• Journal of Chest Surgery
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• 제12권1호
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• pp.67-74
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• 1979

Esophagocardiomyotomy [modified Heller procedure] is a widely accepted operation for relief of dysphagia in patient with esophageal achalasia. But patients with advanced achalasia were more likely to get poorer results from a modified Heller myotomy because of the dependent pouch that creates an angulation at the junction of thick-walled dilated esophagus with the thin wailed aganglionic segment and hinders complete emptying. Thorbjarnarson[1975] proposed the method including truncal vagectomy and pyloroplasty. Vagectomy and pyloroplasty should lesson the severity of acid-peptic esophagitis, if reflux should occur postoperatively. Here we presented 4 cases esophageal achalasia treated by modified Heller operation of 3 cases and one case of Thorbjarnarson method. All postoperative results are good.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1098-1101
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• 1992

Esophageal achalasia is a disease with characteristic disorder of esophageal motility. Also, this disorder is known to be predisposing factor of malignancy. Although the incidence of esophageal cancer in patients with achalasia varies widely, the incidence hed been reported from l% to 29% in many articles. It is known that delay in management of achalasia is believed to increase the risk of malignant degeneration. We experience a case with esophageal cancer complicating longstanding esophageal achalasia.

• Journal of Chest Surgery
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• 제27권8호
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• pp.717-721
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• 1994

Extramucosal esophagomyotomy by thoracotomy, first described by Heller in 1913 was the principal therapy for achalasia. Recently however, video-assisted thoracoscopic surgery has been implied in esophageal surgery, and we have experienced 23 year old male patient with dysphagia and was diagnosed as achalasia who underwent thoracoscopic esophagomyotomy. The esophagogram showed typical bird beak appearance and the lower esophageal sphincter pressure was increased to 35 mmHg. Thoracoscopic surgery was done twice due to incomplete myotomy in first operation and the patient was released of dysphagia in the second operation.

• Journal of Chest Surgery
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• 제17권4호
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• pp.792-795
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• 1984

The modified Hellers myotomy for esophageal achalasia is known as the best procedure. A properly performed transthoracic esophagomyotomy is essential to prevent complications. But it has some problems such as persistent achalasia due to inadequate myotomy, recurrence due to the healing of myotomy and reflux esophagitis due to destruction of the lower esophageal sphincter. The methods of the reoperation after esophagomyotomy for achalasia of the esophagus consist of 1 ] for persistent achalasia due to inadequate myotomy, additional myotomy feasible. 2] for esophageal reflux, a long-limb jejunal gastric drainage after vagotomy and hemigastrectomy, jejunal after conservative resection for stricture. We experienced 3 cases of reoperation after esophagomyotomy for achalasia of the esophagus. The 1st and 3rd case belongs to 30 cases which were undertaken the primary operation at the National Medical Center from 1961 to 1984. The 2nd case was undertaken the primary operation at other hospital. The 1st and 3rd case were reoperated because of persistent achalasia due to inadequate myotomy and 2rid case was caused by stricture due to reflux esophagitis. The methods of the reoperation were additional myotomy in 1st case, esophagogastrectomy and lower thoracic esophagogastrostomy in 2nd case, and esophagogastrectomy and mid-thoracic esophagogastrostomy in 3rd case. All three cases were complicated with postoperative reflux esophagitis.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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• pp.9.3-9
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• 1977

Achalasia는 식도의 확장을 동반하는 탐도분문부의 비기질적폐색을 이르키는 질환으로 그 원인은 불명하나 식도하부괄약근의 이완장애와 식도체부에서의 정상연동운동의 결여로 나타나는데 원래 근육신경계의 기능장애의 하나로 중추신경계통의 병변으로 신경 신경절 및 근육의 변성을 이르켜 생긴다는 설이 유력시되고 있다. 주요증상은 연하장애 음식물토출 및 심와부 동통등이다. 저자들은 43세 여자에서의 achalasia 1례를 치험하였기에 문헌적고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제1권1호
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• pp.53-60
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• 1968

Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia. regurgitation and weight loss are outstanding features,however, complicated pulmonary troubles aspiration pneumonitis, bronchiectasis, lung abscess etc. --are sometimes more apparent than the disease entity in children though achalasia is rarely encountered in children. During the period of January, 1961, to May, 1968, the authors experienced 9 cases of achalasia of the esophagus in Chest Surgery Department,N.M.C. 1. Seven of nine were male and four were under 5 years of age. 2. So-called symptoms triad noted in almost every case, and 3 of 4 children showed recurrent attacks of pneumonitis. 3. Chest film showed widened superior mediastinum by dilated esophagus in 6 cases, and pulmonary infiltrations in 3 cases of children. 4. Preoperative diagnosis were achalasia,esophageal stricture by rodent-cidal ingestion and suggestive esophageal cancer in 7 cases,one case and remaining one case. respectively. 5. Modified Heller procedure was performed in all cases with definite diagnosis of achalasia at operation table in misdiagnosed 2 cases. 6. Immediate postoperative complications were 2 cases of wound infection and one case of atelectasis and no operative mortality encountered. 7. Seven of nine showed excellent result of operation, and good in one case. Remaining one case failed relieving obstruction and underwent interposition of ileocolonic segment with excellent result.

• Journal of Chest Surgery
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• 제10권1호
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• pp.71-76
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• 1977

Achalasia is a functional disorder of a short segment of the lower esophagus showing obstruction of the esophagogastric junction. Dysphagia, regurgitation, and weight loss are outstanding features and are some times more apparent than the disease entity in children though achalasia is rarely encountered in children. A 6 years male had complained of dysphagia, regurgitation and severe weight loss and was operated by modified Heller`s operation. Before he was operated, he could swallowed only milk but swallowed all regular diet after being operated.

• Journal of Chest Surgery
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• 제15권4호
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• pp.451-455
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• 1982

For recently 2 years, 3 cases of esophageal achalasia were surgically treated by modified Heller operation with gastric fundoplication. Esophageal achalasia is functional disorder of lower esophagus of which symptoms are dysphasia, regurgitation, and weight loss. Preoperative diagnosis was made by clinical manifestations and radiologic examination, esophagoscopy and confirmed at operative table. Operative procedures are variable, but modified Heller operation is common method to handicap reflux esophagitis and postoperative esophageal stricture. Now, our patients who were surgically treated were well alive without complaining of specific symptoms for followed period.

• 대한기관식도과학회지
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• 제3권2호
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• pp.302-306
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• 1997

Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.

• Journal of Chest Surgery
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• 제12권2호
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• pp.75-81
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• 1979

Eophagocardiomyotomy (modi/red Heller procedure) is a widely accepted operation for relief of dysphagia in patients with esophageal achalasia. But patients with advanced achalasia were more likely to get poorer results from a modified Ileller myotomy hecause of the dependent pouch that creates an angulation at the junction of thick-walled dilated esophagus with the thin walled aganglionic segment and hinders complete emptlllg. Thorhjarnarson(1975) prposcd the method including truncal vagectomy and pyloroplasty. Vagectomy and pyloroplasty should lesson the severity of acid-peptic esophagitis, if reflux should occur postoperatively. Here we presented 4 cases esophageal achalasia treated by modified Heller operation of 3 cases and one case of Thorbjarnarson method. All postoperative results are good.