• 대한두경부종양학회지
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• 제7권2호
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• pp.120-128
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• 1991

Reconstruction of the pharynx and cervical esophagus presents a tremendous surgical challenge to the Head and Neck Surgeon. Because life expectancy of patients with advanced carcinoma of the hypopharynx, and cervical esophagus is limited, treatment must be aimed at palliation. A variety of techiques have been proposed over the years with none proving entirely satisfactory. These techiques include prosthesis; skin graft; cervical flaps; tubed cutaneous and myocutaneous chest flaps; visceral reconstruction with stomach, colon. and jejunum; and jejunal free autografts. Many factors dictate the best method of reconstruction in any given clinical situation. The goal of the surgery is a one-stage reconstruction of swallowing function with minimal morbidity to allow as short a hospital stay as posible. Nine patients underwent the free jejunal autograft reconstruction of the pharyngoesophagus after the ablative surgery for the advanced hypopharyngeal cancer. Postoperative complications included one perioperative death, two abdominal wound dehiscences, two neck hematomas, one carotid rupture, one funtional dysphagia, one late strictures. There were no graft failure, no immediate stenosis and no fistula. An oral diet was started between days 8 and 16, with an average of 9 days and median of 8 days. Patients left the hospital between days 9 and days 38, with an average of 23.4 days and median of 23 days. This method of reconstruction is advocated as reliable palliative procedure with short-term follow-up. In conclusion, we at Korea Cancer Center Hospital are of the opinion that the free jejunal autograft offers an excellent, safe and relative easy method of the pharyngeal and cervical esophageal reconstruction with significant advantages over other techiques.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4399-4402
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• 2013

Objectives: To analyze underlying disease, fatality rate and the major causes of death of in-patients with malignant tumors in Sichuan Cancer Hospital. Methods: Clinical data of in-patients from 2002 to 2012 were retrospectively analyzed. Results: The top 10 tumors (82.0%of the total) of the malignant tumors of the in-patients were lung, cervical, esophagus, breast, colorectal, nasopharynx, liver and gastric cancers, lymphomas and ovarian cancers. The overall fatality rate was 2.7% during these eleven years, 3.4% and 2.0% for male and females, respectively with statistical significance for the difference (${\chi}^2$=164.737, P<0.001). The top 10 death causes were lung cancer, liver cancer, colorectal cancer, esophagus cancer, gastric cancer, lymphoma, breast cancer, pancreatic cancer, ovarian cancer and nasopharynx cancer. In-patients with pancreatic cancer had the highest fatality rate (9.6%). There were different ranks of death causes in different sex groups and age groups. Conclusion: Prevention and control work of cancer should be enhanced not only for cancers with high incidence such as lung cancer, esophageal cancer but also for the cancers which have low incidence but high fatality rate, such as pancreatic cancer and gallbladder cancer, which would help to improve the survival rate and quality of life of cancer patients in the future.

• Journal of Chest Surgery
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• 제26권8호
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• pp.633-637
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• 1993

Twenty-five patients with perforation of esophagus were managed at Pusan National University Hospital, from 1981 to 1993. The hospital course of 14 of these patients was evaluated with a special emphasis on the cause and location of perforation, clinical presentation, time elapsed from perforation to treatment, method of treatment, and outcome. Patients with anastomotic leak and cancer were excluded.The perforation was iatrogenic in 7 patients, spontaneous in 5, ingestion of foreign body in 1, and traumatic in 1. There were 7 cervical perforations, 2 upper thoracic perforations, and 5 lower thoracic perforations. Chest pain, fever, and dyspnea were frequent symptoms. Esophagography was most diagnostic [11 patients] but thoracentesis was of little diagnostic aid.Antibiotics were administered intravenously to all patients:hyperalimentation was accomplished intravenously in 11, and nasogastric suction was used in all cases. No patient required any surgical procedure, minor or major.

