• Proceedings of the KOR-BRONCHOESO Conference
• /
• 2010.03a
• /
• pp.35-35
• /
• 2010

• Journal of Chest Surgery
• /
• v.38 no.11 s.256
• /
• pp.791-794
• /
• 2005

After esophagectomy, the stomach is used most commonly for the method of reconstruction. However, the stomach may not be large enough to be reached the site of anastomosis when it is above the pharynx. We experienced a double primary cancer of the lower esophagus and the larynx. Total laryngectomy and total esophagectomy were done with cervical pharyngojejunogastrostomy for reconstruction. Free jejunal graft is interposed between the oropharyngeal stump and the stomach is pulled-up. We could restore the alimentary track without tension at the anastomotic site and obtain sufficient blood supply.

• Korean Journal of Bronchoesophagology
• /
• v.17 no.1
• /
• pp.40-45
• /
• 2011

Background and Objectives Detailed information about the impacted esophageal foreign body is essential for safe extraction. Three dimensional reconstruction technique was applied to know shape, size and location of the simulative foreign bodies of stone, hyoid bone and endotracheal tube. Materials and Methods Submandibular gland stone, hyoid bone and endotracheal tube were used to simulate impacted foreign bodies. Axial CT, multi-planar reconstruction, volume of interest and virtual camera of Rapidia software were used to get information about the simulative foreign bodies from CT data. Shape and size were compared with the real materials. Exact locations were measured in appropriate modes of Rapidia. Results Shapes of the simulative foreign bodies matched well with the real materials. Size and location could be measured in various modes with some variable results. Conclusion 3D technique can be applied to get information about the simulative foreign bodies. This technique could be applied to the impacted esophageal foreign body.

• Journal of Chest Surgery
• /
• v.36 no.1
• /
• pp.55-58
• /
• 2003

Although postanastomosis of esophageal reconstruction is rare but it is a very unwelcome complication. Previously, the problem was solved by balloon dilatation, reoperation, and feeding jejunostomy. However, balloon dilatation is not effective because of high recurrence rate, reoperation is difficult due to its operative approachableness and also jejunostomy is inconvenient for patients. Therefore, we inserted esophageal stent as a method of relieving postanastomosis stenosis, From Jan, 2001 to Dec, 2001, there were three patients with postanastomosis stenosis, who received esophageal stent insertion, one had case is benign esophageal stenosis, two had esophageal carcinoma. We followed up them over 12 months after inserting the stent, Dysphagia was improved, so we report that the clinical performance was satisfactory

• Journal of Chest Surgery
• /
• v.32 no.6
• /
• pp.573-578
• /
• 1999

Background: After an esophageal resection for an esophageal disease, the stomach becomes the most common organ for a substitute. The stomach has the advantages of being simple with fewer complications when used properly. The complications of an esophageal reconstruction using the stomach as the substitute are assessed and discussed. Material and Method: Between 1990 and 1998, 44 patients who underwent esophagogastric anastomosis were treated in the department of Thoracic and Cardiovascular Surgery of Yongdong Severance Hospital, Seoul, Korea. Result: The rate of postoperative complications and mortality in these 44 patients were 70.5% and 13.6%, respectively. The major complications in our series involved the stricture of anastomosis(13.6%), pneumonia(11.4%), and wound infection(9.1%). The most frequent causes of postoperative deaths were pulmonary complications and sepsis(6.8%). Conclusion: Anastomotic leakage is no longer a major complication of an esophagogastrostomy. Most postoperative stricture can be overcome with frequent esophageal dilations. Postoperative pulmonary infection, nutrition, and physiotherapy are very important in reducing the rate of pulmonary morbidity and mortality.

• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.626-631
• /
• 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.

• Journal of Chest Surgery
• /
• v.57 no.1
• /
• pp.53-61
• /
• 2024

Background: In the treatment of esophageal cancer, a gastric conduit is typically the first choice. However, when the stomach is not a viable option, the usual alternative is a colon conduit. This study compared the long-term surgical outcomes of gastric and colon conduits over the same interval and aimed to identify factors influencing the prognosis. Methods: A retrospective review was conducted of patients who underwent esophagectomy followed by reconstruction for primary esophageal cancer between January 2006 and December 2020. Results: The study included 1,545 patients, with a gastric conduit used for 1,429 (92.5%) and a colon conduit for 116 (7.5%). Using propensity-matched analysis, 116 patients were selected from each group for comparison. No significant difference was observed in longterm survival between the gastric and colon conduit groups, irrespective of anastomosis level and pathological stage. A higher proportion of patients in the colon conduit group experienced postoperative complications compared to the gastric conduit group (57.8% vs. 25%, p<0.001). Multivariable analysis revealed that age over 65 years, body mass index below 22.0 kg/m², neoadjuvant therapy, postoperative anastomotic leakage, and renal failure were risk factors for overall survival in patients with a colon conduit. Regarding conduit-related complications, cervical nastomosis was the only significant risk factor among those with a colon conduit. Conclusion: Despite the association of colon conduits with high morbidity rates relative to gastric conduits, the long-term outcomes of colon conduits were acceptable. More consideration should be given perioperatively to the use of a colon conduit, particularly in cases involving cervical anastomosis.

