• Title/Summary/Keyword: 식도수술

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Dissecting Intramural Hematoma of the Esophagus - A case report - (박리성 벽내성 식도 혈종 - 1예 보고 -)

  • Choi, Jin-Wook;Lee, Sung-Soo;Choi, Ho;Moon, Jong-Hwan;Chung, Sang-Ho
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.782-786
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    • 2008

  • Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of, acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.

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Jejunal Free Graft for Complicated Corrosive Esophageal Stricture (유리공장이식편을 이용한 합병된 부식성 식도협착의 재건술)

  • I Hoseok;Lee Sungsoo;Shim Young Mog
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.445-449
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    • 2005

  • The management of failure of colonic graft or corrosive stricture with impaired colonic circulation continues to be a challenge to surgeons. We present four cases of complicated corrosive esophageal stricture, which were successfully treated using jejunal free graft. As the initial surgical treatment, three patients underwent colonic interposition, and one underwent Whipple's procedure due to panperitonitis. Ore patient underwent transposition of jejunal free patch graft, two underwent interposition of jejunal free graft, and one underwent esophagojejunocolojejunostomy using jejunal free graft. All patients did not show dysphagia after long term follow-up. Complex esophageal reconstruction with jejunal free graft was performed successfully and long term functional outcome was good.

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Surgical Option for Sufficient Safety Margine in Locally Advanced Type II Cardia Cancer - Left Colon Interposition (국소 진행된 Type II 분문부 선암의 절제연 확보를 위한 수술 방법: 좌측 대장 간치술)

  • Yoon, Ho Young;Kim, Hyoung-Il;Lee, Sang Hoon;Kim, Choong Bai
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.97-103
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    • 2008

  • Purpose: Radical surgery is the standard therapy for patients with resectable cardia cancer. In the case of type II disease with esophageal invasion, a transhiatal extended radical total gastrectomy is needed or a gastroesophagectomy through an abdomino-thoracotomy, depending on the extent of the esophageal invasion. We analyzed the indications and outcome of left colon interposition as an esophageal substitution. Materials and Methods: Between 1 January 1994 and 31 December 2006, 10 patients underwent left colon interposition after gastroesophagectomy through an abdomino-thoracotomy or the tanshiatal approach for type II cardia cancer at the Department of surgery, Yonsei University College of Medicine. The outcomes of these patients were reviewed and compared, with those who underwent a Roux-en-Y, by gender and age matched analysis, retrospectively. Results: There were nine males and one female with a mean age of 52.5 (range, 16~72). The operation time was $449.00{\pm}87.39minutes$. The mean distance between the proximal resection margin and the cancer was $6.56{\pm}3.65cm$; the maximum size of the tumor was $9.90{\pm}3.97cm$. These measures differed significantly from patients who underwent Roux-en-Y. The patients had a double primary cancer in the cardia and esophagus. There were no events of colon necrosis. However, a pneumothorax occurred in one patient (10%) and a proximal anastomotic stricture occurred in one patient. There were no reports of heartburn, regurgitation, thoracic or epigastric fullness, and one patient even gained weight, 16 kg. Conclusion: Colon interposition after esophagogastrectomy was safe and effective and should be considered as an additional surgical option for locally advanced type II cardia cancer patients with esophageal invasion.

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