• Journal of Chest Surgery
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• 제42권3호
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• pp.396-400
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• 2009

다빈치 로봇수술은 현재 다양한 외과영역에서 시행되고 있으나 폐, 식도 외과영역에서는 아직까지 널리 이용되지 않고 있다. 본원에서는 74세 남자환자가 딸꾹질과 연하곤란을 주소로 내원하여 시행한 검사에서 식도암으로 진단되어 da Vinci 로봇을 이용하여 식도절제술을 시행한 후, 복강경으로 위장튜브를 만들어 흉골하 통로를 통해 경부에서 위장-식도 단단 문합을 시행하였다. 환자는 수술 후 특별한 합병증 없이 완쾌 퇴원하였다. 향후 다빈치로봇을 이용한 최소 침습수술이 식도암을 비롯한 폐, 식도외과 영역에의 활용에 있어서 좋은 결과가 기대되므로 보고하는 바이다.

• Journal of Chest Surgery
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• 제38권11호
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• pp.791-794
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• 2005

식도절제술 후 재건술에서 위장은 가장 흔한 식도 대체물로 사용된다 그러나, 인두 이상의 위치까지 위장을 끌어 올려 연결하는 경우 위장만으로는 길이가 모자라는 경우가 많이 있다. 후두암과 식도암을 동반한 환자에서 후두전절제술과 식도전절제술을 시행하였고 유리공장이식편을 이용하여 경부에서 인두공장위장문합을 시행하였다. 유리공장을 이용하여 문합에 충분한 길이를 확보함으로써 문합부 긴장을 줄이고, 혈액공급을 확보할 수 있었다.

• Journal of Chest Surgery
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• 제29권5호
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• pp.536-541
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• 1996

Between June 1988 and June 1994, twenty five patients with locAlly advanced esophageal carcinoma received preoperative chemotherapy (Cisplatln, 5-Fluorouracil with or without Etoposide) and followed by resection. All patients had clinical evidence of airway involvement or distant Iymphnode involve- ment (M 1 Iymphnode) on bronchoscopy or computed tomographic scans. The major response rate to chemotherapy decided by the postoperative stage was 48% (12125). The resection rate was 92% (23/25) with overall complete resection rate of 72% (18125). Two patients had exploratory laparotomy (thorn- cotomy) only. Thirteen patients had esophagogastrostomy with a combined abdominl and Rt. thoracic approach (Ivor Lewis operation), slx pAtients had transhiatal esophagectomy, four patients had esophagogastrostomy with a combined Rt. thoracotonly & abdominal, cervical approach. There were three postoperative deaths (12%). Follow-up duration was between 3.3 months to 65 months. Median survival ime of resected patients except hospital death was 14.8 months. Actuarial survival at 12, 24 months was 72.9%, 26.2%. Signifi- cant better survival was associated with responder group (postoperative stage less than lIB) (P=0.029). These results demonstrate that 1) Preoperative Cisplatin based combined chemotherapy Produce high response rate, 2) High complete resection rate with acceptable mortality rate occur after preoperative chemotherapy, 3) Better surviL dl can be anticipated if complete resection performed after major re- sponse to preoperative chemotherapy.

• Safety and Health at Work
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• 제11권1호
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• pp.41-49
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• 2020

Background: We performed this study to investigate the inequalities in site-specific cancer incidences among workers across different occupations in Korea. Methods: Subjects included members of the national employment insurance. Incident cancers among 8,744,603 workers were followed from 1995 to 2007. Occupational groups were classified according to the Korean Standard Occupational Classification. Age-standardized incidence rate ratios were calculated. Results: We found that men in service/sales and blue-collar occupations had elevated rates of esophageal, liver, laryngeal, and lung cancer. Among women, service/sales workers had elevated incidences of cervical cancer. Male prostate cancer, female breast, corpus uteri, and ovarian cancers, as well as male and female colorectal, kidney, and thyroid cancer showed lower incidences among workers in lower socioeconomic occupations. Conclusions: Substantial differences in cancer incidences were found depending on occupation reflecting socioeconomic position, in the Korean working population. Cancer prevention policy should focus on addressing these socioeconomic inequalities.

