• Archives of Plastic Surgery
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• v.39 no.3
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• pp.257-260
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• 2012

This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia), and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.5.3-5
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• 1983

Esophageal stricture due to various caustic agents has led to decrease markedly with the improvement of the way of life and socioenvironmental change, and can be prevented with adequate procedure and management. However, there are still sporadic incidents of esophageal stricture due to inadequate treatment and uncooperation of patients. Esophageal stricture was treated with various kinds of bougies ; peroral esophagoscopic bougie, Hurst or Maloney type weighted bougie, endless bougie, retrograde esophageal bougie and open surgery. Recently the authors had experienced a case of severe esophageal stricture after ingestion of HCl, which was treated by gastrostomy and endless bougienage with good result.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.252-256
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• 2004

Purpose: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. Materials and Methods: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. Results: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3：1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in $14\%$ (32/228) of the total gastrectomy cases, in$15.9\%$ (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in $13.2\%$ (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases ($12.5\%$) and 25 of the remaining 172 cases ($14.5\%$) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. Conclusion: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1233-1237
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• 1990

When the perforation of intrathoracic esophagus occurs in the presence of preexisting esophageal stricture, aggressive and definitive therapy often provides the only chance for patient salvage. Two adults suffering from intrathoracic esophageal perforation with underlying stricture underwent transhiatal esophagectomy. The perforations were due to esophageal instrumentation. Restoration of alimentary continuity with a primary cervical pharyngogastric anastomosis was carried out in one patient. Another patient underwent a cervical esophagostomy and had a subsequent colonic interposition 3 months later.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.107-114
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• 1990

During a ten-year period from August, 1978 to September, 1989 45 patients with benign esophageal stricture were surgically evaluated. The results are as follows; l. Out of 45 patients, there were 26 males and 19 females ranging from 2 to 70 years of age with a mean of 31.9 years. 2. The most common cause of benign esophageal stricture was corrosive burn due to caustic agents[40 cases, 88.9 %]. Corrosive agents were 15 cases of lye, 22 cases of acid and 3 cases of other agents. Other causes were two cases of esophageal web and each one case of previous surgical result, inflammation and idiopathic mediastinal fibrosis respectively. 3. The most frequent stricture site was whole esophagus as 21 cases[46.7 %] and the next was lower a third thoracic esophagus[10 cases, 25.0%]. 4. In 33 of total 45 cases, colon interposition with right colon was performed without resection of the strictured esophagus except one case which was complicated esophageal cancer. Other procedures were 4 cases esophagogastrostomy with segmental resection, 2 cases of plastic repair and so on. 5. Major postoperative complications which were needed for secondary operation were 5 cases[11.1 %]. [2 cases of stenosis, ileus and ulcer bleeding respectively] Overall mortality rate was 4.4 %.

• Korean Journal of Veterinary Service
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• v.24 no.4
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• pp.375-377
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• 2001

Rectal stricture occurred in 2 finishing pigs submitted for necropsy from Moguchon, the meat processing plant, chonbuk. Grossly, the wall of the rectum was harden and thickened by fibrous tissue. Anteriro to the stricture, the descending colon was dilated up to 30cm in diameter, filled with gas and pasty green fluidal feces. Histologically, the epithelia of rectal mucosa were necrotized. The mucosa and submucosa of rectum were infiltrated by macrophages, eosinophils and lymphocytes. This infiltration was the most extensive in the deeper layer of submucosa and intensive fibrosis was observed in deeper submucosa layer. This case is report for rectal stricture of finishing pig.

• Journal of Veterinary Clinics
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• v.33 no.2
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• pp.129-130
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• 2016

A 5-year-old male Laika dog was referred with chief complaint of dyschezia and tenesmus. The dog had rectal prolapse and it was corrected with rectal resection and anastomosis, a year ago. On rectal examination, the stricture of rectum was identified. The irregular scar tissues on serosal and muscular layers of rectum were noted and they were dispersed with partial thickness incision around rectum. Then, the colopexy and mechanical dilation with balloon catheter were applied. No recurrence of rectal prolapse and other complications were noted during follow up periods of 1 year. This report described a successfully corrected anastomotic rectal stricture in a dog.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1032-1037
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• 1995

