• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.30-38
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• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.172-178
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• 1991

It is a rare case that fistula between the tracheobroncheal tree and the esophagus are cause by tuberculosis. We experienced the case of tuberculosis of the stomach with broncheoesophageai fistula, which was treated medically. Fiberoptic biopsy revealed tuberculous granuloma at esophagus and gastric cardia site. The patient had good response to antituberculous therapy with complete resolution without any surgical procedure.

• Journal of Gastric Cancer
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• v.21 no.2
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• pp.132-141
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• 2021

Purpose: Intracorporeal esophagojejunostomy during reduced-port gastrectomy for proximal gastric cancer is a technically challenging technique. No study has yet reported a robotic technique for anastomosis. Therefore, to address this gap, we describe our reduced-port technique and the short-term outcomes of intracorporeal esophagojejunostomy. Materials and Methods: We conducted a retrospective review of patients who underwent a totally robotic reduced-port total or proximal gastrectomy between August 2016 and March 2020. We used an infra-umbilical Single-Site^® port with two additional ports on both sides of the abdomen. To transect the esophagus, a 45-mm endolinear stapler was inserted via the right abdominal port. The common channel of the esophagojejunostomy was created between the apertures in the esophagus and proximal jejunum using a 45-mm linear stapler. The entry hole was closed with a 45-mm linear stapler or robot-sewn continuous suture. All anastomoses were performed without the aid of an assistant or placement of stay sutures. Results: Among the 40 patients, there were no conversions to open, laparoscopic, or conventional 5-port robotic surgery. The median operation time and blood loss were 254 min and 50 mL, respectively. The median number of retrieved lymph nodes was 40.5. The median time to first flatus, soft diet intake, and length of hospital stay were 3, 5, and 7 days, respectively. Three (7.5%) major complications, including two anastomosis-related complications and a case of small bowel obstruction, were treated with an endoscopic procedure and re-operation, respectively. No mortality occurred during the study period. Conclusions: Intracorporeal esophagojejunostomy during reduced-port gastrectomy can be safely performed and is feasible with acceptable surgical outcomes.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.531-535
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• 2007

The esophagus is a rate site for rarely involved site of tuberculosis. The most common cause of esophageal tuberculosis is secondary involvement from adjacent tuberculous lymphadenitis. Esophago-nodal or esophagobronchial fistulas may be formed when tuberculous lymph nodes erode the adjacent esophageal or bronchial wall. We report a patient diagnosed with esophageal tuberculosis, which was complicated by an esophago-mediastinal fistula, by endoscopy, sputum acid fast bacilli (AFB) stain, chest computed tomography (CT), and an esophagogram. The patient was treated with antituberculous agents and chest CT and endoscopy showed that the fistula had closed completely.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.278-282
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• 2012

An esophageal perforation following anterior cervical fusion is rare. Early development of an esophageal perforation after anterior cervical fusion is usually due to iatrogenic injury from retraction, injury associated with the original traumatic incident, improperly placed instruments or a bone graft. A 31-year-old man had a cervical dislocation and spinal cord injury because of severe cervical trauma after a traffic accident. He was quadriplegic and had no feeling below T4 dermatome. Anterior decompression of the cervical spine and anterior fusion with mesh with autobone were performed. An esophagocutaneous fistula occurred 7 days after anterior cervical surgery. A second anterior surgery was done because of pus drainage. The mesh was changed with an iliac bone graft, and the esophagocutaneous fistula site was primary repaired, but pus continued to drain. Conservative treatment, which consisted of wound drainage and intravenous administration of antibiotics, was tried, but was unsuccessful. After all, we removed the plate and screws, but did not removed the iliac bone graft, We closed the esophageal fistula, and transposed the sternocleidomastoid muscle flap to the interspace between the esophagus and the cervical spine. The wound to the esophagus was well repaired. In conclusion, precautionary measures are needed to avoid the complication, and adequate treatment is necessary to resolve those complications when they occur.