• Journal of Gastric Cancer
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• 제4권2호
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• pp.131-133
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• 2004

Plummer-Vinson syndrome (sideropenic dysphagia) is characterized by dysphagia due to an upper esophageal or a hypopharyngeal web in a patient with chronic iron deficiency anemia. The main cause of dysphagia is the web of the cervical esophagus, and an abnormal motility of the pharynx or the esophagus is found to play a significant role in the above cause. Patients with this syndrome are thought to be precancerous because squamous cell carcinomas of the hypopharynx, oral cavity, or esophagus take place in $10\%$ of those patients. However, for Plummer-Vinson syndrome to be combined with gastric cancer is most unusual. We report the case of a 43-year-old woman who was first found to have stomach cancer under a diagnosis of Plummer-Vinson syndrome and who recovered after surgery.

• 대한두경부종양학회지
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• 제16권1호
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• pp.26-32
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• 2000

Background and Objectives: Various flaps are using for reconstruction of hypopharyngeal and esophageal defect. However, complication and indication of each flap are not fully analyzed. Patient and Methods: Records of 52 hypopharyngeal cancer patients who had surgical treatment and 13 other head and neck cancer patients who underwent hypopharyngeal and/or esophageal reconstruction with flap were retrospectively analyzed. Eighty three percent(54 cases) of patients needed reconstruction other than primary pharyngeal closure. Five split thickness skin graft, 1 pectoralis major myocutaneous flap, 20 forearm free flap, 13 jejunal free flap, 15 gastric pull up were used. Result: Flap failure was noted in 2 cases who had subsequent gastric transposition. Wound dehiscence and fistula were most common problem of forearm free flap. Most fistulas were developed in patients with conduit type reconstruction of forearm flap while there wasn't any fistula in patient with patch type reconstruction. Stenosis of lower anastomosis was the frequent problem of jejunal transfer. Gastric pull-up has frequent com-plication of stomal stenosis. All but three patients had reached oral feeding postoperatively. Conclusion: Based on this study, forearm flap is effective in partial hypopharyngeal defect while jejunum is the choice for circumferential defect. Gastric pull-up is for combined esophageal defect.

• Radiation Oncology Journal
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• 제27권2호
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• pp.71-77
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• 2009

목 적: 동시적 항암화학방사선치료를 받은 식도암 환자의 치료성적과 예후인자를 분석하였다. 대상 및 방법: 1994년 1월부터 2007년 7월까지 식도암으로 방사선치료를 받은 환자 246명 중 근치적 목적으로 45Gy이상의 방사선치료와 함께 동시적 항암화학요법을 받았으며 생존확인이 가능하였던 78명을 대상으로 후향적 분석을 시행하였다. AJCC 병기 IIA~IVB까지의 환자를 대상으로 하였는데, IVB는 상부식도암이 아닌 환자에서 쇄골상부림프절 전이가 있거나 하부식도암이 아닌 환자에서 복강림프절 전이가 있는 경우만을 포함시켰다. 방사선치료는 중앙값 54 Gy를 조사하였고, 항암화학요법은 대부분의 환자(88%)에서 5-FU와 cisplatin (FP) 병합요법으로 시행되었다. 추적관찰기간은 2~117개월(중앙값 14개월)이었다. 결 과: 흉부단층촬영이나 식도내시경을 통해 치료에 대한 반응을 확인할 수 있었던 54명의 환자중 완전관해가 17명, 부분관해가 18명이었다. 완전관해를 보인 환자에서 재발할 때까지의 기간은 중앙값 20개월이었고 첫 재발부위로 국소재발이 3명, 원격전이가 7명이었다. 1년, 2년, 5년 전체 생존률은 각각 58.9%, 21.7%, 12.2%이었고 중앙 생존기간은 14개월이었다. 전체 생존률에 대한 단변량분석에서 치료에 대한 반응과 FP병합요법의 횟수가 통계적인 유의성을 보여주었다. 환자의 숫자가 적었으나 방사선감작제로 일단위 혹은 주단위의 cisplatin이 FP 병합요법보다 좋은 결과를 보였다. 결 론: 원격장기로의 전이가 없는 국소진행성 식도암 환자에서 동시적 항암화학방사선치료는 기존의 연구와 유사한 결과를 보여주었다. 일단위 혹은 주단위의 cisplatin이 전신상태가 FP 병합요법에 적절하지 않은 환자에서 대안으로 사용될 수 있을 것으로 생각된다.