• Journal of Chest Surgery
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• 제20권3호
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• pp.619-623
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• 1987

We experienced a surgical case of esophageal atresia and tracheoesophageal fistula combined with imperforated anus, tracheal bronchus in a one day baby. A vacuum delivered full term baby, weighing 4.1 Kg showed grunting respiration, repeated regurgitation and distended abdomen after birth. Esophagogram revealed markedly dilated proximal esophagus as blind pouch and also noted displaced type of tracheal bronchus of right upper lobe by incidental bronchogram. Surgical correction with Haight anastomosis was performed successfully on the second day.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1061-1065
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• 1992

There are more patients with tracheal stenosis lately due to the increased use of tracheostomy and assisted ventilation. Recently we have experienced two cases of post tracheostomy tracheal stenosis and successfully performed circumferential resection and end-to-end anastomosis of the trachea. Postoperative tracheostomy was not performed. The postoperative courses were uneventful and they are now conducting an usual life.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.473-483
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• 2019

Surgical therapy for adenocarcinoma of the esophagogastric junction II requires distal esophagectomy, in which a transhiatal management of the lower esophagus is critical. The 'dorsal track control' (DTC) maneuver presented here facilitates the atraumatic handling of the distal esophagus, in preparation for a circular-stapled esophagojejunostomy. It is based on a ventral semicircular incision in the distal esophagus, with an intact dorsal wall for traction control of the esophagus. The maneuver facilitates the proper placement of the purse-string suture, up to its tying (around the anvil), thus minimizing the manipulation of the remaining esophagus. Furthermore, the dorsally-exposed inner wall surface of the ventrally-opened esophagus serves as a guiding chute that eases anvil insertion into the esophageal lumen. We performed this novel technique in 21 cases, enabling a safe anastomosis up to 10 cm proximal to the Z-line. No anastomotic insufficiency was observed. The DTC technique improves high transhiatal esophagojejunostomy.

• Journal of Gastric Cancer
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• 제21권1호
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• pp.63-73
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• 2021

Purpose: This study aimed to compare the surgical outcomes of total laparoscopic total gastrectomy without mesentery division (LTG without MD) and conventional total laparoscopic total gastrectomy (CLTG), as well as evaluate the appropriate method for esophagojejunostomy (EJ) reconstruction after total laparoscopic total gastrectomy (TLTG). Materials and Methods: We retrospectively analyzed data from 301 consecutive patients who underwent TLTG for upper or middle third gastric cancer between January 2016 and May 2019. After propensity score matching, 95 patients who underwent LTG without MD and 95 who underwent CLTG were assessed. Data on clinical characteristics and surgical outcomes, including operation time, length of postoperative hospital stay, pathological findings, and postoperative complications were analyzed. Results: The LTG without MD group showed a shorter time to first flatus (3.26±0.80 vs. 3.62±0.81 days, P=0.003) and a shorter time to soft diet (2.80±2.09 vs. 3.52±2.20 days, P=0.002). The total EJ-related complications in the LTG without MD group were comparable to those in the CLTG group (9.47% vs. 3.16%, P=0.083). EJ-related leakage (6.32% vs. 3.16%, P=0.317) and EJ-related stricture (3.16% vs. 1.05%, P=0.317) rates were not significantly different between the LTG without MD and CLTG groups. No significant differences were found between the two groups in terms of other early surgical outcomes such as early complications, late complications, hospital stay, and readmission rate. Conclusions: LTG without MD is a safe surgical treatment for upper or middle third gastric cancer. LTG without MD may be an alternative procedure for EJ anastomosis during TLTG.

• Archives of Plastic Surgery
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• 제51권2호
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• pp.212-233
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• 2024

This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.

• Advances in pediatric surgery
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• 제6권1호
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• pp.40-44
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• 2000

Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

• 한국임상수의학회지
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• 제40권1호
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• pp.73-77
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• 2023

Rectal prolapse is encountered in all domestic animal species but clinical report regarding the condition in the elk is limited. A 10-year-old elk bull weighing 400 kg was referred to the Large Animal Hospital of Kyungpook National University with clinical signs including intermittent tenesmus related to rectal prolapse and anorexia for the previous 5 days. Type II rectal prolapse was diagnosed based on the history and clinical signs. An emergency resection and anastomosis including a purse string suture was performed under general intravenous (IV) anesthesia in field to prevent injury of the patient and the staff. The patient recovered uneventfully after the surgery without excitement. A systemic antibiotic and an anti-inflammatory drug were given to prevent postoperative complication and relieve pain. The follow up on the patient after 4 weeks of the surgery showed that the prolapse recurred due to intermittent straining after 2 weeks of the surgery. The patient was on the glucocorticoid for the following 3 days but was finally euthanized owing to the exacerbation of the prolapse 1 week after the recurrence. This report describes a rare case of rectal prolapse in an elk bull and the clinical outcome of the surgical repair in detail.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.276-280
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• 2023

Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

• 한국임상수의학회지
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• 제40권5호
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• pp.354-359
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• 2023

This case report describes the clinical presentation and successful surgical repair of a diaphragmatic hernia-related small intestinal strangulation in a neonatal foal. A nine-day-old foal presented with colic signs and respiratory distress. History taking showed that the dam of the foal experienced difficulty during delivery, and the owner assisted in delivery by pulling on the foal. Radiography and ultrasonography confirmed the diaphragmatic rent and the presence of a small intestine within the thoracic cavity. Surgical intervention was required to repair the diaphragmatic defect and address the intestinal strangulation. The diaphragm was reconstructed, and the nonviable incarcerated portion of the small intestine was resected and anastomosed using an end-to-end technique. This unusual case report provides insights into the surgical repair and outcomes of an acquired diaphragmatic hernia in a neonatal foal.

• 한국간담췌외과학회지
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• 제28권2호
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• pp.266-269
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• 2024

Choledochal cyst is a condition involving an abnormal dilation of the bile ducts, which can lead to various symptoms and comorbidities, including cancer. The treatment of choice for choledochal cyst is surgical correction including choledochal cyst excision and Roux-en-y hepaticoenterostomy. Minimal invasive methods like laparoscopic methods or robotic methods are used for surgical correction of choledochal cysts; however, it is still controversial which method is superior. A Korean company, LIVESMED, developed Artisential^®, a laparoscopic surgical instrument that can overcome the drawbacks of laparoscopic methods. This article presents a case of the first Artisential^®-performed surgical excision of a choledochal cyst and hepaticojejunostomy.