Between September 1988 and December 1993, 32 cases of benign esophageal stricture, of which 12 males and 20 females, were managed in Seoul National University Hospital hospital. Their age ranged from 2 to 61 years, and the mean age was 33.9 years. The ingestion of caustic agent was the most common cause, and the caustic material was acid in 16 patients [58% and alkali in 11patients [39% . Nearly all of the patients complained of dysphagia, and some of chest pain, epigastric pain, weight loss, vomiting, general malaise, and dyspnea. The most frequent site of stricture was found in the upper thoracic esophagus with 34% incidence followed by the lower thoracic esophagus[28% , whole esophagus[19% , and the mid esophagus[16% . The operations performed were 17[53% ECG[esophagocologastrostomy , 5[16% PCG[pharyngocologastrostomy , 5[16% EG[esophagogastrostomy , 2 EJG [esophagojejunogastrostormy by free jejunal graft , and 1 case each of EJ [esophagojejunostomy , esophageal end to end anastomosis, jejunostomy only, and gastrostomy only. In 23 patients [72% , diseased esophaguses were resected, using transhiatal total esophagectomy in 15 [47% and transthoracic partial esophagectomy in 8 [25% . Of those 23 patients, 3 patients [9.4% were diagnosed as esophageal carsinoma on microscopic examination. The postoperative most common complications were unilateral vocal cord palsy in 6 patients [19% , followed by cervical anastomosis leakage in 4 patients [12.5% , wound infection in 2 patients [6% , and pneumothorax in 2 patients [6% . Late death occurred 8 months after the operation in one patient, which was associated with infection due to anastomotic leakage. Our experience shows that the rate of mortality and the morbidity were low in patients receiving surgical management for esophageal stricture and that the cancer transformation rate was high. We recommend esophageal reconstruction surgery with esophagectomy [transhiatal or transthoracic for the esophageal stricture because it can avoid a chance of prevent cancer transformation.

• Journal of Chest Surgery
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• v.16 no.4
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• pp.584-593
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• 1983

Esophageal reconstruction was performed in 344 patients with irreversible stricture of the esophagus resulting from caustic burns at National Medical Center from 1959 to 1982.There were 113 males and 231 females, and ranging from 2.5 to 58 years of age, and mean age was 26.5 years, and 25 cases were less than 10 years old. Caustic materials were 286 [83.2%] alkali and 50[14.5%] acid. The most frequent stricture site was upper thoracic esophagus as 56.7%, and the next was cervical as 31.4%, and lower, 11.9%. The stomach was involved in 10.8% totally, and hypopharyngeal stricture was also noticed in 3.2%, and in 3 cases, hypopharyngeal reconstruction was needed due to extensive scar change. In 329 of total 344 cases, colon interposition was performed without resection of the strictured esophagus except 4 cases which were complicated T-E fistula or perforation, and most of them, about 10-15 cm of terminal ileum with right half of the colon was used as the graft. The left colon with anti-peristalsis was used as graft only in 30 cases. The most common postoperative complication was anastomotic leak as 16.7% of total cases, and it was 12.5% from neck, 3.3% from ileocolostoma and 0.9% from cologastrostoma. Next common complication was neck stenosis [8.8%], aspiration pneumonia [6.4%], and graft necrosis [3.9%] in order. Overall operative mortality was 5.5% [14/329], and main causes of death were graft necrosis, sepsis due to anastomotic leak, gastric bleeding, and intestinal obstruction. Besides of colon interposition, according to shape or level of the stricture, plastic repair or segmental resection and direct anastomosis was done in 9, and 1 of them were complicated stenosis at the anastomotic site. In lower stricture, esophagogastrostomy was done in 10 cases, and 1 case expired due to hepatitis, and anastomotic stenosis was occurred in 2 cases at 1.5 months and 2.4 years later. During follow-up of 298 cases colon interposition from 6 months to 22 years, 82.6% was excellent, and 2.9% was complained of mild discomfort, and 4 cases were dead laterly, but 3 of them were not related to reconstruction.

• Korean Journal of Bronchoesophagology
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• v.15 no.1
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• pp.35-40
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• 2009

Background: Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients raBackground Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients ranging from 29 to 69 years of age. The complication was two anastomosis site leakage, one gastric necrosis and one mortality due to bowel strangulation and sepsis. Conclusion: Transhiatal esophagectomy and intracervical esophagogastrostomy is safety and useful method at selection case even though corrosive esophageal resection is debated.