• Journal of Chest Surgery
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• v.43 no.3
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• pp.324-327
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• 2010

Killian-Jamieson diverticulum is a rare disease that is seen at the cervical esophagus. It has quite a different pathogenesis and anatomical location compared with that of Zenker's diverticulum. The pathophysiology and strategy for treating Killian-Jamieson diverticulum are not fully understood. We performed surgery using one incision for treating a case of Killian-Jamieson diverticulum and we review the medical literature that's related to this unusual diverticulum.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.450-453
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• 2005

Broncholithiasis is uncommon in patients with silicosis. Bronchoesophageal fistula complicated by broncholithiasis is especially rare and only one case has been reported in Korea. Surgical treatment of broncholithiasis should be as conservative as possible to preserve the adequate pulmonary function. Meticulous dissection and division of the fistula with the interposition of viable tissues will prevent recurrence, We report a rare case of bronchoesophageal fistula complicated by broncholithiasis in a patient with silicosis.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.753-758
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• 1996

From January 1987 to December 1994, twenty five patients with cancer of the esophagus were t eated surgically at the department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul ll General Hospital. Among them, male was 24 cases, female was 1 case, with age ranged from 40 to 74 years, mean age was 60.4 years. The most common symptoms were dysphagia 92.0%, general weakness 28.0%, subsiernal pain 16.0%, weight loss 16.0 oyo , The tumor locations were the upper third in 2, middle third in 17, lower third in 6. Surgical treatment was done with transthoracic esophagectomy and esophagogastrostomy 1~4 cases, transthoracic esophagectomy and esophagocologastrostomy 5 cases, Transthoracic esophagectomy and jeT junal interposition 2 cases, palliative feeding gastrostomy 4 cases. The postoperative complications included anstomotic leakage in 3 cases, empyema in 3 cases, wound in- fection in 2 cases, atelectasis in 2 cases, pleural effusion in 1 case, hoarseness in 1 case, pneumothorax in 1 case, necrosis of jejunal loop in 1 case, aspiration pneumonia in 1 case. The operative mortal ty were 3 cases (12.0 %) and causes of death were aspiration pneumonia 1 case. sepsis and respiratory failure in each 1 . The mean survival period was 9.75 months. Recurrence of cancer revealed in 3 cases.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.420-426
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• 1996

We previously reported 344 cases of esophageal reconstruction for caustic esophageal stricture between 1959 and 1982, and this is the second report of 69 cases during 12 year period from Jan. 1983 to Feb. 1995. There were 32 males and 37 females, ranging in age from 4 to 65 years(mean 36.4 years). Caustic materials were acid in 37 (53.7%) and alkali in 31 (44.9%). All cases underwent colon interposition without esophageal resection except 3 cases of cancer complication which were resected through thoracotomy. In 64 cases isoperistaltic right colon with teminal ileum interposition were performed, and 5 cases were interposed with left colon either isoperistaltic (2 cases) or antiperistaltic (3 cases) method. Anastomotic leakage was the most frequently encountered c mplication (14.4%, 10 cases), and they were 11.6%(8 cases) from cervical, 2.8% (2 cases) from ileocolostoma. Overall operative mortality was 2.9% (2169), main causes of death were sepsis due to graft necrosis and mediastinitis. During 6 months to 12years (mean 2.Syears) follow-up of survived 67 cases, 88.1% (59 cases) ate normally, 7.5% (5 cases) complained of moderate dysphagia (eating liquid diet), and 4.5% (3 cases) were unable to eat by mouth. In our experience, reconstruction of the esphagus with the colon is a satisfactory method that can be accomplished with acceptable morbidity and mortality. The right colon is a durable and functional esophageal substitute.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.28-28
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• 1991

