• Journal of Chest Surgery
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• 제31권7호
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• pp.711-717
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• 1998

배경: 식도 문합술은 여러가지 문합방법과 문합재료를 사용해오고 있지만 문합부 누출과 협착이 다른 장문합에 비해 빈번하고 발생하면 중한 결과를 초래한다. 최근 저자들은 식도문합술 거의 대부분에서 polypropylene사를 이용한 단속단층 문합술을 시행하고 있다. 대상 및 방법: 이에 본 동아대학교병원 흉부외과에서는 1990년 4월부터 1996년 12월까지 시행한 식도문합술 90례의 임상결과를 분석하여 이 문합방법의 효용성을 알아 보기위해 이 연구를 시행하였다. 문합부 누출은 모두 5례(5.6%)에서 발생하였고 이 중 1례가 사망하였다. 결과: 문합부 협착은 수술 생존자를 대상으로 조사하였는데 모두 15례(17.4%)에서 발생하였다. 이 협착은 식도-위 문합술에서 가장 높은 빈도(22%)로 나타났고, 식도-대장문합술에서 가장 낮은 빈도(5%)로 나타났다. 이러한 결과는 다른 여러학자들의 자동 문합기에 의한 문합방법을 포함한 다른 문합방법들의 결과들과 비교할만한 결과였다. 결론: 저자들은 식도문합에 있어 이 문합방법은 식도폐쇄증 교정을 포함한 여러 식도문합에서 만족스러운 결과로 계속 사용되어 질 수 있으리라고 생각된다.

• Advances in pediatric surgery
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• 제5권2호
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• pp.111-115
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• 1999

The results of hepatic portojejunostomy in 34 patients with biliary atresia operated upon by one surgeon between May 1989 and December 1997 were analyzed. Eleven (32.3 %) patients were 60 days or younger, 14 patient (41.2 %) were between 60 and 90 days, and 9 (26.5 %) were over 90 days of age. Jaundice cleared in 20 cases (58.8 %). Three patients died of liver insufficiency, 2 were anicteric but died from esophageal variceal bleeding. Three patients died as a result of sepsis, heart failure and left kidney agenesis. Five patients were lost to follow-up. The five-year survival rate was 73.8 %. Two patients over 90 days of age, survived more than 5 years. Survival rates were not significantly related to the age at operation. We conclude that hepatic portojejunostomy should be considered as a primary surgical modality for biliary atresia, even at age 90 days or more. Early detection of esophageal varices and sclerotherapy may be necessary. Liver transplantation is necessary if hepatic failure develops.

• Advances in pediatric surgery
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• 제9권1호
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• pp.6-11
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• 2003

This study reviews 14 years' experience treating esophageal atresia with special emphasis on the clinical profile and outcome. From May 1989 to February 2003, 65 cases of esophageal atresia (EA) were treated at Asan Medical Center. Boys outnumbered girls 2.4 to 1. Prematutity and low birth weight were 27.7% and 38.5%. Esophageal atresia with distal tracheoesophageal fistula (TEF) was the most common type (87.7%), followed by pure EA and H type fistula. Forty-six patients (70.8%) had one or more associated anomalies, cardiac malformations were the most common. Duodenal atresia was found in 7 cases. There were 6 patients (9.2 %) with VATER cluster. VACTERL cluster was present in 18 patients (27.7%), one of who fulfilled the complete syndrome. Waterston group A, B and C made up 21.5%, 40.0% and 38.5% of the total group. Surgical treatment was attempted in 63 patients and deferred in 2 who had severe associated malformations. For EA with distal TEF, primary esophago esophagostomy was carried out in 51 cases, and division of TEF and gastrostomy in 4 cases and no operation in 2 cases. For pure EA, colonic graft was done in 2 after gastrostomy and esophagostomy, and esophago esophagostomy was performed in 2 after gastrostomy. Two patients with pure EA are waiting for the second operation after gastrostomy. Division of TEF was carried out in 2 cases with H type TEF. The overall survival rate was 76.9%, and survival by Waterston classification was 100% in group A, 80.8% in B and 60.0% in C. Thorough workup for associated anomalies, interdepartmental approach and more careful surgical decision and technique are required to improve the outcome of EA.

• Advances in pediatric surgery
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• 제6권2호
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• pp.100-105
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• 2000

Eleven children with gastroesophageal reflux disease underwent fundoplication. Eight had neurological impairment, two had hiatal hernias and one had a history of esophageal repair for esophageal atresia. The most common and significant symptom was vomiting(81.8 %), followed by recurrent respiratory infections(72.7 %) and failure to thrive(72.7 %). The most common diagnostic tool was 24 hour esophageal pH study, which showed pH less than 4 for more than 10 % of the total recorded time in 6 of 9 patients. Nissen fundoplication was performed in 10 patients. Thal fundoplication was carried out in one patient with esophageal atresia. Stamm gastrostomy was added for nutritional and/or swallowing problem in all 8 patients with neurological impairment. The median follow up period was 13 months. There was one late death of unrelated cause and one recurrence. The quality of life after antireflux surgery was greatly improved. Antireflux surgery should be done if indicated, and a simultaneous gastrostomy considered in a patient with neurological impairment.

• Journal of Chest Surgery
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• 제3권1호
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• pp.25-30
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• 1970

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2008년도 제49차 학술대회 초록집
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• pp.22-24
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• 2008

• Advances in pediatric surgery
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• 제9권2호
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• pp.143-144
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• 2003

• Advances in pediatric surgery
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• 제9권2호
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• pp.145-147
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• 2003

• Advances in pediatric surgery
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• 제9권2호
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• pp.126-127
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• 2003

• Advances in pediatric surgery
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• 제9권2호
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• pp.128-130
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• 2003