• Proceedings of the KOR-BRONCHOESO Conference
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• 2008.10a
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• pp.35.1-35.1
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• 2008

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.5.2-5
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• 1982

With the improvement of living standard and socioenvironmental change, esophageal stricture due to acetic acid, Hcl, insecticides and lye has led to decrease remarkably. Esophageal stricture has decreased because of immediate treatment and adequate management. However there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. The authors recently have experienced seven severe cases of esophageal stricture. All six patients were treated with 18-51 French Sippy esophageal dilating bougie. One patient was transfered to thoracic surgery department due to complete esophageal obstruction. Case 1. A 23 year old housewife who ingested Hcl for suicide. After Witzel's operation, she visited to dilate esophageal first constriction stircture due to swallowing difficulty postoperation 2 months later. We were treated successfully. Case 2. A case of esophageal stricuture in the second and third physiologic constriction part. The patient was 51 years old man who ingested lye accidently, and was dilated by bougination. Case 3. The patient was 43 year-old man who ingested acetic acid as a mistake and was treated inadequately at hopsital. Inspite of treatment, esophageal stricture developed at the third physiologic part. We are trying to dilate the esophagues now. Case 4. The patient was 55 year-old woman who had ingested Hcl for the purpose of suicidal attempt. 2 months later gastroduodenal anastomoisis due to pyloric region stenosis, the first physiologic constriction stricture was dilated successfully. Case 5. The patient was 41 year-old woman who ingested Hcl for suicide 4 months ago. There was indwelled orogastric tube for 1 month but esophageal stricture developed at the first and 3rd constriction part. She was treated by using a bougination. Case 6. An athlete 21 year old man, ingested acetic acid 2 spoonful per 3 days by purpose in order to soften the bone for last 14 months. There was complete esophageal obsturction in esophagogram and transferred to the thoracic surgery department. Case 7. A 3 year-old girl was ingested lye at a accident. She had a bougination for 16 months under the general anesthesia for dilation due to whole irregular esophageal stricture. She developed lower esophageal perforation, but healed eventually.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.581-584
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• 2000

Because the penetrating cervical tracheoesophageal injury may be associated with significant morbidity and mortality, it is important to choose the optimal method of diagnosis and management in patient with tracheoesophageal injury. We obtained a satisfactory result from repair of tracheoesophageal injuries using cardiopulmonary bypass. If the bleeding from the unidentified deep injury and the spread of infection could be controlled, the repair using CPB might increase the margin of safety during operation in the similar cases.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.115-118
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• 2009

A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

• Proceedings of the KTCVS Conference
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• 1998.04a
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• pp.32-33
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• 1998

• 대한미세수술학회:학술대회논문집
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• 1998.11a
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• pp.190.1-190.1
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• 1998

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.39-39
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• 1991

뇌하수체 종양에 대한 경비중격 경접형동 수술은 1907년 Schloffer가 비절개수술에 의한 방법을 보고한 이래 1914년 Cushing이 sublabial approach를 정립하였으나, 이후 약 반세기 동안 경비중격 경접형동 수술이 개두술에 비해 종양의 재발율이 높다는 이유로 기피되어왔다. 1968년에 이르러 Cottle의 maxilla-premaxilla approach로 비중격에 대한 수기가 축적되고 수술현미경의 발달로 미세수술이 도입되면서 경비중격 경접형동수술이 다시 각광을 받게 되었다. 이후 sublabial approach, alotomy approach, columellar approach, external rhinoplasty approach 등이 개발되어 보고되었으며 접형동의 함기화가 불완전한conchal 형이나 터어키안 상측부로의 종양의 확장이 심한 예를 제외하고는 모두 이 방법으로 수술을 시행하는 것이 보편화되어 있으며 문헌고찰에 의하면 개두술시의 술후 사망율이 17%인데 비해 경비중격 경접형동술의 경우 1.8%라고 보고되고 있다. 서울대학교병원 이비인후과에서는 sublabial approach로 터어키안까지 종양을 노출시킨 후 신경외과의와 공동으로 뇌하수체 종양을 치료한 예를1977년부터 1988년까지 135례를 보고한 바 있다. 최근에는 sublabial approach의 단점을 보완하면서 외비의 해부학적인 구조에 익숙해질 수 있는external rhinoplasty approach를 이용하여 경비중격 경접형동 수술을 시행하고 있으며 1977년부터의 치험례를 임상분석하여 특히 external rhinoplasty approach의 수술성적을 보고하는 바이다.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1142-1144
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• 1997

A case of fatal hematemesis due to an aberrant right subclavian arterioesophageal fistula which is a rare complication of the vascular ring is presented. A 42-year-old man with multiple injury by traffic accident presented severe upper gastrointestinal bleeding and was taken emergent operation. He was keeping tracheostomy tube and nasogastric tube for 7 weeks. We could find an aberrant right subclavian arterioesophageal fistula through left thoracotomy which was made by irritation of the prolonged nasogastric ube. We carried division of the aberrant right subclavian artery and fistulectomy. He was doing well postoperatively. But massive bleeding occurred at the fifth postoperative day. We performed emergent reoperation at CCU and found the tear point on the suture site of the aorta, which might be developed due to irritation of the chest tube andfor infection of the surrounding tissues. He was expired at the 8th postoperative day due to ischemic brain damage.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1392-1397
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• 1996

Over the past two years the free jejunal transfer have been used in 7 consecutive patients to restore alimentary tract continuity artier the resection of esophagus. Six patients had squamous cell carcinomas and one had esophageal stricture . The patients underwent partial esophagectomy with modified radicAl neck dissection or mediastinal Iymph node dissection. The microvascular anastomosis was performed to the neck vessels in 4 patients and to the in ercostal vessels in 3 patients. Postoperative complications were graft necrosis in one patient, and a temporary anastomotic leakage with spontaneous closure in one patient. Reconstruction of the esophagus was successful in 6 of 7 patients. We emphasize that esophagectomy followed by transplantation of a free jejunal transfer is suitable for esophageal carcinoma or intractable esophageal stricture, and involvement of the midesophagus is not a contraindication to the use of the free Jejunal transfer.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2009.04a
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• pp.34-35
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• 2009