• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.178-183
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• 2001

A 72-year-old women whose symptom was severe dysphagia and x-ray film revealed esophageal stricture and dilatation. She had attempted suicide by swallowing lye liquids 50 years ago. A conclusive clinical and histological diagnosis of esophageal carcinoma after corrosive stricture was made following a esophagectomy with esophagogastrostomy, I experienced one case of esophageal carcinoma after corrosive stricture and reviewed it with references.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.57-60
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• 1975

Congenital esophageal stricture is infrequent disease entity and usually occurs in the mid esophagus. Tracheobronchial remnants in the esophagus causing esophageal stricture are extremely rare, and only few cases were reported in the literature. During last 17 years the authors experienced a case of congenital esophageal stricture due to ectopic tracheal cartilaginous ring who was complicated by peptic esophageal stricture 11 years after esophagogastrostomy. During thoracotomy we thought that the patient had unual achalasia of the esophagus, and couldn`t perform cardiomyotomy because of firm ring encircling the lower esophagus just above the hiatus. The patient was operated on lower esophagectomy including cardia and esophagogastrostomy at his age of two and a half years. Postoperatively the patient did well for 11 years but later he developed intermittent regurgitation without substernal burning, and reoperated under the diagnosis of peptic esophageal stricture-lower esophagectomy, proximal gastrectomy, esophagogastrostomy and Heineke-Mikulicz pyloroplasty with good operative result.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.534-536
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• 1985

In a review of our cases presenting with urethral strictures, we noted a high incidence following open heart surgery. In an attempt to elucidate factors predisposing to the occurrence of urethral stricture, we studied the following data; preoperative laboratory study, aortic clamp time, dosage of heparin and protamine, degree of hypothermia, platelet count, and blood pressure. No significant differences were found between the stricture group and the non-stricture group. Of 33 patients admitted in our hospital with urethral stricture, 8 had suffered after open heart surgery. We believe that the urethral catheter is at least partly responsible for stricture formation. Associated factor, for example urethral ischemia, may be contributory.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.90-94
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• 1990

Between Dec. 1958 and Oct. 1989, we had been experienced 14 cases of the esophageal corrosion carcinoma among 562 cases of corrosive esophageal stricture, which incidence was revealed 5.6 % of total esophageal carcinoma cases and 2.5 9o of total benign esophageal stricture cases. The age distribution was from 15 to 64 years, and the mean age was 45.6 years. Ten of the patients were women. The caustic agents were lye in 12 patients and hydrochloric acid in 2 patients. The latent time from injury to the development of carcinoma was from 12 years to 45 years, and the mean latent time was 29 years. In majority of cases, the developing site of carcinoma was just or just above the benign stricture portion of the esophagus. Corrective surgery were made in seven cases; three cases were made esophagectomy and esophagogastrostomy, and the other four cases were made esophagectomy and colon interposition. Palliative surgery including feeding gastrostomy were made in seven cases. All cases had a longstanding history of difficult oral swallowing especially at the site of stricture. We think chronic food irritations of stricture portion of the esophagus induced the development of corrosion carcinoma. In conclusion, we had to suspect possibility of carcinoma in patient with long standing history of benign esophageal stricture. So we recommended preoperative esophagoscopic biopsy in such cases.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.225-230
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• 1973

Five cases of esophageal cancer developed at the site of esophageal lye stricture were reported. Duration of lye stricture was between 13 and 40years, and all 5 cases had taken normal diet without appreciable troubles after recovery from the acute stage of burn till the suspected onset of esophageal malignaney. Outstanding symptoms of this grave condition were rather acute progressive dysphagia and frequent episodes of esophageal foreign bodies, Diagnosis could be confirmed easily by endoscopic biopsy in suspected eases, and all were epidermoid carcinoma histopathologically. Curative resection of this condition was made in neither of the cases, and their prognoses were more grave than other esophageal malignancies in our experience. The development of esophageal carcinoma at the site of corrosive esophagitis with resulting benign stricture has now been suspected as a cause and effect relationship between these two conditions, and Kiviranta: stated that the incidence of esophageal cancer in patients with lye stricture of longer duration is a thousand times higher than normal population. During last one decade the authors experienced 5 cases of esophageal carcinoma developed at the site of lye stricture of the esophagus among about 350 cases of lye burned esophagus at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul, Korea. In Korea they still use lye as a detergent in rural area, and there are still many persons ingesting lye for suicidal attempt or on accident. Lye stricture of the esophagus is, therefore, the most common esophageal disease needing surgical procedures, and the authors believe that there will be much more eases of lye stricture complicated by esophageal eareinoma repoted in near future in this Country.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.71-77
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• 2021

