• Journal of Chest Surgery
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• v.30 no.11
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• pp.1069-1076
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• 1997

There remains controversy regarding the appropriate surgical treatment for coarctation of the aorta because of relatively high rate of recoartation and high mortality in the cases associated with complex anomalies. We evaluated 31 consecutive patients who underwent surgical repair of coarctation of the aorta from May 1992 through June 1996. Nineteen patients(61.3%) were neonates and 26(83.9%) were under three months. Nine patients did not have major associated anom lies(Group I), 15 patients had ventricular septal defect(Group II), and 7 patients had major complex anomalies(Group III). 35.5% of the patients had arch hypoplasia. Surgical procedures performed were as follows: extended end-to-end anastomosis in 17 patients, combined resection-flap procedure in 7 patients, and subclavian flap aortoplasty in 7 patients. Residual coarctation occurred in 7(25%) of 28 patients; 2 after subclavian (lap aortoplasty(2/6, 33.3%), none after combillrd resection-flap procedure(0/7, 0%), and 5 after extended end-to-end anastomosis(5/15, 33.3%). Higher incidence of residual coarctation was noticed in the group with arch hypoplasia. The incidence of postoperative coarctation at a mean follow-up of 20.5 months in survivals was 12.0%(3/25); 2 cases after subclavian flap aortoplasty(2/6, 33.3%), none after combined resection-flap procedure(017, 0%), and one after endtoend anastomosis(1/12, 8.3%). The mortality rate related to coarctation repair was 9.7%(3 patients all in Group III). This study revealed that isolated coarctation of aorta and coarctation with ventricular septal di3fect(groups I & ll) can be repaired with low mortality, but repair of coarctation with complex anomaly had a high operative mortality Also the patients with arch hypoplasia had higher incidence of post-operative residual coarctation.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.617-621
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• 2004

End-to-end anastomosis for benign esophageal stricture (BES) is technically easier and relatively lower in morbidity than esophago-enterostomy. We performed segmental resection and end-to-end anastomosis in 2 cases of short segmental BES who were failed repeated endoscopic dilatation. A 13-month-old female with postoperative stricture was treated successfully. However, a 27-year-old female with corrosive stricture required second operative management of esophago-colo-gastrostomy following end-to-end anastomosis. Our experiences suggested that end-to-end anastomosis for BES could be used as a valid procedure for well selected patients. However, further studty is needed to compare with esophago-enterostomy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.13.1-13
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• 1987

저자들은 1984년 12월 17일부터 1987년 2월 26일까지 경희대학교 의과대학 부속병원 이비인후과 및 흉부외과에서 경험한 9례의 기관협착증환자를 대상으로 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1) 연령 및 성별분포는 여자 3례, 남자 6례이었고, 10세이하 3례, 10대 2례, 20대 2례, 40대 이상이 2례 이었다. 2) 원인은 지속적 기관내삽입관에 의한 경우가 4례이었고 1례는 선천성 혈관기형인 double aortic arch에 의해 기관이 눌리어 기도협착증상이 있었던 경우이었다. 상기관절개술에 의한 경우가 2례, 경부외상 1례, 기관내 종양 2례이었다. 3) 협착부위의 길이는 1.5cm에서 2cm까지가 4례로 가장 많았고 3cm이내가 2례, 4cm이내 1례, 6cm이내 1례이었다. 4) 치료는 보존적인 방법으로 내시경하에서 육아조직 및 반흔조직을 laser를 이용하여 제거한 후 silastic stent 혹은 Montgomery T-tube 삽입후 4주에서 6주후 제거하여 치료한 경우가 2례이었고 협착부위절제 및 단단문합술을 시행한 경우가 6례이었다. 1례에서는 aortic arch division을 시행하였다. 5) 예후는 9례중 단단문합술을 시행한 6례 그리고 보존적 방법으로 laser를 이용한 육아조직의 제거 및 지지물삽입을 시행한 3례에서 모두 현재까지 재발은 보이지 않고 있다. 6) 기관협착의 길이가 1.5cm에서 4cm까지의 경우에는 supralaryngeal release procedure없이 단단문합술을 시행하였고 협착길이가 6cm인 1례에서는 supralaryngeal release를 하여 tension없이 문합술을 시행할 수 있었다.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.800-804
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• 2001

