• Journal of Chest Surgery
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• v.20 no.4
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• pp.859-864
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• 1987

The microwave tissue coagulator was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases. We experienced the good result of the microwave tissue coagulation therapy in the patient with the restenosis of esophagogastrostomy. The patient was 67 year-old female, who was admitted due to the lye stricture of esophagus for 40 years. We made the lower esophagectomy and the esophagogastrostomy with the upper intact esophagus in the right thorax. But the restenosis occurred at the esophagogastrostomy site because of the polypoid mucosal protrusion at one month after operation. We applied the microwave tissue coagulator 3 times with 6 day interval under esophagoscopy and the good symptomatic and endoscopic relief was alleviated. We think that the microwave tissue coagulation is a very convenient and advisable method in the case of restenosis after esophageal surgery.

• Korean Journal of Bronchoesophagology
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• v.19 no.1
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• pp.11-14
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• 2013

Gastro-esophageal reflux disease (GERD) is a recurrent, long-term gastrointestinal condition characterised by the abnormal reflux of stomach contents into the esophagus. Heartburn is the most dominant symptom, which can be life long and can considerably reduce quality of life. The main goals of treatment are to alleviate symptoms and prevent relapses, esophageal stricture and adenocarcinoma. This paper presents a review comparing the effectiveness of omeprazole with Nissen fundoplication surgery for the treatment of GERD. Nissen fundoplication is more effective in controlling heartburn symptoms, healing esophagitis and preventing relapses than omeprazole. Quality of life, in terms of productivity and ability to work, is difficult to assess in the omeprazole group and, as a result, a comparison of this aspect is limited. Although fundoplication is expensive in the short term, it is more cost-effective than omeprazole. Nurses need to be aware of the effectiveness of omeprazole and fundoplication to provide patients with accurate information, which assists patients in decision making regarding treatment options.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.113-120
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• 2009

Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.293-297
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• 1976

One mid-esophageal carcinoma underwent esophagogastrectomy using an exclusive right thoracic approach entailing mobilization of the stomach through the esophageal hiatus. 62 year old male farmer was admitted with chief complaints of dysphagia and weight loss of 5 Kg. for 6 months, and regurgitation after soft meal for one week prior to this admission. Preoperative esophagogram revealed stricture with fungating mass at the level of the carina, which was diagnosed as squamous cell carcinoma at the time of esophagoscopic biopsy about 33 cm from incisor. Bronchoscopy revealed no invasive lesion or carinal fixation, and laboratory examinations were excellent for operative intervention. An exclusive right thoracic approach through right 5th rib bed was made for radical esophagectomy, mobilization of the stomach through the esophageal hiatus and primary esophagectomy. Postoperative recovery was uneventful except increased bronchial secretion due to senile emphysema, and follow up for 5 months after esophagectomy revealed good functioning esophagus with mild epigastric fullness after meal. Exclusive right thoracic approach for radical esophagectomy seems to be the procedure of choice in selected cases.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.819-828
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• 1984

Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.1-11
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• 2008

The aim of this study is to analyze the outcomes of the esophageal atresia with tracheoesophageal fistula over the last 2 decades. The records of 51 patients born between 1987 and 2006 were reviewed. Twenty-seven patients were male. Mean values of the age, gestational age and birth weight were 2.9 days, 296 days and 2.7kg, respectively. All patients had Gross type C anomalies. Thirty-one patients (60.7 %) had one or more associated congenital anomalies and the most common anomaly was cardiac malformation. In 48 cases, primary anastomosis was done and staged operation was done in one case. Circular myotomies in the proximal esophagus were performed in 9 cases. Postoperative complication developed in 26 cases (54 %): pulmonary complication in 12 cases, anastomotic leakage in 10 and anastomotic stricture in 10, recurrent trachoesophageal fistula in one and tracheomalasia in 2 cases. Reoperation was carried out in 2 patients with anastomotic leaks, the remaining leaks were managed non operatively. Three of the strictures were reoperated upon and the others were successfully managed by balloon dilatations. Overall mortality rate was 15.6 %. Mortality rate of the second 10 years (8 %) period decreased significantly compared to that of the first 10 years (23 %) period.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.12-20
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• 2008

