• Title/Summary/Keyword: stricture

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Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures

  • Rashed, Yasser K.;El-Guindi, Mohamed
    • Clinical and Experimental Pediatrics
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    • v.62 no.10
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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.

Prepubic Urethrostomy for Surgical Correction of the Urethral Stricture and Rectourethral Fistula after Perineal Urethrostomy in a Cat (고양이에서 회음부 요도개구술 후 발생한 직장요도 루 및 요도 협착의 외과교정을 위한 치골 요도개구술 증례)

  • Heo, Su-Young;Lee, Hae-Beom;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.331-333
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    • 2012
  • A 2-year-old, castrated male domestic short-haired cat was presented with dysuria. The physical and radiographic examinations were revealed the urethral stricture and rectourethral fistula after perineal urethrostomy (PU). A prepubic urethrostomy was performed to resolve these problems. After the treatment, the cat had normal urination and complete wound healing without any complications. This is the first case report on co-occurrence of the urethral stricture and rectourethral fistula after PU in the cat.

Esophageal Stricture Secondary to Candidiasis in a Child with Glycogen Storage Disease 1b

  • Lee, Kyung Jae;Choi, Shin Jie;Kim, Woo Sun;Park, Sung-Sup;Moon, Jin Soo;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.1
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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.

Complications of endoscopic resection in the upper gastrointestinal tract

  • Takeshi Uozumi;Seiichiro Abe;Mai Ego Makiguchi;Satoru Nonaka;Haruhisa Suzuki;Shigetaka Yoshinaga;Yutaka Saito
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.409-422
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    • 2023
  • Endoscopic resection (ER) is widely utilized as a minimally invasive treatment for upper gastrointestinal tumors; however, complications could occur during and after the procedure. Post-ER mucosal defect leads to delayed perforation and bleeding; therefore, endoscopic closure methods (endoscopic hand-suturing, the endoloop and endoclip closure method, and over-the-scope clip method) and tissue shielding methods (polyglycolic acid sheets and fibrin glue) are developed to prevent these complications. During duodenal ER, complete closure of the mucosal defect significantly reduces delayed bleeding and should be performed. An extensive mucosal defect that comprises three-quarters of the circumference in the esophagus, gastric antrum, or cardia is a significant risk factor for post-ER stricture. Steroid therapy is considered the first-line option for the prevention of esophageal stricture, but its efficacy for gastric stricture remains unclear. Methods for the prevention and management of ER-related complications in the esophagus, stomach, and duodenum differ according to the organ; therefore, endoscopists should be familiar with ways of preventing and managing organ-specific complications.

Comparison of Had-Sewn and Mechanical Esophagogastric Anastomosis After Esophageal Resection for Cancer (식도암수술시 식도-위연결부 수기봉합과 기계봉합의 비교)

  • Shin, Jae-Seung;Choi, Young-Ho;Kim, Kwang-Taik;Hwang, Jae-Joon
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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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.

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End-to-End Anastomosis for Benign Esophageal Stricture-2 Cases (양성 식도협착에 대한 단단문합술 치험 2예)

  • Lee, Song-Am;Kim, Kwang-Taik;Son, Ho-Sung;Lee, Sung-Ho;Sun, Kyung;Kim, Tae-Sik;Kim, Yo-Han
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.617-621
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    • 2004
  • End-to-end anastomosis for benign esophageal stricture (BES) is technically easier and relatively lower in morbidity than esophago-enterostomy. We performed segmental resection and end-to-end anastomosis in 2 cases of short segmental BES who were failed repeated endoscopic dilatation. A 13-month-old female with postoperative stricture was treated successfully. However, a 27-year-old female with corrosive stricture required second operative management of esophago-colo-gastrostomy following end-to-end anastomosis. Our experiences suggested that end-to-end anastomosis for BES could be used as a valid procedure for well selected patients. However, further studty is needed to compare with esophago-enterostomy.

Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length

  • Lim, Geon Woo;Yu, Young Dong;Choi, Kyung Hwa;Rhee, Seung Ryeol;Park, Dong Soo;Hong, Young Kwon
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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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.

Surgical Management of the Ventricular septal Defect Complicating Myocardial Infarction -A Case Report- (심근경색에 합병된 심실중격결손증 1례 보고)

  • 최순호
    • Journal of Chest Surgery
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    • v.21 no.6
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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.

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A Case of Total Pharyngo-laryngo-esophagogastrectomy and Colon Transposition in a Patient with Esophageal Cancer following Partial Esophagectomy and Gastic Pull-up due to Esophageal Stricture (식도협착으로 식도부분절제술과 위간치술 후 발생한 식도암에서 시행한 전인두후두식도위적출술 및 대장치환술 치험 1예)

  • 왕수건;손봉형;이병주;이형렬
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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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.

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Clinical Experience of Stenotic Anastoma of Neck after Reconstuctive Surgery for Corrosive Esophageal Stricture (재수술을 요한 식도재건술 환자의 원인분석과 임상적 고찰)

  • 안욱수
    • Journal of Chest Surgery
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    • v.25 no.2
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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.

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