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Surgical Treatment in Local Recurrence of Esophageal Cancer with Free Jejunal Graft -A Case Report (흉부식도암의 근치적절제후 국소 재발에서의 유리공장 이식술 -1례-)

  • 이종목;임수빈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.449-452
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    • 1997
  • We managed surgically a case of local recurrence in esophageal cancer Twenty month after transthoracic subtotal esophagectomy and csophago-gastrostomy, he su(fared from dysphagia. Chest CT and percutaneous needle aspiration biopsy showed . Local recurrence involving residual esophagus, thyroid gland, posterior membraneous portion of trachea. We did cervical esophagectomy, laryngectomy thyroidectomy, partial resection of trachea and reconstruction with free jejunal antograft successfully.

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경부기관절제 및 단단문합술

  • 김광문;홍원표;최홍식;조정일;최은창;김명상
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1995.04a
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    • pp.90.1-90
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    • 1995
  • 저자들은 최근 4년간 11례에서 기관절제 및 단단문합술을 사용하였기에 그 치료 결과를 살펴보고 치료적용의 범위를 넓혀보고자 한다. 대상은 후두-기관협착증 2례, 기관협착증 8례, 갑상선암 1례로 총 11례였으며 이중 3례에서 기관-식도누공이 동반되어 있었다. 술후 발거가 가능했던 경우는 8례였으며 발거가 불가능했던 경우는 술전에 이미 양측성대마비가 있던 경우 l례, 문합부위 아래에 새로운 협착 부위가 생겼던 1례, 기관 연골의 과도한 결손이 있었던 경우가 1례 있었다. 합병증으로 창상감염 1례, 육아조직 3례의 경우는 치료되었으며 양측성대마비가 있던 경우는 편측성대절제를 하여 관찰 중이다. 이상의 결과를 볼 때 기관절제 및 단단문합술이 실패한 경우는 2례로 술전 동반질환의 정확한 검사 및 절제부위의 국소화, 수술시 문합부위의 장력을 최소화하여 시행한다면 합병증은 비교적 받아들일만 하며 비교적 성공율도 기대할 만한 술식으로 여겨졌다.

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MANAGEMENT OF NASOLACRIMAL APPRATUS IN RESECTION OF NASAL CAVITY OR PARANASAL SINUS TUMOR (비강 및 부비동 종양 적출시 누액 배출계의 절제후 처치법)

  • Choi, Gun;Yoon, Jong-Tae;Chae, Sung-Won;Hwang, Soon-Jae
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.41-41
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    • 1991
  • 비강 및 부비동 종양 적출시 종양의 침범이나 시야의 확보를 위해 누액 배출계의 절제가 불가피하여 이로 인한 술후 유루가 발생하는 례를 종종 경험하게 된다. 이에 저자들은 누액 배출계의 절제후 적절한 처치 방법에 대해 알아 보고자, 1989년 1월부터 1990년 12월까지 2년간 비강 및 부비동의 양성 또는 악성 종양의 적출시 누액 배출계를 절제한 13례에서 누액 배출계의 처치 방법과 이에 따른 유루의 발생 여부를 후향적으로 검토하여 다음과 같은 결과를 얻었다. 누낭에서 절단한 7례중 6례에서, 누낭에서 절단 후 silastic tube를 4주간 유치한 6례 중 1례에서 유루를 경험하여 누액배출계의 절제시 silastic tube의 유치는 술후 유루 발생의 방지에 도움이 될 것으로 사료된다.

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Pulmonary Infarction of Left Lower Lobe after Left Upper Lobe Lobectomy - 1 case report - (좌 상엽의 폐엽 절제 후 발생한 좌하엽의 폐 경색 치험 1례)

  • 윤용한;강정신;홍윤주;이두연
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.318-321
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    • 1999
  • The remaining lung infarction is a rare but life-threatening complication after a thoracic operation and trauma. We report a case of this rare complication after the left upper lobectomy due to pulmonary aspergilloma. The infarction of the remaining left lower lobe occurred due to kinking of the pulmonary vessels after the left upper lobectomy and the completion pneumonectomy was performed in the post-operative second day. Therefore, prompt diagnosis and treatment may be necessary to prevent morbidity and mortality associated with pulmonary infarction from torsion of pulmonary artery and vein.