From 1979 to 2006, fifty eight patients with esophageal atresia were treated by one pediatric surgeon at Hanyang University Hospital. We analyzed the clinical findings and outcome of these 58 patients. There were 30 males and 28 females. Their mean birth weight was $2,960{\pm}400g$ (1,170~4,020 g). The most common type of anomaly was Gross type C (49 patients; 84.5 %). There was no type B. Fifty-two patients underwent definitive surgery. Postoperative complications were as follows: anastomotic leakage in 17 patients (32.7 %), anastomotic site stricture in 15 (28.8 %), gastroesophageal reflux in 10 (19.2 %) and recurrent TEF in 1 (1.9 %). A total of 152 associated anomalies were detected from 48 patients (82.2 %). The cardiovascular system was the most commonly affected (30 patients with 46 anomalies). The VACTERL association was present in 14 patients (24.1 %). Operative mortality was 17.3 % including self-discharge patients after operation.

• Clinical Endoscopy
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• v.56 no.1
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• pp.38-49
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• 2023

Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I²=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I²=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I²=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

• Journal of Chest Surgery
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• v.6 no.1
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• pp.89-94
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• 1973

Esophagel atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination. First described by Durston in 1670, esophageal atresia was not successfully treated until 1939 when Ladd in Boston and Leven in St. Paul obtained the first survivors utilizing the methods of gastrostomy, esophagostomy and extrapleural ligation of the tracheoesophageal fistula as multiple operations which required months of hospitalization. Two years later Cameron Haight performed the first successful primary repair and afterward about 2000 cases of esophageal atresia with distal tracheoesophageal fistula reported in the world. In Korea, there appeared about 27 cases in the literature and 8 successful repaired cases noted in these year. Anther report two cases of esophageal atresia, of which one case was successfully treated with Haight`s method. Case 1.: Normal full term delivered boy with chief complaints of respiratory difficulty and persistent drooling with chocking, 3. lkg, was admitted with emergency 5 hours after delivery. Physical findings revealed no specific abnormal signs except distended abdomen and grunting respiration. Esophagograrn and bronchogram revealed proximal esophageal atresia and distal tracheoesophageal fistula proximal to the carina. Parent refused operative therapy and patient died 24 hours after discharge. Case 2. :3. lkg. normal full term delivered girl was admitted 4 days after delivery with chief complaints of regurgitation after feeding, chocking, cyanotic spell and fever since the day after delivery. Physical examination revealed persistent drooling, grunting respiration, and fever with moderate dehydration. Tracheoesophageal suction and fluid therapy with antibiotics improved her condition and subsided ]pneumonic condition. Esophagogram revealed markedly dilated proximal esophagus as blind loop and stomach distended with gas, and repairing operation as Haight`s method was performed on the 7th day after delivery. Patient tolerated all the operative procedure well and recovered uneventfully. Esophagogram on the 7th postoperative day showed passage of the lipiodol through the anastomotic side with moderate stricture,and feeding permitted. Patient tolerated all the feeding amount well and discharged on the 11th postoperative day. Followup revealed intermittent regurgitation after feeding and corrected with bougination.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1117-1120
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• 1997

Ten cases with esophageal foreign body were treated surgically from July 1980 to October 1995 at the Departme t of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The mean age was 45.3 years, with a range from 25 to 71. Out of ten cases, 6 were female and four were male. Common symptoms were dysphagia, fever, foreign body sensation and neck pain. Three cases of foreign bodies were of fish bones, two of bubble paclcage of drugs, one case of a Eeer bottle cap, one of a piece glass, one of a bathtub plug, one of chicken and one of a bean. The diagnosis was established by esophagography using a water soluble contrast material and esophagoscopy. Among of ten cases, two had esophageal stricture due to the ingestion of Aye at a young age. One case had experienced psychological problems. All foreign bodies were removed by surgical procedures. Five cases were treated by cervical esophagostomy, one case by right thoracotomy, one case by retrograde bougienation through gastrostomy and two cases by cervical incision and drainage for cervical abscess. Three cases developed pos operative esophageal leaks which healed spontaneously and transient hoarseness developed in one case. One case developed traumatic pneumothorax and subcutaneous emphysema which was treated by closed thoracostomy. There were no operative deaths. C(ocean J Thorac Cardiovasc Surg 1997;30:1117-20)