• Clinical and Experimental Pediatrics
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• 제62권10호
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• pp.395-399
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• 2019

Background: The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported. Purpose: The study aimed to evaluate the methodology, efficacy, and side effects of Mitomycin C in the treatment of esophageal strictures. Methods: This study included 30 children with resistant esophageal strictures. Upper GI endoscopy was performed up to the area of stricture, esophageal dilatation was done, endoscopy was repeated, and Mitomycin C was applied topically under direct endoscopic vision. The effect of the procedure was followed over a period of 3-5 years. Results: The response to Mitomycin C was excellent (clinically and endoscopically) in 28 patients (93.3%) and good (endoscopically only) in 2 patients (6.7%). No side effects of topical Mitomycin C in children with esophageal strictures were reported in this study. Conclusion: Esophageal dilatation followed by local Mitomycin C application may be a useful strategy for treating resistant esophageal strictures.

• 한국임상수의학회지
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• 제29권4호
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• pp.331-333
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• 2012

두 살 된, 거세된 수컷, 단모종 고양이가 배뇨곤란을 주 증으로 내원하였다. 신체검사 및 방사선 검사에서 회음부 요도개구술 후 직장요도루 및 요도 협착이 발생한 것으로 진단되었다. 이 문제를 해결하기 위하여 치골 요도개구술을 실시하였다. 이후 합병증 없이 창상 치유가 잘 이루어져 정상적인 배뇨가 이루어지고 있다. 고양이에서 회음부요도개구술 후 요도 협착과 직장요도 루가 동시에 발생한 첫 번째 증례이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.71-75
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• 2016

Esophageal candidiasis is commonly seen in immunocompromised patients; however, candida esophagitis induced stricture is a very rare complication. We report the first case of esophageal stricture secondary to candidiasis in a glycogen storage disease (GSD) 1b child. The patient was diagnosed with GSD type 1b by liver biopsy. No mutation was found in the G6PC gene, but SLC37A4 gene sequencing revealed a compound heterozygous mutation (p.R28H and p.W107X, which was a novel mutation). The patient's absolute neutrophil count was continuously under $1,000/{\mu}L$ when he was over 6 years of age. He was admitted frequently for recurrent fever and infection, and frequently received intravenous antibiotics, antifungal agents. He complained of persistent dysphagia beginning at age 7 years. Esophageal stricture and multiple whitish patches were observed by endoscopy and endoscopic biopsy revealed numerous fungal hyphae consistent with candida esophagitis. He received esophageal balloon dilatation four times, and his symptoms improved.

• 대한기관식도과학회지
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• 제5권2호
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• pp.143-152
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• 1999

Background : the technical modality of esophagogastric anastomosis plays an important part in the factors leading to anastomotic leakage and stricture. Objective : The objective of this study was to compare the leakage and stricture rates between the different anastomosis techniques. Materials and Methods : A retrospective study was undertaken in the patients with esophageal cancer who underwent a esophagectomy. Hand-sewn anastomosis was performed in one layer with interrupted sutures(Manual group). The stapler group was divided into two subgroups, such as PCEEA group and Endo-GIA group. Results : The differences of preoperative patient profiles between the groups were not significant. Overall mortality fates were 5% in manual group, 5% in PCEEA group and 11.5% in Endo-GIA group. Fewer anastomotic leakage occurred in manual group(5%) than in PCEEA group(10%) or in Endo-GIA group(15.4%). The postoperative stricture rate was higher in PCEEA group(35%) than in manual group(5%) or in Endo-GIA group(0%) Conclusion : Statistically, there were no significant differences in the anastomotic leakage and stricture rates between the hand-sewn and mechanical anastomosis. But the stricture rate was lower in the group using the linear stapling device and the leakage rate was lower in the hand-sewn group than the other groups.

• Journal of Chest Surgery
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• 제37권7호
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• pp.617-621
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• 2004

양성 식도협착에 대한 분절절제술 및 단단문합술은 식도-장관 문합술에 비해 수술침습도가 적고 식도 고유기능을 보존할 수 있으므로, 짧은 분절의 식도협착에서 수술방법으로 고려해야 하지만 임상 보고나 분석에 대한 연구는 매우 적은 실정이다. 본원 흉부외과에서는 수술 후 문합부 협착이 있는 13개월 여아와 부식성 식도협착이 있는 27세 여자를 대상으로 단단문합술을 적용한 임상경험을 하였기에 보고하는 바이다. 생후 2일째 식도무형성증-식도기관누공에 대한 수술 후 발생한 문합부 협착인 경우는 결과가 좋았으나, 경부 식도의 고도 부식성협착에서는 단단문합술 후 다시 협착이 재발하여 인후-대장-위 문합술을 시행하게 되었다. 양성 식도협착에 대한 단단문합술은 협착의 범위와 원인에 따라 적응증을 선택하여 사용된다면 좋은 치료 방법이라고 생각하나 더 많은 연구가 필요하리라 생각한다.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.179-186
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• 2018

Background: To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries. Methods: A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation. Results: The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis. Conclusion: Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.

• Journal of Chest Surgery
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• 제21권6호
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• pp.1071-1077
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• 1988

Surgical treatments were performed in 765 patients of the esophageal diseases at National Medical Center from 1959 to 1982. During these periods, we experienced 945 cases of the esophageal diseases. There were 401 males and 364 females and ranging from 4 days to 76 years of age and mean age was 32.4 years. The most highest mortality noted as 23.0% in esophageal perforation cases. In esophageal strictures cases, the rate of surgical mortality was 5.4%[21/386]. The over all mortality in esophageal surgical cases was 10.8%. We want to expressed about the incidence of Corrosion Carcinoma which developed from the benign esophageal stricture as 2.2%[12/550] of total stricture and as 4.9%[12/241] of total esophageal carcinoma. And the esophagoscopic biopsy must be done who had long standing history of esophageal stricture as a preoperative evaluation purpose.

• 대한기관식도과학회지
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• 제9권2호
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• pp.69-73
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• 2003

Various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the oncologic needs of the situation. If the entire esophagus or significant part of the thoracic esophagus is involved by tumor, then total esophagectomy and gastric pull-up or colon transposition is indicated. But for most hypopharyngeal tumors, laryngopharyngeal tumors, and cervical esophageal tumors, segmental resection of these area and replacement with a jejunal fee or forearm free flap has become the standard technique. The authors have experienced a case of total pharyngo-laryngo-esophago-gastrectomy and colon transposition in a patient of esophageal cancer following partial esophagectomy and gastic pull-up due to corrosive esophageal stricture. We report this case with brief review of the literatures.

• Journal of Chest Surgery
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• 제25권2호
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• pp.183-187
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• 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
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• 제28권1호
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• pp.85-89
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• 1995

The early esophgeal carcinoma is limited to the mucosa or submucosa without lymph node metastsis which shows good 5-years survival rate. It is nearly 85-90% nowadays,if we just find and manage it.It is really helpful to use the endoscope in management and diagnosis, in addition the biopsy under the endoscopic finding.We experienced one case of early esophageal carcinoma. The patient was 57years old female,who ingested lye 27years ago for suicidal attempt, after 10years, the dysphagia was aggravated slowly. Before admission dysphagia was severely aggravated during 2months. Confirmation of diagnosis was made by endoscopic biopsy.Operation method was substernal colon bypass and total esophagectomy through right thoracotomy. Postoperative course was smooth.We report early esophgeal carcinoma related to lye stricture that was detected by the method of endoscopic examination and biopsy. It is important to screen the patients with longstanding history of benign esophageal stricture by the endoscopic biopsy.