Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Free Jejunal Transfer for Benign and Malignant Esophageal Disease -7 Cases Reports

유리 공장이식 술을 이용한 식도 질환의 외과적 치료

  • 신호승 (한림대학교 의과대학 흉부외과학) ;
  • 옥창석 (한림대학교 의과대학 흉부외과학)
  • Published : 1996.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Over the past two years the free jejunal transfer have been used in 7 consecutive patients to restore alimentary tract continuity artier the resection of esophagus. Six patients had squamous cell carcinomas and one had esophageal stricture . The patients underwent partial esophagectomy with modified radicAl neck dissection or mediastinal Iymph node dissection. The microvascular anastomosis was performed to the neck vessels in 4 patients and to the in ercostal vessels in 3 patients. Postoperative complications were graft necrosis in one patient, and a temporary anastomotic leakage with spontaneous closure in one patient. Reconstruction of the esophagus was successful in 6 of 7 patients. We emphasize that esophagectomy followed by transplantation of a free jejunal transfer is suitable for esophageal carcinoma or intractable esophageal stricture, and involvement of the midesophagus is not a contraindication to the use of the free Jejunal transfer.

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.

Keywords

References

  1. Ann Thorac Surg v.49 Surgery for high cervical esophageal carcinoma: experience with II patients Mansour,K.A.;Picone,A.L.;Coleman,J.J.III.
  2. Ann Surg v.205 Jejunal interposition for benign esophageal disease Wright,C.;Cuschieri,A.
  3. Ann Surg v.149 Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment Seidenberg,B.;Rosenak,S.S.;Hurwitt,E.S.;Som,M.L.
  4. N Engl J Med v.264 Replacement of the cervical esophagus and hypopharynx by a revascularized free jejunal autograft Roberts,R.E.;Douglass,F.M.
  5. Current therpy in Cardiothoracic surgery Free jejunal graft M.J.Jurkiewicz;Christian E.Paletta
  6. Am J Surg v.133 Modern management of anastomotic leak after esophagogastrectomy Wilson,S.E.;Stone,R.;Scully,M.;Ozeran,L.;Berfield,J.R.
  7. Ann thorac Surg v.56 Salvage of colon interposition by antethoracic free jejunal transfer Carsol,G.W.;Anderson,T.M.;Galloway,J.R.;Mansour,K.A.
  8. Ann Plastic Surg v.31 Microvascular reconstruction of the esophagus with pedicled small intestine Gorbunov,G.N.;Marinichev,V.L.;Volkow,O.N.(et al.)