• Journal of Chest Surgery
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• 제29권8호
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• pp.923-926
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• 1996

식도 소세포암은 매우 드문 악성 종양으로 알려져 있다. 본 인제 대학교 부산백병원 흉부외과학교실에서는 식도에서 발생한 소세포암 1례를 수술 치험하였다. 68세된 남자로서, 술전 위내시경 조직검사에서 신경내분비종양이 의심되어 식도절제술 및 위-식도 문합술을 시행하였고, 술후 경과는 양호하여 합병 증없이 퇴원하였다.

• Journal of Chest Surgery
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• 제30권2호
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• pp.241-245
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• 1997

식도의 원발성 소세포암은 매우 드문 형태의 식도암이며, 위험한 예후를 동반한 극히 불량한 종양이다. 이런 악성적인 가능성으로 인하여 소세포암의 치료는 일반적으로 항암치료가 우선이다. 우리는 식도하부에 발생한 소세포암 환자 1례를 경 험하였다. 환자는 53세된 남자였으며, 진단 당시 국소적 임파절전이가 있었고, 완전 절제와 항암치료를 받았다.

• 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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• 제53권4호
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• pp.152-159
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• 2020

Minimally invasive esophagectomy (MIE) was first introduced in the 1990s. Currently, it is a widely accepted surgical approach for the treatment of esophageal cancer, as it is an oncologically sound procedure; its advantages when compared to open procedures, including reduction in postoperative complications, reduction in the length of hospital stay, and improvement in quality of life, are well documented. However, debates are still ongoing about the safety and efficacy of MIE. The present review focuses on some of the current issues related to conventional MIE and robot-assisted MIE based on evidence from the current literature.

• Journal of Chest Surgery
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• 제35권8호
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• pp.621-625
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• 2002

식도평활근종은 식도에 발생하는 양성종양 중에서 그 빈도가 가장 흔하지만, 식도에서 발생하는 모든 종양 중단지 1%를 차지할 정도로 비교적 흔치 않은 식도 질환이다. 식도평활근종은 식도근층에서 유래한 벽내 종양이 대부분을 차지하지만, 점막근층에서 유래하여 식도강내 육경을 가진 폴립과 유사한 형도 약 1%의 빈도로 드물게 보고된다. 최근에 30세 남자환자가 연하곤란을 주소로 본원에 입원하였다. 방사선학적 검사에서 직경 5cm의 강내 종양이 경부식도에서 발견되었다. 내시경검사에서 종양조직은 정상 점막으로 덮여 있음을 보였다. 좌측 경부절개를 통해 식도 전벽에 종절개를 가한 후 육경성 종양을 성공적으로 적출할 수 있었다. 조직학적 검사에서 식도 평활근종으로 확진되었다. 연하장애 등 합병증없이 술후 회복과정은 순조로웠다.

• Journal of Chest Surgery
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• 제28권3호
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• pp.280-286
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• 1995

In our hospital we have seen 38 cases of esophageal cancer from June 1984 until June 1994. They composed of 34[89% men and 4[11% women, their age distributed from 35 to 74, mean age was 57.55 7.43. Their symptoms were varied, dysphagia[97% , pyrosis[58% , chest pain[31% , weight loss[31% , anemia[8% , vomiting[5% , and hoarseness[1% . Surgical treatment was done with esophagectomy and upper GI reconstruction 35 cases, and palliative gastrostomy was 3 cases. There was no operative mortality, and operative morbidity was 8 cases of anastomotic leakage, 5 cases of wound infection, 5 cases of pleural effusion, hoarseness, pneumothorax, and lung abscess. Pathologic lesion distribution: upper thoracic esophagus 6 cases[16% , middle thoracic esophagus 17 cases[45% , and lower thoracic esophagus 15 cases[39% . There was no statistical difference of transhiatal esophagectomy and transthoracic esophagectomy in complications and hospitalization period in this study but we proved the superiority of gastric upper GI reconstruction rather than colon upper GI reconstruction in anastomotic leakage and hospitalization period. Cumulative survival rate was 76.2% in 1 year survival, 33.9% in 3 year survival, 25.4% in 5 year survival, 12.7% in 10 year survival. There was no relationship with the time of dysphagia with survival in this study.

