• 제목/요약/키워드: stricture

검색결과 272건 처리시간 0.031초

Percutaneous Transhepatic Treatment of Benign Bile Duct Strictures Using Retrievable Covered Stents: Long-Term Outcomes in 148 Patients

  • Byung Soo Im;Dong Il Gwon;Hee Ho Chu;Jin Hyoung Kim;Gi-Young Ko;Hyun-Ki Yoon
    • Korean Journal of Radiology
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    • 제23권9호
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    • pp.889-900
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    • 2022
  • Objective: To investigate the long-term outcomes of percutaneous treatment of benign biliary strictures using temporary placement of a retrievable expanded polytetrafluoroethylene (PTFE) covered stent. Materials and Methods: We retrospectively analyzed the outcomes of 148 patients (84 male and 64 female; age range, 11-92 years) who underwent percutaneous transhepatic placement and removal of a retrievable PTFE-covered stent for the treatment of benign biliary strictures between March 2007 and August 2019 through long-term follow-up. Ninety-two patients had treatment-naïve strictures and 56 had recurrent/refractory strictures. Results: Stent placement was technically successful in all 148 patients. The mean indwelling period of the stent was 2.4 months (median period, 2.3 months; range, 0.2-7.7 months). Stent migration, either early or late, occurred in 28 (18.9%) patients. Clinical success, defined as resolution of stricture after completing stent placement and removal, was achieved in 94.2% (131 of 139 patients). The overall complication rate was 15.5% (23 of 148 patients). During the mean follow-up of 60.2 months (median period, 52.7 months; range, 1.6-146.1 months), 37 patients had a recurrence of clinically significant strictures at 0.5-124.5 months after removal of biliary stent and catheter (median, 16.1 months). The primary patency rates at 1, 3, 5, 7, and 10 years after removal of biliary stent and catheter were 88.2%, 70.0%, 66.2%, 60.5%, and 54.5%, respectively. In the multivariable Cox proportional hazard regression analysis, sex, age, underlying disease, relation to surgery, stricture type, biliary stones, history of previous treatment, and stricture site were not significantly associated with the primary patency. Conclusion: Long-term outcomes suggest that percutaneous treatment of benign biliary strictures using temporary placement of retrievable PTFE-covered stents may be a clinically effective method.

식도확장술 후 발생한 식도천공의 식도 열공을 통한 식도적출술 치험 1례 (Transhiatal Esophagectomy after Instrumental Esophageal Perforation)

  • 정일영
    • Journal of Chest Surgery
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    • 제27권8호
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    • pp.714-716
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    • 1994
  • Perforation of the esophagus, with any of its possible consequences, consetitutes an emergeny. We are reporting one case of transhiatal esophagectomy with esophagogastrostomy. The cause of esophageal perforation was baloon dilatation with underlying stricture. We recognized immediately intrathoracic perforation through routin check of Chest PA and confrormed dye leakage through esophagogram. She underwent emergency operation.

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운동이 뇌 혈류 변화에 미치는 영향 (Effect of Exercises on the Cerebral Blood Flow)

  • 송명수;최수희
    • 대한임상전기생리학회지
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    • 제1권2호
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    • pp.1-9
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    • 2003
  • The purpose of this study was to analyze the effect given to the variable details which disturb the flow of blood in brain artery disease through Aerobic exercises. It chose the subjects of study : 5 persons in an exercise group and 5 persons in a non-exercise group. Peak brain blood velocity, mean velocity, and resistance & artery stricture ratio were measured with TCD, measure machine for brain artery blood flow. The conclusion of the study was as follows: 1. At pre-test of an exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed much lower in the variation of left common carotid artery(LCCA). 2. At post-test of an aerobic exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed just a little decrease ratio but were not significant different in the variation of left common carotid artery(LCCA). Viewing on the base of these result, continuing exercises promote the functional improvement of the heart blood system and were showed the positive variation of artery stricture ratio according to brain blood flow velocity, the pulse and resistance or blood velocity. Therefore programs for prescriptions through aerobic exercises must be developed in many ways.

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식도 질환의 외과적 치료 (Surgical Treatment of Esophageal Disease)

  • 우석정
    • Journal of Chest Surgery
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    • 제26권8호
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    • pp.627-632
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    • 1993
  • A clinical study was performed on 64 cases of the esophageal diseases experienced at the Department of Thoracic & Cardiovascular Surgery of Kyungpook University Hospital from Jan. 1988 through Dec. 1992. The results were as follows: The most common esophageal disease was cancer which occurred in 37.5% of the total. In esophageal cancer patients, 24 cases were operated on and cancer resection was feasible in 19 cases with 2 cases of hospital death. The overall 1 year survival rate was 41.6% and the most favorable follow up result was revealed in stage I group. Esophageal stricture occurred in 22 cases and its causes were alkali and acid. The most common stricture site was mid-esphagus. Colon interposition was performed on 15 cases. Achalasia occured in 8 cases and was treated with modified Heller`s myotomy. Esophageal perforation occurred in 6 cases and its operative mortality rate was 16.6%. Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case, which occurred in an adult, is of Braimbridge,s typeII classification. The second one which occured in an child with sequestration, is of Braimbridge,s type IV classification. Diverticulectomy was performed in 1 case of esophageal diverticulum. Enucleation of tumor was performed in 1 case of esophageal leiomyoma.