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Treatment of Synovial Sarcoma in Popliteal Fossa Adjacent to Tibia - A Case Report - (경골과 접한 슬와부 활막육종의 치료 - 증례 보고 -)

  • Shin, Duk-Seop;Kwack, Byung-Hoon;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.201-206
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    • 2007
  • It is a well-accepted tenet that wide surgical margins are necessary for the treatment of soft-tissue sarcomas, and it is still true that the rate of recurrence depends on the adequacy of the surgical margins. Sarcomas that rest directly against bone pose a dilemma for the surgeon. A wide margin is not possible in the literal sense without excision of the bone. Whereas reconstruction of skeletal defects is possible, it adds to the complexity of the surgery and increases potential complications. We report the experience of treatment in a case of synovial sarcoma which located at popliteal fossa adjacent to proximal tibia.

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Radiologic Evaluation for Resectability of Pancreatic Adenocarcinoma (췌장 선암의 절제 가능성 평가)

  • Shin Hye Hwang;Mi-Suk Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.2
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    • pp.315-334
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    • 2021
  • Imaging studies play an important role in the detection, diagnosis, assessment of resectability, staging, and determination of patient-tailored treatment options for pancreatic adenocarcinoma. Recently, for patients diagnosed with borderline resectable or locally advanced pancreatic cancers, it is recommended to consider curative-intent surgery following neoadjuvant or palliative therapy, if possible. This review covers how to interpret imaging tests and what to consider when assessing resectability, diagnosing distant metastasis, and re-assessing the resectability of pancreatic cancer after neoadjuvant or palliative therapy.

The Effects of Ca and Mg Supplementation on Serum and Liver Lipid Parameters in Ovariectomized and Ca Deficiency Rats (난소절제 칼슘결핍 흰쥐에서 칼슘과 마그네슘의 보충이 혈액과 간의 지질함량에 미치는 영향)

  • Bae, Yun-Jung;Kim, Mi-Hyun;Sung, Chung-Ja
    • Journal of Nutrition and Health
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    • v.40 no.7
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    • pp.616-623
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    • 2007
  • This study was carried out to investigate the Ca and Mg supplementation on the serum and liver lipid parameters in ovariectomized and Ca deficiency rats. Total 50 Sprague Dawley female rats (6 weeks) were divided into 5 groups and bred for 12 weeks: sham operated control group (SNCa), OVX Ca deficiency poop (OLCa) with Ca deficiency diet (0.1% Ca modified AIN-93N diet), OVX Ca deficiency & Mg supplement group (OLCaMg), OVX adequate Ca group (OACa; 0.5% Ca AIN-93N diet) and OVX adequate Ca & Mg supplement group (OACaMg). There were no significant difference among the five groups in serum total cholesterol, triglyceride and HDL-cholesterol levels. LDL-cholesterol of OVX groups was significantly higher than that of SNCa group (p < 0.01). AI (Atherogenic index), TPH (Total cholesterol/HDL-C) and LPH (LDL-C/HDL-C) of OACa group were significantly lower than those of OLCa groups. OACaMg group had significantly lower levels LDL, AI and TPH than OLCa group. There was no significant difference in lever cholesterol level. However, liver total fat content of OACa was significantly lower than that of OLCa. From the above the results, it is concluded that the accumulation level of calcium shows how the supplement of magnesium affects hyperlipidemia. Therefore, in order to prevent women#s hyperlipidemia after menopause, and to keep healthy, it is encourage able to consider how the supplement of magnesium relates calcium intake.

