• Journal of Gastric Cancer
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• 제13권2호
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• pp.79-85
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• 2013

There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1144-1149
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• 1995

Adenocarcinoma involving esophago-gastric junction[EGJ is usually originated from the gastric cardia and it presents unique clinical manifestations, requires special surgical care, and bears a much poor prognosis. We analyse the clinical data of 109 adenocarcinoma involving EGJ operated between August, 1987 and March, 1994. Curative resection of primary tumor including esophagus and lymph node dissection was possible on 102 cases[93.5% . Among these cases, 89 cases were advanced state over the stage III. The operative mortality was 1.8% and postoperative morbidity was 16.5%. The overall 3 year and 5 year survival rate was 48.5%, 34.1% each, and median survival was 27.5 month in the curative resected cases. The treatment failure was mainly distant metastsis including lymph node, except one local recurrence.Among many factors influencing long term results of resected adenocarcinoma involving EGJ, the only effort a surgeon can make is to attain completeness of tumor removal by dissecting all involved lymph node and ensuring adequate tumor free margins of both esophageal and cardiac side.

• Journal of Chest Surgery
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• 제14권3호
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• pp.218-224
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• 1981

Acute gastric volvulus is one of the most fatal complications of the eventration of diaphragm and require emergency surgical treatment unless it is possible to pass a nasogatric tube. This 10 year old female patient was admitted because of severe abdominal pain and marked abdominal distention before about 3 days. On chest P-A and plain abdomen, there were the elevation of the left hemidiaphragm and marked dilatation of stomach and the triad of symptoms emphasized by Bochdalek in 1904 was present. Emergency operation [wedge resection of necrotic area of stomach and gastropexy after gastric decompression and plication of diaphragm] was performed. The type of gastric volvulus was organo-axial rotation, in which the stomach rotated around the line that connects the cardia with the pylorus [Fig. 4].

• Journal of Chest Surgery
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• 제19권3호
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• pp.407-411
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• 1986

Between March 1978 and December 1985, 39 patients were admitted to our hospital & surgery was performed to 27 patients. Among 39 patients, male patients were 31 cases, female 8 cases and the age ranged from 42 years old to 69 yrs old with the average of 55 years old. Main symptoms of esophageal cancer were dysphagia [6%], weight loss [20%], retrosternal and epicardial discomfort [18%], hoarseness [13%], and hiccup [5%]. The anatomical locations of esophageal cancer were followed as; 51% in lower esophagus & cardia, 44% in middle, and 5% in upper esophagus. Among 27 cases, 5 cases were managed by feeding gastrostomy and jejunostomy due to inoperability, 19 cases by esophagogastrostomy, and 3 cases by colon bypass with the resection of esophageal cancer. Postoperative complications were noticed in 7 cases, such as anastomotic leakage in 2 cases [7%], respiratory insufficiency in 2 cases [7%], intussusception in 1 case [4%], wound dehiscence in 1 case [4%], and hepatitis in 1 case [4%]. Among 2 respiratory insufficiency, 2 patients die as a result of that complication and operative mortality was 7%.

• Journal of Chest Surgery
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• 제8권1호
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• pp.57-60
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• 1975

Congenital esophageal stricture is infrequent disease entity and usually occurs in the mid esophagus. Tracheobronchial remnants in the esophagus causing esophageal stricture are extremely rare, and only few cases were reported in the literature. During last 17 years the authors experienced a case of congenital esophageal stricture due to ectopic tracheal cartilaginous ring who was complicated by peptic esophageal stricture 11 years after esophagogastrostomy. During thoracotomy we thought that the patient had unual achalasia of the esophagus, and couldn`t perform cardiomyotomy because of firm ring encircling the lower esophagus just above the hiatus. The patient was operated on lower esophagectomy including cardia and esophagogastrostomy at his age of two and a half years. Postoperatively the patient did well for 11 years but later he developed intermittent regurgitation without substernal burning, and reoperated under the diagnosis of peptic esophageal stricture-lower esophagectomy, proximal gastrectomy, esophagogastrostomy and Heineke-Mikulicz pyloroplasty with good operative result.

• Journal of Chest Surgery
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• 제4권1호
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• pp.51-54
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• 1971

37 years old female was admitted with chief complaints of dyspnea on exertion and hemoptysis. Past history and family history were non-contributory. Physical examination showed Grade III systolic murmur at the apex, which transmitted to the back. E. K. G. and X-ray findings were compatible with the mitral insufficiency. With small size of Beall mitral valve, mitral valve replacement was done under the cardia-pulmonary bypass using hemodilution technic. Patient was tracheotomized after operation and assisted respiration was done for four weeks. Postoperatively, all signs were fine and patient walked around the ward without any difficulty, but she was in psychotic state. On postoperative 60th day, she complained of sudden dyspnea and on chest film, tracheal stenosis was found and recannulation of the tracheal tube was made. Thereafter, she was quite fine until postoperative 110th day when she, by berself, removed the tracheal cannula and died of asphyxia. Autopsy findings of the valve showed no thrombosis, no variance of the valve, and good endothelization of the valve cuffs. Asphyxia, due to removal of the tracheal connula by herself under psychotic state, was considered to be the cause of death in this patient who had tracheal stenosis after tracheostomy.

• 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 Gastric Cancer
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• 제15권1호
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• pp.64-67
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• 2015

Inflammatory myofibroblastic tumors (IMTs) of the stomach are extremely rare in adults, and their oncologic prognosis is not well understood. We present a 28-year-old man with a proximal gastric IMT. The patient visited the emergency department of Yeouido St. Mary's Hospital with syncope and hematemesis. Hemoglobin levels were <5.5 g/dl. Gastric fibroscopy showed a protruding mass $4{\times}4cm$ in size, with central ulceration on the posterior wall of the fundus and diffuse wall thickening throughout the cardia and anterior wall of the upper body. Endoscopic biopsy revealed indeterminate spindle cells, along with inflammation. Given the risk of rebleeding, an operation was performed despite the uncertain diagnosis. Because the mass was circumferential, laparoscopic proximal gastrectomy and double-tract anastomosis were performed to ensure a safe resection margin. The pathological diagnosis was consistent with an IMT originating from the stomach, although the tumor was negative for anaplastic lymphoma kinase gene mutation.

• 한국임상수의학회지
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• 제38권6호
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• pp.290-294
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• 2021

An 8-year-old neutralized male Dachshund was presented with severe vomiting, anorexia, and weight loss for two weeks. The patient had to feed in a standing position due to problem of vomiting immediately after meal. Serum chemistry and CBC results were all within reference limits. CT imaging revealed a mass distributed widely in the caudal part of the esophagus including the sphincter and the gastric cardia. Complete surgical removal was difficult because of adhesion to the caudal vena cava. A partial surgical excision and gastropexy with MIC-key feeding tube were performed under the owner's permission. Histologically, the mass was interpreted as leiomyoma. This patient is doing well at present time, six years after the tube installation in 2015.

• Clinical Endoscopy
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• 제56권1호
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• pp.23-37
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• 2023

Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.