Hypopharyngeal reconstruction is a surgically challenging procedure, and postoperative management is important due to a high rate of complications following surgery. In particular, stricture and fistula formation is the most common long-term postoperative complication. Through systematic review and meta-analysis of 21 studies, a significant radiation effect of stricture and fistula formation was found in patients who underwent hypopharyngeal reconstruction. The perioperative radiation must be seen as a critical factor for stricture and fistula formation in hypopharyngeal reconstruction.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.550-555
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• 1990

Since Steichen and Ravich`s pioneer work in 1972 proved that staples reduced anastomotic leaks and operative time, the use of EEA stapler`s in esophagogastrostomy have gained acceptance and popularity. But overriding these benefits are the high stricture rate, which leads to the reappearance of dysphagia. The mechanism for the development of stricture in stapled anastomosis is likely to be due to the lack of mucosa to mucosa apposition and presence of necrotic tissue between the luminal edge and the rows of the stapler. All strictures were easily dilated. Recently, we encountered a patient who suffered from an esophageal stricture that slowly developed 10 months after an esophagogastric anastomosis with a EEA 425 was performed due to severe muscular hypertrophy of esophagus. Because the stricture failed to respond to the Bougienage, we reoperated using a EEA 28 this time. We feel that this case review helps to show that despite the very low leakage rate in small size EEA stapler, there is also a very high risk of stricture.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1003-1009
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• 1996

Although esophagogastric (EG) anastomosis with a circular surgical stapler (EEA or ILS) is a safe find convenient proc dure with less anastomotic leakage, a concern for the anastomotic stricture still remains, especially in patients with small esophagus. We modified cervical EG anastomotic technique using straight thoracoscopic endostapler to prevent EG anastomotic stricture. Prospective clinical study was performed to determine the feasibility of our modification using Endo-GIA (US Surgical Corp., Worwalk), during the period from October, 1994 to July, 1995, in thirteen patients with carcinoma of the thoracic esophagus. A stomach tube was reanastomosed to the cervical esophagus utilizing a 30 mm Endo-GIA after esophagectomy and node dissection. There was one early mortality due to respiratory failure and pulmonary tuberculosis. Anastomotic leakage with resultant stricture was noticed in one patient, and it was re- lated to ischemic necrosis of the stomach tube. The overall incidence of stricture was 7.6 % (1113). During the 8 month follow-up period, the remaining 11 patients did not show any clinica evidence of stricture such as dysphagia. All patients were on a regular diet. We conclude that our new technique for cervical EG anastomosis with GIA-Endo stapler is a safe and convenient procedure in preventing anastomotic stricture.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1217-1221
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• 1998

Background: The advent of EEA stapler has lowered the leakage rate of esophagogastric anastomoses and thereby contributed to a decrease in the operative mortality of the easophageal resection. Recent surgical reports, however, have documented 10% to 20% prevalence of benign anastomotic stricture formation after the use of EEA stapler to construct an esophagogastric anastomosis. We analyzed the cases of anastomotic strictures to reduce the incidence of anastomotic strictures with EEA stapled esophagogastrostomy. Material and Method: EEA stapled esophagogastrostomy was performed in 195 parients during the period of over 11 years from Jan. 1986 to Dec. 1996 in Kosin Medical Center. Ten patients of them died in the early postoperative days. In the remaining 185 patients, we studied the incidence and the onset time of anastomotic strictures, relationship between the patients' ages, the anastomotic sites, and the size of the cartridges with incidence of anastomotic stricture. We also studied the method of treatment and its effect in the anastomotic strictures. Result: Benign anastomotic strictures occurred in 39 cases among 185 patients(21%), 25 cases(64.1%) of the 39 cases developed in one to three months postoperatively. The patients' ages and the anastomotic sites did not effect with the incidence of anastomotic stricture, but high incidence of anastomotic stricture in EEA stapled esophagogastrostomy(p=0.04)was observed in small cartridge sizes. One or two balloon dilatation(89%) relieved the anastomotic strictures. Conclusion: We conclude that a larger size cartridge is recommended in EEA stapled esophagogastrostomy to reduce the incidence of anastomotic stricture if possible, and one or two balloon dilatation would seem to be a safe and reliable method in treating anastomotic stricture when the anastomotic stricture was occurrs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.144-147
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• 1998

Isolated injury to the extrahepatic biliary tract following blunt abdominal trauma is rare, and there is little information especially in children regarding the endoscopic diagnosis and management of occult injury to the biliary tract. We experienced a 5-year-old boy who presented with jaundice 16 days after blunt abdominal trauma and was diagnosed as isolated distal common bile duct stricture by ultrasonography of abdomen. We could get more detailed information about the injury by endoscopic retrograde cholangiopancreatography. We could also manage this isolated common bile duct stricture successfully with endoscopic nasobiliary drainage and plastic stent insertion instead of surgical correction. There appeared to be no recurrence of stricture as evidenced by biochemical test and ultrasonography during 2 years of follow up.