• Journal of Chest Surgery
• /
• v.4 no.1
• /
• pp.35-42
• /
• 1971

This is a report on four cases of bypass for esophageal stricture due to gastro-esophageal carcinoma in the Department of Thoracic Surgery, Chonnam University Hospital. Bypass was performed intrathoracal esophago-jejunostomy by a segment of jejunum. Three patients received end to end anastomosis and the other one side to end esophagojejunostomy. Postoperative results were as follow; There was no swallowing disturbance with regular diet and the patients appear to be more comfortable by bypass than gastrostomy or jejunostomy. Postoperative condition of all the patients was satisfactory because other organs were intact. However, two patients expired in 12 months and 6 months after operation by wide metastasis and the other 2 cases are living now with regular diet in 4 months and 2 months after operation.

• Clinical Nutrition Research
• /
• v.11 no.2
• /
• pp.146-152
• /
• 2022

Patients with short bowel syndrome (SBS) have a high risk of developing parenteral nutrition (PN)-associated complications. Therefore, diet or enteral nutrition and PN should be modified to limit such complications. N balance analysis is a method of calculating the amount of protein required to achieve N equilibrium in the body based on intake and excretion. It is important to reduce dependence on PN and achieve the recommended range of N balance 2-4 g with an appropriate diet. We report a recent experience with nutrition modification using N balance analysis and suggest it as a useful method to reduce dependence on PN in nutrition management of SBS patients and in continuing active intestinal rehabilitation.

• Journal of Chest Surgery
• /
• v.28 no.11
• /
• pp.1032-1037
• /
• 1995

Between September 1988 and December 1993, 32 cases of benign esophageal stricture, of which 12 males and 20 females, were managed in Seoul National University Hospital hospital. Their age ranged from 2 to 61 years, and the mean age was 33.9 years. The ingestion of caustic agent was the most common cause, and the caustic material was acid in 16 patients [58% and alkali in 11patients [39% . Nearly all of the patients complained of dysphagia, and some of chest pain, epigastric pain, weight loss, vomiting, general malaise, and dyspnea. The most frequent site of stricture was found in the upper thoracic esophagus with 34% incidence followed by the lower thoracic esophagus[28% , whole esophagus[19% , and the mid esophagus[16% . The operations performed were 17[53% ECG[esophagocologastrostomy , 5[16% PCG[pharyngocologastrostomy , 5[16% EG[esophagogastrostomy , 2 EJG [esophagojejunogastrostormy by free jejunal graft , and 1 case each of EJ [esophagojejunostomy , esophageal end to end anastomosis, jejunostomy only, and gastrostomy only. In 23 patients [72% , diseased esophaguses were resected, using transhiatal total esophagectomy in 15 [47% and transthoracic partial esophagectomy in 8 [25% . Of those 23 patients, 3 patients [9.4% were diagnosed as esophageal carsinoma on microscopic examination. The postoperative most common complications were unilateral vocal cord palsy in 6 patients [19% , followed by cervical anastomosis leakage in 4 patients [12.5% , wound infection in 2 patients [6% , and pneumothorax in 2 patients [6% . Late death occurred 8 months after the operation in one patient, which was associated with infection due to anastomotic leakage. Our experience shows that the rate of mortality and the morbidity were low in patients receiving surgical management for esophageal stricture and that the cancer transformation rate was high. We recommend esophageal reconstruction surgery with esophagectomy [transhiatal or transthoracic for the esophageal stricture because it can avoid a chance of prevent cancer transformation.