• Title/Summary/Keyword: 식도 수술

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A Case of Long Segment Myomectomy for the Treatment of Esophageal Hemangioma (식도 근육 절제로 치료한 식도 혈관종 치험 1예)

  • 이현주;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.206-210
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    • 2003
  • Hemangiomas in the esophagus comprise less than 3% of all benign esophageal neoplasms. They are frequently small and easily treated with resection via either endoscopy or thoracotomy. We report a cavernous hemangioma occurred in the distal esophagus successfully treated with circumferential myomectomy.

Clinical Comparison of Complications Between Esophagogastrostomy and Jejunal Free Transfer After Resection of Thoracic Esophageal Cancer (흉부식도암 절제술 후 식도-위 문합술군과 유리공장이식술군간의 조기 합병증 비교)

  • 신호승;이재진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.843-847
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    • 2001
  • Background: Replacement of the esophagus remains a challenge for surgeons involved in esophageal disease. From 1996 to 1999, a total of 27 patients with esophageal cancer underwent free jejunal transfer(12cases) or esophagogastrostomy(15cases). To determine the results such as leakage of anastomosis site, stenosis, reflux esophagitis and operation time, respiratory complications, etc. we reviewed the 4 years experiences. Material and method: Palliative bypass surgery or esophageal prosthesis and cancers of the pharyngoesophageal or esophagogastric junction were excluded in this study. Resection was usually peformed through right thoracotomy and anastomosis was made with EEA staplers in esophagogas-trstomy. In cases of jejunal free transfer, 6cases of proximal esophagojejunostomy were stapled anastomosed and remaining 6 cases and all distal site were hand-sewn anastomosed. All reconstruction was done through posteromediastinal route. Result: There were two mortalities from thoracic esophagogastrostomy and one from jeunal free transfer. Major and minor complications(anastomosis site leakage: 3 cases, graft failure: 2cases etc) occurred in 27 cases. In 15 thoracic esophagogastrostomy cases, 11 patients had mild to moderate reflux esophagitis and 5 patients incurred stricture of the anastomosis. Operation time was about 550$\pm$280 minutes in jejunal free transfer, and about 300$\pm$ 160 minutes in esophagogastromy patients. Conclusion: Post operative reflux esophagitis and dysphagia were more frequent in Ivor-Lewis operation group than jejunal free transfer group; however, respiratory complications and operation time were significantly longer in jejunal (roe transfer group(p<0.05). To minimize the incidence of postoperative reflux esophagitis and dysphagia, patient evaluation focused on jejunal free transfer surgery is better than esophagogastrostomy followed by adequate post operative care.

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Esophagectomy with Operating Mediastinoscope (종격동경을 이용한 식도절제수술 -1례-)

  • 윤용한;이두연;이성수
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1110-1115
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    • 1998
  • Esophagectomy has a high morbidity rate, mainly related to pulmonary complications. The respiratory morbidity of open esophagectomy is high, ranging from 6% to 10%. This high morbidity is partially responsible for the 6∼15% mortality rate of esophagectomy. Many techniques of esophagectomy without thoracotomy have been described since the initial report of Orringer and Sloan. Endoscopic microsurgical dissection of the esophagus was clinically introduced in 1989. Endoscopic microsurgical dissection of the esophagus was developed as a minimally invasive procedure that avoids thoracotomy and provides precise vision during the operation in order to reduce mediastinal trauma and to improve the peri- and post-operative situation. A 20 year-old women who accidentally swallowed about 150 cc of glacial acetic acid underwent an esophagectomy using the operating mediastinoscopy, cervical esophagogastric anastomosis, pyloromyotomy, and feeding jejunostomy tube placement for esophageal stricture. The postoperative course was uneventful and the patient was discharged on the 17th postoperative day. Our clinical experience shows that endoscopic microsurgical dissection of esophagus is a safe and feasible method because it offers excellent optical control and enables the surgeon to operate in a minimally invasive manner.

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AN INTERESTING CASE OF ESOPHAGEAL FOREIGN BODY REMOVED BY EXTERNAL APPROACH (최근 경험한 식도이물의 수술적 적출 1례)

  • 박광헌;이양선;박종대;김용탁;마도훈
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.17.3-18
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    • 1987
  • 식도이물은 이비인후과영역에서 흔히 접하는 질환이며, 그 예는 국내외를 막론하고 대단히 많은 보고가 있는데, 그 종류도 다양하여 지역, 시기, 민족, 생활환경, 생활양식, 개인의 습관, 오락, 취미 등에 따라 각양각색이다. 대부분의 식도이물은 식도경하에서 적출이 가능하지만, 특별한 경우에는 외과적 수술에 의해서만 적출이 가능하다. 최근 저자들은 양고기 뼈(절단된 관절 연골부)가 식도 제삼 협착부에 수평으로 체류하여 식도 직달경 하에서 여러가지 감자로 적출을 시도하였으나 실패하여, 외과적 수술로 적출한 1례를 경험하여, 이에 문헌적 고찰과 함께 보고하는 바이다.

