• Title/Summary/Keyword: 식도암

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Current Status and Consensus on Esophageal Cancer Management (식도암의 치료, 어디까지 와 있는가?)

  • Joon Han Jeon;Dae Young Cheung
    • Journal of Digestive Cancer Research
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    • v.1 no.1
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    • pp.17-23
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    • 2013
  • Over the decades, the treatment of the esophageal cancer has been debated. Multimodal therapy is a important keystone in advanced esophageal cancer. Neoadjuvant chemoradiation therapy is now known to provide advantages for treating stage II and stage III esophageal squamous cell cancer and can also be considered for the esophageal adenocarcinoma. Definitive chemoradiation therapy results in long-term survival compared with surgery alone. This review aims to provide recent consensus recommendations based on the data and literatures.

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Thoracoscopic Radical Esophagectomy in Cervico-Thoracic Esophageal Cancer (경구경계부식도암에서 흉강경을 이용한 근치적 식도암적출술)

  • 박재길;이선희
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.681-688
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    • 1996
  • Most patients with carcinoma of the cervico-thoracic esophagus present with locally advanced disease. For this reason, therapeutic efforts have been largely palliative, focused on eradicating locoregional dis- ease, and have been attended by high morbidity rates. A 61 year old man was diagnosed to advanced cervicothoracic esophageal cancer(Type 1) and reli ved concurrent chromo-radiotherapy for 2 months in St. Mary's Hospital. And then he underwent transhiatal subtotal esophagectomy and radical dissection of cervical and superior mediastinal Iymph nodes with thoracoscopy. The histologic diagnosis was early esophageal cancer(Type 0-llb, SM2) and the curability of operation was calculated to highly curative(Clll). And the postoperative course was unevenful.

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Clinical Comparison of Complications Between Esophagogastrostomy and Jejunal Free Transfer After Resection of Thoracic Esophageal Cancer (흉부식도암 절제술 후 식도-위 문합술군과 유리공장이식술군간의 조기 합병증 비교)

  • 신호승;이재진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.843-847
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    • 2001
  • Background: Replacement of the esophagus remains a challenge for surgeons involved in esophageal disease. From 1996 to 1999, a total of 27 patients with esophageal cancer underwent free jejunal transfer(12cases) or esophagogastrostomy(15cases). To determine the results such as leakage of anastomosis site, stenosis, reflux esophagitis and operation time, respiratory complications, etc. we reviewed the 4 years experiences. Material and method: Palliative bypass surgery or esophageal prosthesis and cancers of the pharyngoesophageal or esophagogastric junction were excluded in this study. Resection was usually peformed through right thoracotomy and anastomosis was made with EEA staplers in esophagogas-trstomy. In cases of jejunal free transfer, 6cases of proximal esophagojejunostomy were stapled anastomosed and remaining 6 cases and all distal site were hand-sewn anastomosed. All reconstruction was done through posteromediastinal route. Result: There were two mortalities from thoracic esophagogastrostomy and one from jeunal free transfer. Major and minor complications(anastomosis site leakage: 3 cases, graft failure: 2cases etc) occurred in 27 cases. In 15 thoracic esophagogastrostomy cases, 11 patients had mild to moderate reflux esophagitis and 5 patients incurred stricture of the anastomosis. Operation time was about 550$\pm$280 minutes in jejunal free transfer, and about 300$\pm$ 160 minutes in esophagogastromy patients. Conclusion: Post operative reflux esophagitis and dysphagia were more frequent in Ivor-Lewis operation group than jejunal free transfer group; however, respiratory complications and operation time were significantly longer in jejunal (roe transfer group(p<0.05). To minimize the incidence of postoperative reflux esophagitis and dysphagia, patient evaluation focused on jejunal free transfer surgery is better than esophagogastrostomy followed by adequate post operative care.

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The Utility of Chest CT in Staging of Esophageal Cancer (식도암의 병기 결정에 있어 흉부 CT의 유용성)

  • 홍성범;장원채;김윤현;김병표;최용선;오봉석
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.992-998
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    • 2004
  • Background: The decision of staging of esophageal cancer have great effect on the resectability of the lesion and estimation of the patient's prognosis. Today, CT is one of the most popular modality for staging of esophageal cancer. However, it has some limitations because of false-positive or false-negative findings on cancer staging. The purpose of this study was to analyze the efficacy of CT in preoperative staging of esophageal cancer. Material and Method: We retrospectively analysed the difference of staging of esophageal cancer between CT and histopathological findings for the 114 patients with histologically proven esophageal cancer who underwent operation at the department of thoracic and cardiovascular surgery, Chonnam national university hospital, between January 1999 and June 2003. We evaluated the efficacy of chest CT in the staging of esophageal cancer compared to postoperative histopathologic findings by calculating sensitivity, specificity, accuracy, and reproducibility of chest CT to detect abnormality. Result: The reproducibilities between chest CT and histopathologic findings were 0.32 (p<0.01) for primary tumor (T), 0.36 (p<0.01) for lymph node invasion (N), and 0.62 (p<0.01) for distant metastasis (M). The reproducibilities between chest CT and histopathologic findings for lymph node invasion (N) and distant metastasis (M) were superior to that of primary tumor (T). The accuracy of primary tumor (T) was 65.8% and 98.2% in group III and IV, which was significantly higher than that of group I and II (78.9% and 62.3%). In general, specificity of chest CT for TNM staging was superior to sensitivity. Conclusion: In conclusion, preoperative CT scanning can provide important information on lymph node invasion and metastasis of lesion than primary tumor invasion.

Surgical Treatment of Esophageal Small Cell Carcinoma -1 Case Report- (식도에 발생한 소세포암의 수술 치험)

  • Kim, Seung-U;Ryu, Ji-Yun;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.923-926
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    • 1996
  • Small cell carcinoma of esophagus is a rare malignant tumor Recently we experienced one case of small cell carcinoma in mid thoracic esophagus. The patient was a 68 year old male patient. On preoperative endoscopic biopsy, neuroendocrine carcinoma was suspected. Esophagectomy and esophagogastrostomy was performed. Postoperative course was uneventful and patient was discharged without specific complicalion.

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