
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    • 1994
  • Echinostomiasis is an endemic intestinal trematodiasis of humans in Korea We observed a human case of Echinostomn honense infection who had ulcerations on the duodenal mucosa. A 55-year old man living in Hamyang-gun, Kyongnam, complained of epigastric pain with hematemesis In April 1994. Endoscopy revealed lesions of early gastric cancer and duodenal ulcerations. A penetrating parasite into the duodenal mucosa was picked out, and identified as E. honense. As the patient was treated 10 praziquantel 10 mg/kg single dose,3 more E. hofene and 7 Metogonimw worms were recovered. This case demonstrates that echinostomiasis causes gross ulcerations in the duodenum.

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Endobronchial Chondroid Hamartoma Removed by Segmentectomy -Surgical Experience of One Case - (폐구역절제술로 제거된 기관지 내 연골성 과오종 -수술치험 1예 -)

  • Cho, Seong-Ho;Park, Sung-Dal
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.652-655
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    • 2005
  • In comparison to parenchymal hamartoma, endobronchial hamartoma is rare benign neoplasm of the lung. Most parenchymal hamariomas are asymptomatic and are found incidentally. However, endobronchial hamartomas are frequently discovered through respiratory symptoms as a result of bronchial irritation or obstruction. A 47-year-old male patient was admitted to our hospital due to dry cough f month prior to admission. On bronchoscopic examination, a polypoid mass was found completely obliterating the anterior segmental bronchus of the left upper lobe. We report a case of endobronchial chondroid hamartoma, which was resected by anterior segmentectomy of the left upper lobe.