The authors reviewed the recent trend of surgical treatment for pediatric as well as adult onset moyamoya disease(MMD). Combined direct and indirect arterial anastomosis or multiple indirect arterial bypasss has been increasing for pediatric MMD and direct arterial bypass is recommended for adult MMD, especially in patients with hemorrhagic MMD. Besides perioperative complications related to the management of MMD and 1999 annual report by the Research Committee on Spontaneous Occlusion of the Circle of Willis(Moyamoya Disease) of the Ministry of Health and Welfare, Japan will be summarizd.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.267-272
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• 2003

Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.82-85
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• 1998

Benign tumors of the trachea are rare and are usually misdiagnosed as bronchial asthma because of the similarity of the symptoms and signs. Although the prognosis of neurofibroma which originats from Schwann cells is good, it may recur or undergo malignant change, so segmental resection of the trachea is recommended. Recently, we experienced a case of primary neurofibroma of the trachea treated successfully by segmental resection of the trachea and end-to-end anastomosis. We report it with a brief review of literatures.

• Journal of Yeungnam Medical Science
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• v.11 no.2
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• pp.202-212
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• 1994

뇌헐혈증은 다양한 요인으로 유발될 수 있겠으나 궁극적으로는 국소적 뇌혈류량이 적정수준 이하로 감소됨으로 해서 초래된다. 이렇게 뇌혈류가 감소된 부위의 중심에는 이미 괴사가 일어난 부위도 있겠지만, 그 주위에 현재 뇌기능은 없으나 장차 혈류가 충분해 지면 소생 가능한 penumbra 영역이 있다. 이런 penumbra영역으로 다시 혈류가 충분히 보충되면 뇌기능이 소생되어 호전의 양상을 보이게 되나, 혈류가 계속 저하되어 있으면 비가역적 뇌손상을 받게 되어 증상이 악환된다. 병변 부위는 자율조절기능(autoregulation)이 파괴되어 혈관이 이완된 상태이기 때문에 측부혈행을 통하여 뇌혈류를 공급시키기기 위해서 혈압을 올리면서 혈액유동을 원활하게 해주는 보존적인 방법을 시행하면서 적응증이 되는 경우에는 수술적으로 외내경동맥문합술과 같은 여러 방법의 bypass혈관 수술이나 경동맥내막절제술로 뇌허혈 부위에 뇌혈류를 적극적으로 증강시켜 호전시킬 수 있다.

• 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.41 no.6
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• pp.787-790
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• 2008

Barrett's esophagus is precancerous lesion of esophageal adenocarcinoma, but this has been rarely reported in Korea. A 81-year-old man with esophageal adenocarcinoma was admitted to our hospital, and we performed a distal esophagectomy and end-to-end esophagogastrostomy. The microscopic examination of the resected tissue revealed the intestinal metaplasia with goblet cells around the esophageal adenocarcinoma, which indicates this was a Barrett's esophagus. We report here on this case along with a review of the relevant literature.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.466-471
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• 1996

Esophageal atresia with tracheoesophageal fistula is a common form of congenital malformation of the esophagus, which was usually overlooked during the physical examination after delivery. The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas-Gibson in 1696. We have performed primary repair by extrapleural approach through the right 4th intercostal space in 4 cases of congenital esophageal atresia with distal racheoesophageal fistula. End to end anastomosis was performed by Haight method in all cases. Postoperatively, two patients showed severe stenosis and one patient showed mild stenosis at the anastomotic site. Ballots dilatation was performed two cases with severe anastomotic stenosis.