• 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.

• Journal of Chest Surgery
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• 제29권6호
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• pp.626-631
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• 1996

The forty patients with carcirLoma of the esophagus or cardia seen at National Medical Center between November 1983 and April 1994 underwent surgical exploration. The esophagogastrectomy was carried out in 29 of 40 patients, one case through right thoracotomy, the others through left thoracotomy. Two patients underwent colon bypass surgeries due to upper esophageal cancer Transhiatal esop agectomy was performed In one case. Feeding gastrostomy or feeding jejunostomy were performed in 8 patients due to the advanced stage or malnutrition. In this report, we evaluated the long-term results in the 28 patients who underwent esophagogastrectomy for palliation through the left thoracotomy. There were 25 men(89%) and 3 women(11 %), and the mean age was 58.65$\pm$7.15 years(range, 46 to 73 years). The most frequent preoperative symptoms included dysphagia (22), weight loss (15), chest pain (6), vomiting (1), and hoarsness (1). Twenty-three patients had sqamous cell cancers of mid-and lower esophagus and five adenocarcionomas of cardia. One patient died in the hospital within 30 days of the op- eration for a hospital mortality rate of ).7%, Cause of death was sepsis due to anastomotic leakage. There were five additional complications in five patients; acute respiratory distress syndrome (1), post-op- erative bleeding (1), diaphragmatic hernia (1), acute renal failure (1) and late raft stenosis (1). The one year, 1틴o years, and three years acturial survival rate were 75.6$\pm$9.5%, 43.2$\pm$ 11.6%, 21.6: 10.5$\circledcirc$ re- spectively. The average survival was 21.8 months. The data from this study suggest that esophagogastrectomy through the left thoracotomy can achieve resonable long-term palliation for carci- noma of the esophagus. The operation can be performed with a low operative mortality and few serious postoperative complications.

• 대한종양외과학회지
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• 제14권2호
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• pp.95-101
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• 2018

Purpose: The standard treatment of esophageal cancer is the Ivor-Lewis operation, which consists of an abdominal phase involving gastric tube formation, and a chest phase involving esophagectomy and anastomosis. We aimed to report our experience of performing thoracic esophagectomy with the laparoscopic gastric pull up (LGPU) technique and its surgical outcomes. Methods: Clinicopathologic data and short-term surgical outcomes of 14 patients who underwent LGPU for thoracic esophageal cancer from August 2008 to May 2016 were retrospectively reviewed. Results: Mean age of the patients was 62.3 years and mean body mass index was $21.7kg/m^2$. Eleven patients had medical comorbidities. Patients' mean American Society of Anesthesiologists score was 2. Mean operation time was 428.5 minutes, with the mean abdominal operation time being 138.9 minutes. There was no open conversion case. Three patients had pneumonia, three patients had surgical site infection, and one patient had subcutaneous emphysema within 30 days after surgery. One patient had minor anastomosis site leakage. There was one 30-day mortality case. One patient with postoperative aspiration pneumonia developed acute respiratory distress disease, and died due to sepsis. Mean postoperative intensive care unit stay was 3.5 days, and mean postoperative hospital stay was 20.6 days. Nasogastric tubes were removed on average at 3.4 days, and mean oral intake time was 3.4 days. Conclusion: If the gastrointestinal surgeon has extensive experience in laparoscopic procedures, LGPU will be a safe and feasible technique for thoracic esophagectomy in patients with intrathoracic esophageal cancer.

• Journal of Chest Surgery
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• 제34권2호
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• pp.189-193
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• 2001

위기관지 누공은 매우 드문 질환으로 대부분의 경우 외상, 상부위장관 수술, 횡경막하 농양, 양성 위궤양, 신생물 등 이 원인으로 생각된다. 식도암의 Ivor Lewis 수술후 2년과 3년에 양성 위궤양으로 인해 발생한 재발성 위기관지 누공 1예를 문헌고찰과 함께 보고하는 바이다.