• Journal of Chest Surgery
• /
• v.39 no.3 s.260
• /
• pp.208-213
• /
• 2006

Background: The prevalence of anastomotic complication is related to anastomotic procedure or site in esophageal cancer operation. We studied the anastomotic leakage and stricture related to the anastomotic procedure & site in patients who received the esophageal resection and reconstruction for esophageal cancer. Material and Method: The anastomotic procedure, site and complication of 321 patients who received the esophageal reconstruction from August 1993 to May 2003 were investigated. Mean age was 64.5$\pm$4.9 (37${\~}$94) years, 300 patients ($93.5\%$) were male and 21 patients were female ($6.5\%$). Result: There were 7 anastomotic leakages ($2.2\%$) and no difference in anastomotic site (cervical anastomosis $4.1\%$, thoracic anastomosis $1.6\%$) and procedure (stapler technique $1.6\%$, semi-staple technique $9.1\%$, hand-sewn technique $0.0\%$). There were 52 anastomotic strictures ($16.2\%$), differences in sites (cervical anastomosis $2.7\%$, thoracic anastomosis $20.2\%$) (p < 0.001) and procedure (stapler technique $20.0\%$, semi-stapler technique $3.0\%$, hand-sewn technique $4.7\%$). And the stapler technique showed higher stricture rate (p < 0.001). Conclusion: Anastomotic technique was less related to anastomotic leakage in esophageal reconstruction for esophageal cancer. However, stapler technique had higher stricture rate than other techniques. Therefore, we suggest that the anastomotic technique be improved to reduce anastomotic stricture.

• Journal of Chest Surgery
• /
• v.25 no.2
• /
• pp.183-187
• /
• 1992

Reconstructive surgery for corrosive esophageal stricture was performed in 392 patients at National Medical Center from 1959 to 1990 Between Jan. 1971 and Dec. 1990, 23 cases were experienced stenotic anastoma of neck after reconstructive surgery for corrosive esophageal stricture. The major procedure of esophageal reconstruction was colon interposition without resection of the strictured esophagus except jejunal interposition in 1 case. There were 12 males % 11 females, and mean age was forty years. The caustic materials were 16[70%] alkali and 7[30%] acid. Half of the cases had hypopharyngeal injury. After reconstructed surgery, dysphagia was developed immediate in 65%, from 2 months to 5 months in 31%, and from years in 4%[1 case]. The complications were anastomatic leakage in 13 cases, anastomatic stenosis in 8 cases, graft gangrene in 1 case, and cancer development in 1 case. The therapeutic procedures were end-to-end anstomolis & partial resection of stenotic anastoma in 18 cases, bourgination in 2 cases, and coin interposition with graft removal in 3 cases. The therapeutic results were excellent in 16 cases, mild discomfort in 3 cases, poor in 3 cases, and death in 1 cases.

• Journal of Chest Surgery
• /
• v.14 no.3
• /
• pp.202-209
• /
• 1981

The results of reconstruction of the lower esophagus with jejunum in a total of 24 cases of primary carcinoma of the lower third esophagus and gastroesophageal carcinoma were presented, and clinical values of substitution for the esophagus with jejunum were also discussed. They were operated in the department of thoracic and cardiovascular surgery, Hanyang University Hospital during the period of 9 years from 1972 to 1981. Surgical managements to lower esophageal reconstruction with jejunum were carded out with not the same procedure in all cases studied, but with three different procedure mentioned below/ In 13 cases of lower third esophagectomy with or without partial `8astrectomy of a total of 24 cases, interposition of jejunum between the esophagus and the stomach were performed after the fashion to esophagojejunostomy with mobilized jejunal loops and 8astro-JeJunostomy with side to side anastomosis. In 7 cases of lower third esophagectomy and total gastrectomy, the continuity of the esophagus were performed the fashion to esophagojejunostomy with mobilized jejunum. In 4 cases of unresectable gastro-esophageal carcinoma, bypass operation of the lower esophagus and the stomach were performed after the fashion to esophagojejunostomy with side to and anastomosis. After the bypass operation, it was observed that oral feeding to the patients was excellent. Following these consecutive series of 20 cases of radical operation for lower esophageal carcinomas and 4 cases of bypass operation for unresectable gastroesophageal carcinomas, no complication such as postoperative leakage and stenosis from anastomotic site or Infection In operating area and operative death were observed.