Evaluation of the Safety and Feasibility of D2 Lymphadenectomy in Elderly Patients with Gastric Cancer (평균 수명 이상의 고령 위암 환자에서의 D2 림프절 절제술의 안정성)

  • Kang, Woo Sung;Cheong, Oh;Jeong, Mi Ran;Kim, Ho Goon;Ryu, Sung Yeop;Park, Yeong Kyu;Kim, Dong Yi;Kim, Young Jin
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.85-90
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    • 2008
  • Purpose: The aim of this study was to evaluate the safety and feasibility of D2 lymphadenectomy in elderly patients with gastric cancerby comparing the surgical outcomes and postoperative courses between an elderly group and a control group undergoing the same procedure. Materials and Methods: Clinical information was reviewed for 1251 patients with gastric cancer who underwent gastrectomy between May 2004 and May 2007. Patients were classified into the following two groups: an elderly group (older than the average life span in Korea) and a control group (younger than the elderly group). Clinicopathologic features and postoperative courses after D2 lymphadenectomy were reviewed and compared between the two groups. Results: There were a total of 120 (9%) elderly group patients among all those reviewed, and 86 (72.2%) of them underwent D2 lymphadenectomy. There was 27.5% postoperative morbidity in the elderly group, which was significantly different from thecontrol group (12.8%, p=0.003). However, on multivariate analysis, ASA score and combined resection were independent predictive factors of postoperative complications, while age was not predictive. Conclusion: Older age is not a predictive factor of postoperative complications in itself, and D2 lymphadenectomy can be safely performed in elderly patients with gastric cancer, provided they have good ASA scores and do not undergo accompanying combined resection.

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Laparoscopy Assisted Total Gastrectomy with Lymph Node Dissection-77 Consecutive Cases (복강경 보조 위 전절제술-연속된 77예의 경험)

  • Lee, Joong-Ho;Song, Jye-Won;Oh, Sung-Jin;Kim, Sung-Soo;Choi, Won-Hyuk;Cheong, Jae-Ho;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.206-212
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    • 2007
  • Purpose: The number of laparoscopy assisted distal gastrectomies (LADG) is gradually increasing for the treatment of early gastric cancer (EGC) patients as a surgical modality for improving quality of life. However, there are few reports on laparoscopy-assisted total gastrectomy (LATG), mainly because this procedure is performed relatively infrequently, and the procedure is more complicated than LADG. This study was performed to evaluate the technical feasibility, safety, and surgical results of LATG with lymphadenectomy through a review of our experience. Materials and Methods: From July 2003 to June 2007, 77 LATG with Roux-en-Y esophagojejunostomy were performed for patients with a preoperative diagnosis of EGC. The clinicopathological features and surgical outcomes were analyzed. Results: There were 49 males and 28 females in the study with a mean age of 61 years (range $30{\sim}85$ years). The mean operation time was 210 minutes (range $100{\sim}400$ minutes) and the operation time was gradually decreased as the case numbers increased. There were 13 operative morbidities (16.9%) and no operative mortalities. The restoration of bowel motility was noted at 3.2 postoperative days; a soft diet was started at 4.4 postoperative days and the duration of hospital stay was 10 days. There were 20 mucosal lesions, 32 submucosal lesions, 15 proper muscle lesions, 7 subserosal lesions and 3 serosal lesions. A total of 20 patients were treated by D2 lymph node dissection, 55 patients were treated by D1+$\beta$ lymph node dissection, and two patients were treated by D1+$\alpha$ lymph node dissection. The mean number of retrieved lymph nodes was 42 (range $11{\sim}86$). Lymph node metastases were noted in 12 patients. Conclusion: This study indicated LATG could be applied safely and effectively for patients with EGC. However, a prospective study comparing laparoscopy-assisted versus open gastrectomy for short-term and long-term surgical outcome is needed.

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The Comparison of Efficacy and Safety between Radiofrequency Ablation Alone and Ethanol Ablation Followed by Radiofrequency Ablation in the Treatment of Mixed Cystic and Solid Thyroid Nodule (낭성 및 고형성 혼합 갑상선 결절 치료에서 고주파 절제술 단독요법과 에탄올 절제 후 고주파 절제술 요법의 유효성 및 안전성 비교)

  • Min Gang Jo;Min Kyoung Lee;Jae Ho Shin;Min Guk Seo;So Lyung Jung
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.618-630
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    • 2024
  • Purpose To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results The RFA group included 204 patients, and the EA + RFA group included 39 patients. The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.