후두암의 수직절제 수술후의 후두 재건 목적은 기관절개를 통하지 않고 후두를 통한 호흡이 가능하도록 하면서 연하시 기도흡인을 피하기 위한 sphincter 능력의 보존, 그리고 발성이 가능하도록 성대진동 mechanism을 재건하는데 있다. 오늘날 수많은 후두학자들에 의해서 고안 개발된 다양한 재건 방법이 있다. 연자는 광범위한 후두절제에 따른 큰 결손을 메우기 위해 bulky하면서도 점막 상피의 재생이 용이한 재건 피판으로 흉유돌근골막 피판을 이용하여 후두 결손부를 재건하여 보았다. 방법은 성견 3마리를 대상으로하여 thiopental sodium 정맥주사로 전신마취를 시행한 후 설골에서부터 흉골상까지 경부 정중앙의 피부를 절개하고 후두를 노출시켜 후두 수직절제술을 시행하였다. 흉유돌근과 흉골에 부착된 골막을 박리하여 흥유돌근골막 피판을 제작한 후 골막이 후두강 안쪽으로 되도록하여 골막연과 후두점막을 봉합하였다. 그리고 3, 5, 9개월에 후두적출술을 시행하여 병리조직학적 및 수술후 경과를 관찰하였다. 3실험견 모두 기관절개술 없이 후두를 통한 호흡이 가능하였고 흡입성 폐렴이나 피하기종등의 합병증없이 창상이 치유되었으며 발성도 양호하였다. 이식된 골막위로 신생혈관의 출현과 함께 점막재생이 잘되 있었다. 단지 봉합사 주위에 소량의 육아종이 관찰되었다. 조직학적으로는 섬유조직위로 편평상피가 재생되었으며 성문하부에서는 일부 섬모가 있는 호흡기 점막도 관찰되고 골막하부에 신생골 형성은 관찰할 수 없었다. 골막 피판은 그 유연성 때문에 결손부위의 점막연에 맞춰도 tension이 없고 공기 누출이 되지 않게 봉합이 가능할 뿐 아니라 점막이 재생할 수 있는 frame-work의 역할을 하는 것으로 사료되었다. 이상과 같은 사실로 미루어 흉유돌근 자체가 견실하고 골막에 혈류공급이 잘되어 창상치유에 좋을 뿐 아니라 큰 후두결손부의 재건이 가능하리라고 사료되었다.로서 몇가지 앞으로의 치료지침에 도움이 되는 결과를 얻었기에 보고하는 바이다. 1) 성별 분포는 남자 16(39 %), 여자 25 (61%)이었으며 1 : 1.5의 빈도를 보였다. 2) 연령 분포는 20대와 30대에서 남녀 모두 25명으로 대부분을 차지하였다. 3) 부식제의 종류는 빙초산이 26명 (63.4 %)으로 대부분을 차지하였고 염산 7 (17.1 %) Lye 3 (0.7 %) 의 순이었다. 4) 음독후 12시간내에 식도경술을 받은 환자가 3명(0.7 %) 12-24시간에 받은 환자가 17명(41.5 %), 24 - 48시간에 받은 환자가 11명(26. 8%)으로 48시간 내에 시행받은 환자가 전체의 75.6%를 차지하였다. 5) 식도경 검사상 나타난 식도화상은 Grade I 11명 (26.8%) G.ade II 18(43.9%) Grade III 7명(17.1%) 이었으며 Grade II 인 경우가 18명(43.9%)로 가장 많았으며 Grade I 11명(26.8 %), Grade III 7명 (17.1 %) Normal 5명 (12.2 %) 순이었다. 6) 조기 식도경 검사에서 41명중 oral cavity burn이 없었던 경우가 15명(36. 1 %) 이었으며, oral cavity burn이 있었던 26명중 5명(19 .2 %)에서 Esophageal burn이 없었다 특히 Esophageal burn의 Grade II, III 25명 중 9명(29.6 %)에서 oral cavity burn이 없었다. 7) 식도 부식중 환자의 치료 원칙으로 Grade I, II, III에서 항생제 및 보존적 치료를 하였으며 Grade I에선 oral feeding을 시켰고 Steroid는 경우에 따라 투여하였으며 Grade III에선 원칙적으로 사용치 않았다. 식도조영술은 Grade I II III에서 3주 후에 모두 시행하였다. 8) 3주 후 식도조영술을 실

• Journal of Digestive Cancer Reports
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• v.8 no.1
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• pp.71-75
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• 2020

Esophageal cancer is easy to infiltrate and metastasize because esophagus does not have serosa, and is difficult to remove it because esophagus is in the middle of the chest. Because of this, treatments of esophageal cancer do not always follow the guideline. In this situation, efforts to increase treatment efficiency and improve survival rate through multidisciplinary treatment are increasing. In this case, we report the patient with three superficial esophageal cancers (one in cervical esophagus and two in thoracic esophagus). The patient was treated with concurrent chemoradiotherapy instead of surgery through multidisciplinary discussion. The patient reached a complete remission through this discussion. This case is intended to inform the usefulness of multidisciplinary treatment in patients with esophageal cancer.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.310-316
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• 2006