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.49-54
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• 2021

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer. Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients' age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated. Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups. Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1261-1266
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• 2012

Introduction: HPV has been found repeatedly in esophageal squamous cell carcinoma (ESCC) tissues. However, reported detection rates of HPV DNA in these tumors have varied markedly. Differences in detection methods, sample types, and geographic regions of sample origin have been suggested as potential causes of variation. We have reported that infection of HPV DNA in ESCC tumors depends on anatomical sites of esophagus of the patients from Mazandaran, north of Iran. Materials and Methods: HPV DNA was examined in 46 upper, 69 middle and 62 lower third anatomical sites of esophageal squamous cell carcinoma specimens collected from Mazandaran province in north Iran, near the Caspian Littoral as a region with high incidence of ESCC. HPV L1 DNA was detected using Qualitative Real time PCR and MY09/MY11 primers. Results: 28.3% of upper, 29% of middle and 25.8% of lower third of ESCC samples were positive for HPV DNA. 13.6% for males and 14.1% for females were HPV positive in all samples. Conclusions: HPV infection is about one third of ESCC in this area. Findings in this study increase the possibility that HPV is involved in esophageal carcinogenesis. Further investigation with a larger sample size is necessary.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.123-129
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• 1985

A retrospective analysis was undertaken of 46 patients who were referred with squamous cell carcinoma of the esophagus during the period of March 1979 through October 1982, and who were treated by curative radiotherapy in the Department of Therapeutic Radiology Seoul National University Hospital. The overall two-year actuarial survival rate was $20\%$ Survival was analyzed with respect to the site of the cancer, its size, radiation dose, and degree of response. Patients with the best two-year survival rate are the ones who had the tumor no of more than 5cm in length $(39.3\%)$ or confined to the upper third of the esophagus $(29.5\%)$. An optimum radiation dose ranged from 1600 to 1700 rets. Patients to complete response had $42.4\%$ of two-year actuarial survival, but those to no response had $0\%$ of survival.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.227-233
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• 1988

During the period between March 1979 and August 1986, 177 patients with carcinoma of the esophagus were treated with radiotherapy in the Department of Therapeutic Radiology, SNUH. Among these, 25 patients who had incomplete treatment were excluded. So a retrospective analysis was undertaken of 152 patients who were treated by curative radiotherapy. More than $80\%$ showed response: Complete remission $(22\%)$, partial remission $(63\%)$ and no response $(15\%)$. The overall two-year and five-year actuarial survival rate were $22.9\%\;and\;13.3\%$ respectively. Prognostic factor was analyzed by its site, size, T stage, and tumor response. Patients with the best five-year survival rate were those who had the tumor no more than 5cm in length $(17\%)$ or confined to the upper third of the esophagus $(20.6\%)$. Complete responders had $34.3\%$ of 5-year actuarial survival, but no responders had $0\%$ of survival.

• Korean Journal of Bronchoesophagology
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• v.10 no.1 s.19
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• pp.46-50
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• 2004

The majority of esophageal Foreign body ingestions occur in the pediatric population. In adults, true foreign object ingestion occurs more commonly among those with psychiatric disorders, mental impairment. The management of esophageal foreign bodies is influenced by the age, clinical condition of ingested material, anatomic location and technical abilities of the endoscopist. Recently the therapeutic endoscopy is becoming wider and more rational in application. We evaluated the role of endoscopy for removal of esophageal foreign bodies during the period of 4 years from January 2000 to December 2003 at the Department of Otolaryngology and Gastroenterology, Seonam University Hospital. The results were as follow, 1) The age ranged from 21 to 74 years old (mean 50.5), most frequent age group was between 61-70 years old and male to female ratio was 1:1.4. 2) Fish bone was the most frequent foreign body in the esophagus ($47.1\%$), food material ($23.5\%$) and meats ($17.6\%$) were next frequent foreign bodies. The most frequent site of lodgement was the first ($78.4\%$), second ($17.6\%$) and third narrowing ($3.9\%$) in order. 3) The most common symptom was foreign body sensation (28.6%). the next common symptoms were chest discomfort($23.8\%$) and dysphagia($19\%$). 4) In duration of lodgement, 49cases ($96.1\%$) were lodged for less than one day. 5) The foreign bodies of esophagus were removed successfully by flexible endoscope with basket, snare, forceps, overtube and endoscopic variceal ligation cap. There were only 3 cases of minimal complications, esophageal mucosal tearing. In conclusion, endoscopic esophageal foreign body removal is useful and safe with minimal or no complications.