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식도 Achalasia 에 대한 재수 (Reoperation after esophagomyotomy for achalasia of the esophagus: report of 3 cases)

  • 유회성;남충희;박국양
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.792-795
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    • 1984
  • The modified Hellers myotomy for esophageal achalasia is known as the best procedure. A properly performed transthoracic esophagomyotomy is essential to prevent complications. But it has some problems such as persistent achalasia due to inadequate myotomy, recurrence due to the healing of myotomy and reflux esophagitis due to destruction of the lower esophageal sphincter. The methods of the reoperation after esophagomyotomy for achalasia of the esophagus consist of 1 ] for persistent achalasia due to inadequate myotomy, additional myotomy feasible. 2] for esophageal reflux, a long-limb jejunal gastric drainage after vagotomy and hemigastrectomy, jejunal after conservative resection for stricture. We experienced 3 cases of reoperation after esophagomyotomy for achalasia of the esophagus. The 1st and 3rd case belongs to 30 cases which were undertaken the primary operation at the National Medical Center from 1961 to 1984. The 2nd case was undertaken the primary operation at other hospital. The 1st and 3rd case were reoperated because of persistent achalasia due to inadequate myotomy and 2rid case was caused by stricture due to reflux esophagitis. The methods of the reoperation were additional myotomy in 1st case, esophagogastrectomy and lower thoracic esophagogastrostomy in 2nd case, and esophagogastrectomy and mid-thoracic esophagogastrostomy in 3rd case. All three cases were complicated with postoperative reflux esophagitis.

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선천성 식도 폐쇄 환자에서 출생 후 위루관 삽입술과 계속적인 금식상태에서 근본수술 후 발생한 비후성 유문 협착증 - 1예 보고 - (Hypertrophic Pyloric Stenosis Occurring in Fasting State with Gastrostomy After Surgery for Esophageal Atresia with Tracheoesophageal Fistula)

  • 정은영;최순옥;박우현
    • Advances in pediatric surgery
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    • 제17권1호
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    • pp.88-92
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    • 2011
  • The onset of hypertrophic pyloric stenosis in the postoperative course of esophageal atresia with tracheoesophageal fistula is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed since birth. The infant presented with an increased amount of orogastric tube drainage and consistently distended gastric air on simple abdominal X-ray. Abdominal ultrasonography showed hypertrophic thick pyloric muscle. The diagnosis of pyloric stenosis was confirmed d is rarely reported. The diagnosis could be delayed due to its mimicking symptoms of other postoperative complications including gastroesophageal reflux or anastomotic stricture. We present an infant who had surgery for esophageal atresia with tracheoesophageal fistula. He had never fed. The infant presented with uring surgery, After pyloromyotomy, the patient's condition improved.

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A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

  • Yoo, Kun-Woon;Shin, Hyun-Woo;Lee, Hye-Kyung
    • Archives of Plastic Surgery
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    • 제39권3호
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    • pp.253-256
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    • 2012
  • A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP) flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료 (Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • 제29권6호
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    • pp.672-674
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    • 1996
  • 유미흉은드물지만 심장수술,횡격막의 식도,대동맥 열공 부위의 수술합병증으로잘알려졌다. 특히 식도의 양성 또는 악성 종양에서 식도제거술이 필요한 영양 결핍상태의 환자에서 유미흥은호흘기능, 영양상태, 면역학적 인 면에서 치사율이 높은 위 험한 질병 이다. 본교실에서는 식도헙착 환자에서 식도열공을 통한 식도 제거술후 발생한 유미흥 1례를 경험하였다. 유미홍의 진단은 공장루를 통한 영양공급후 흥막 삼출액의 변화와 술후 5일째 흉막액의 Triglyceride 치의 증가로 진단하였다. 금식 상태에서도 하루 1500내지 2000cc의 유미삼출액이 배액되어 13일째 우 측 개흉술을 통해 횡격막 상부 흉관 결찰을 시 행하였으며, 좋은 결과를 얻을 수 있었다.

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유리 공장이식 술을 이용한 식도 질환의 외과적 치료 (Free Jejunal Transfer for Benign and Malignant Esophageal Disease -7 Cases Reports)

  • 신호승;옥창석
    • Journal of Chest Surgery
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    • 제29권12호
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    • pp.1392-1397
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    • 1996
  • 지난 2년동안 식도암 환자 6례, 식도협착 환자 1례에서 식도절제술후 유리공장 이식수술을 시행하였다. 환자들은 부분 식도절제술과 함께 기능적 경부청소술 또는 종격동 임파절 절개을 시행하였다. 유리공장이식술은 대개 경부식도 질환에서 경부혈관을 이용하여 시행되어 왔으나, 저자들은 늑간동정맥을 이용하여 3례 에서 공장이식을 하였다. 수술후유증은 이식괴사 1례, 문합부 누출 1례 였다. 유리공장이식술은7명의 환자중6명의 환자에서 성공하였가. 늑간동정 맥을 이용하면 흉부 식도 질환에서도 유리공장이식술을 할수 있으며, 5명의 환자는 현재 추적관찰 중이다.

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