Background: We study the QOL (quality of life) & functional improvement in patients underwent esophageal surgery for cancer by the viewpoint of the patient and would like make the guideline of recovery course. Material and Method: Between Dec. 1996$\sim$Aug. 2002, 250 patients were operated and 57 patients was enable interview, didn't have evidence of recurrence & survived more than 1 year postoperatively at Asan Medical Center. Questionnaire made by direct or telephone interview & include diet habitus, change of body weight, G-E (gastroesophageal) reflux, dumping symptom, change of daily life. Result: There were 53 men (93%), 4 women (7%) with mean age of $62.05{\pm}8.7$ (range: $37{\sim}94$). Operation method was Ivor Lewis operation in 43 case (75.4%), Esophagocolojejunostomy 4 case (7.1%), Mckeown operation 10 case (17.5%). In Diet habitus, 55 patients (96.5%) ate more than three times in a day with mean diet frequency was 3.5 times/day, 51 patients (89.5%) have been ate solid, regular diet, 5 patients (8.8%) enable to eat liquid diet. To compare with preoperative state, 32 patients (56.9%) had a diet speed more than 80%, 28 patients (39.1%) had a diet amount more than 80%. 32 patients (56.9%) had a little change of body weight within a 10%, 25 patients (43%) had a improvement rather than preoperative state. In G-E reflux, 4 patients (7%) had a reflux after every diet, 27 patients (47.4%) had a little reflux after diet. In dumping symptom. 7 patients (12.3%) had a diarrhea after meal. 38 patients (66.6%) had a normal activity 19 patients (33.3%) had a decreased activity. At present state, majority (53 patient-93%) of patient were satisfactory to the operation result, in spite of discomfort from time to time. In the emotional status, 50 patients (88%) had a well sleeping without disturbance. 65% of patients were comfortable in the psychology state. 39% of patients had a libido. Compare with their median age (63 y), it's a normal varient. Conclusion: QOL in patients underwent esophageal surgery for esophageal cancer nearly recovery to preoperative state.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.184-187
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• 2004

The synchronous double cancer of the esophagus and lung is rare. Right lower lobectomy and Ivor Lewis procedure were performed simultaneously in a 75 year-old male patient who had synchronous double primary squamous cell carcinoma of the thoracic esophagus and right lower lobe of the lung, Left upper lobectomy was performed in a 69 year-old male patient who had squamous cell carcinoma of the left upper lobe of the lung, and four months later we performed Ivor Lewis procedure for the squamous cell carcinoma that occurred in the thoracic esophagus. The above two patients were doing well 10 months and 24 months after the operation respectively without recurrence. We treated the two cases of synchronous double cancer of the esophagus and lung with complete resection, and report this with review of literature.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.18.1-18
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• 1987

1972년 Jako와 Strong이 후두질환에 $CO_2$레이저 사용을 발표한 이래 최근 이비인후과영역에서 $CO_2$레이저를 이용한 수술방법이 각광을 받고 있으며 특히 후두 및 기관지 협착증에서의 $CO_2$레이저 이용은 현재까지 가장 좋은 방법의 하나로 소개되고 있다. 이와 더불어 최근 레이저를 이용한 기관지경술이 이용되고 있는데, 이는 기관 및 기관지의 여러 질환중에서 유두종등의 양성종양의 제거, 기관 및 기관지 협착증의 치료, 그리고 원발 혹은 전이에 의한 기관내 악성종양의 고식수술(姑息手術)등에 이용되고 있다. 최근 저자들은 성문하부 및 기관내에 발생한 후두 및 기관유두종 2례와 육아조직에 의한 성문하부 및 기관협착증 2례에서 coherent $CO_2$레이저 기관지경을 이용한 기관지경술로 만족할 만한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.23.2-23
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• 1987

저자들은 1977년부터 1986년까지 10년동안 서울대학병원 이비인후과에서 유년기성 비인강 혈관섬유종의 진단하에 치료받았던 27명의 환자에 대해 임상적 조사를 시행하여 다음과 같은 결과를 얻었다. 1) 남녀비율은 전례에서 남성이었으며 연령은 9세∼22세의 분포를 보였고 16∼17세가 가장 많았다. 2) 주증상으로는 전례에서 비출혈을 동반하는 비폐색증을 보였으며 편측인 례가 7례였다. 3) 종양의 크기는 21례에서 비인강 및 비강내에 국한되어 있었고, 4례에서 익상상악와, 2례에서 두개내 침습을 보였다. 4) 종양의 혈액공급은 동측의 내상악동맥에서 이루어지는 경우가 27례, 동측의 상행인두동맥이 13례, 양측에서 이루어지는 경우가 9례 있었다. 5) 치료는 23례에서 수술적 요법을, 4례에서 방사선치료를 시행하였다. 수술적 요법 23례중 11례 에서 경반구개제거술(hemipalatal approach), 8례에서 경전구개제거술(transpalatal appoach), 2례에서 경전구개 및 경상악동제거술(transantral approach), 2례에서 외비절제술(lateral rhinotomy approach)에 의해서 종양을 적출하였다.