• Title/Summary/Keyword: 식도협착

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VOICE REHABILITATION FOLLOWING LARYNGECTOMY -MYOMUCOSAL TRACHEOESOPHAGEAL SHUNT- (후두전적출술후 Myomucosal tracheoesophageal shunt를 이용한 음성 재활에 관한 연구)

  • 엄재욱;이건주;박춘근
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.27-27
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    • 1991
  • 저자들은 후두전적출술을 시행한 환자의 음성재활을 위해 식도의 근육과 점막을 이용한 shunt를 만들고 이상적인 shunt의 기능을 위해 shunt의 길이, 직경, 적절한 괄약효과 보강, 음성훈련 요령등에 대해 개 5마리를 이용한 동물실험 및 5례의 임상 적용을 통해 다음과 같은 지식을 얻었기에 문헌 고찰과 아울러 보고하는 바이다. 1. shunt의 협착에 대한 문제는 없었다. 2. 식도측의 입구를 좁혀 줌으로서 기관으로의 흡인을 방지할 수 있었다. 3. Nelaton catheter는 72시간 삽입이 적당했다. 4. 음성훈련은 3주부터 시작함이 적당했다. 5. shunt의 길이는 3 cm가 적당했다.

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Esophagogastirc Anastomosis: Analysis of Postoperative Morbidity and Mortality (위장을 이용한 식도재건술의 합병증)

  • 신화균;이두연;강정신;윤용한;김도형
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.573-578
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    • 1999
  • Background: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. Material and Method: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. Result: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). Conclusion: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.

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Esophageal Actinomycosis after Insertion of Esophageal Stent -A Case of Surgical Experience - (식도 스텐트 삽입후 발생한 식도 방선균증 - 수술 치험례 -)

  • 조성례;신현우;장희경
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.601-604
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    • 2000
  • Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism(usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.

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VATS Resection of Giant Leiomyoma of the Esophagus -1 case- (흉강경을 이용한 식도의 거대 평활근종 절제술 -치험 1예-)

  • 황호영;한국남;김주현;김영태
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.715-717
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    • 2004
  • A 59-year old woman visited us for incidentally detected posterior mediastinal mass. Preoperative esophagography, esophagoscopy, esophageal ultrasound and computed tomography showed a esophageal submucosal tumor. With the diagonsis of esophageal leiomyoma, the patient underwent right side video-assisted thoracoscopic surgery (VATS): The mediastinal pleura and the esophageal muscle layers were longitudinally opened and the tumor was enucleated. Esophagography performed at 6th postoperative day revealed no esophageal mucosal bulging or leakage. The patient was discharged reveiving a soft diet on the 7th postoperative day.

A Case of Esophageal Foreign Body (식도이물 1례)

  • 문영철;조승호;김병우;곽문섭;이홍균
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.8.2-8
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    • 1981
  • The majority of esophageal foreign bodies can be removed by esophagoscopy, but some cases may require removal by external route. Recently, we experienced an impacted denture in the third esophageal constriction area, and the patient has pre-existing progressive muscular dystropy. We tried esophagoscopic removal for several times, but failed because the denture clasps were penetrated into the esophageal wall. Open thoracotomy was performed and impacted denture was successfully removed.

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Treatment of Tracheal Stenosis Using Silicone T-tube (기관협착증에 대한 Silicone T-tube의 치료경험)

  • 이종원;정종진;조용범
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.4.3-5
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    • 1981
  • The Silicone tracheal T-tube was designed to maintain an adequate tracheal airway as well as to provide support in the stenotic reconstituted or reconstructed trachea. This report is our experiences with using silicone T-tube which were successfully used to two cases with extensive laryngotracheal trauma, and one case with decannulation difficulty for 9 months. Authors strongly believe that silicone T-tube is an excellent device out of consideration for our experienced cases, though many techniques have been applied for the treatments of tracheal problems.

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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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Surgical Treatment and Analysis of Esophageal Diseases (식도 질환의 외과적 치료 및 분석)

  • Choe, Yeong-Ho;Jo, Seong-Jun;Jo, Won-Min;Kim, Gwang-Taek
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1123-1128
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    • 1996
  • A clinical study was performed on 152 cases of surgical esophageal disease treated by the Department of Thoracic & Cardiovascular Surgery of Korea University Hospital from Jan. 1989 through July 1994. The most common esophageal disease was cancer which was seen in 73 cases (48%) among 152 cases. All were treated surgically' 52 patients (71%) were managed by curative or palliative resection with reconstruction and feeding gastrostomy or jejunostomy, otherwise Celestine tube insertion was performed on the remaining 21 patients for palliatio'n. Esophageal leiomyoma occurred in 6 cases(3.9%), among them 1 case was performed with trio recoscopic enucleation . Achalasia were in 7 cases (4.6%) and was treated with modified Heller's m otomy and with Belsey Mark IV operation. Diverticulum were in 11 cases (7.2%). Esophageal stricture occurred in 20 cases (14.1 %) and 17 of 20 cases were managed with bypass surgery. Esophageal perforation was seen in 20 cases, its cause was instrumental trauma in 7 cases, stab wound in 4 cases, foreign body in 4 cases, spontaneous perforation in 3 cases, and others 1 case Other disease including congenital lesion was seen In 1 Scases.

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