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Transhiatal Esophagectomy in Esophageal Cancer (식도암에서 경열공 식도절제술의 적용에 대한 고찰)

  • 박재길
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.773-778
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    • 2002
  • Surgery remains the main stay in the treatment of carcinoma of the esophagus and the results of surgery for esophageal cancer have improved over the past 10 years. The ideal operation for cancer of the esophagus should have good palliation, low morbidity and mortality, and optimize both long-term function and survival. The two main approaches currently used for surgical treatment of esophageal cancer are: transthoracic esophagectomy (TTE) and transhiatal esorhagectomy(THE). The advantages of THE are low morbidity and mortality, short operating time, a short hospital stay and low interference with respiratory physiology The selection criteria for this procedure may differ but there are two situations which could clearly benefit from THE; these are epithelial and superficial submucosal lesions, particularly in cases of multiple lesions, and any resectable tumor at any stage with poor clinical status. I reviewed the selection criteria, surgical procedures, and results of THE in esophageal cancer with the literatures.

Experience with a Safe Anastomotic Method for Ivor Lewis Operation (Ivor Lewis 수술 후 발생되는 문합 부위 합병증을 예방하기 위한 술식 평가)

  • Kim, Jeong-Won;Lee, Yong-Jik;Chang, Yong-Jin;Park, Chang-Ryul;Jung, Jong-Pil
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.625-629
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    • 2008
  • Background: When it comes to esophageal cancer operations, the prevalence of anastomotic complications that adversely affect quality of life is related to the type of anastomotic procedure and the operative site. We studied outcomes related to a safe anastomotic method used in Ivor Lewis esophagogastrectomy for preventing anastomotic leakage and stricture formation. Material and Method: Between May 2003 and April 2007, 18 patients with esophageal cancer underwent this type of esophagogastrectomy. Four people were lost to follow-up. There were 17 men (94.4%) and 1 woman. The mean patient age was 61 years (range, $46{\sim}73$ years). Result: The mean follow-up period was 17.2 months (range, $1{\sim}45$ months). There was no anastomotic leakage. There was one benign anastomotic stricture (5.6%) requiring esophageal balloon dilatation, which was accomplished with a 25 mm circular stapler. Conclusion: We experienced relatively good postoperative results using a safe anastomotic method in the Ivor lewis operation for preventing anastomotic complications. These results suggest that this anastomotic method is effective in reducing the incidence of benign anastomotic complications.

Battery Type Surgical Handpiece Using Brushless DC Motor Drive (배터리형 외과수술용 핸드피스 브러시리스 직류 전동기 구동 드라이브)

  • Yu, Jae-Sung;Park, Jong-Chan
    • Proceedings of the KIEE Conference
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    • 2007.11c
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    • pp.128-130
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    • 2007
  • 외과수술용 핸드피스는 현재 국내 외 병원에서 사용되고 있는 수술 장비 중 필수 보유 장비이다. 선진 수술 기법인 인공관절 대체 수술 시 뼈(Bone)절단, 다듬질 구멍 등, 초 섬세 가공을 목적으로 하는 기기이다. 기존의 공압식(Air Type)은 수술 시 많은 양의 질소(N2 Gas)가 소모됨으로써 질소탱크 보관에 많은 공간이 필요하고 잦은 교체를 필요로 한다. 또한 기계소음과 공압식 호스의 이동으로 시술자와 환자사이에 불편함이 발생하고 감염의 위험성이 있으므로 최근에는 충전식을 선호하고 있다. 이러한 이유로 기존의 공압식을 대체할 배터리형 외과수술용 핸드피스를 연구하게 되었다.

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Battery Type Surgical Handpiece Using Brushless DC Motor Drive (배터리형 외과수술용 핸드피스 브러시리스 직류 전동기 구동 드라이브)

  • Park, Sang-Hoon;Yoon, Yong-Ho;Lee, Byoung-Kuk;Won, Chung-Yuen;Jeon, Jae-Hong;An, Il-Sun
    • Proceedings of the Korean Institute of IIIuminating and Electrical Installation Engineers Conference
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    • 2006.05a
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    • pp.334-337
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    • 2006
  • 외과수술용 핸드피스는 현재 국내 외 병원에서 사용되고 있는 수술 장비 중 필수 보유 장비이다. 선진수술 기법인 인공관절대체수술 시 뼈(Bone) 절단, 다듬질, 구멍등 초섬세 가공을 목적으로 하는 기기이다. 기존의 공압식(Air Type)은 수술 시 많은 양의 질소(N2 Gas)가 소모됨으로써 질소탱크 보관에 많은 공간이 필요하고 잦은 교체를 필요로 한다. 또한 기계소음과 공압식 호스의 이동으로 시술자와 환자사이에 불편함이 발생하고 감염의 위험성이 있으므로 최근에는 충전식을 선호하고 있다. 이러한 이유로 기존의 공압식을 대체할 배터리형 외과수술용 핸드피스를 연구하게 되었다.

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Thoracoscopic Esophagectomy for Esophageal Cancer -One Case Report- (식도암에서의 흉강경 식도적출술 치험 1례)

  • Jeong, Jin-Yong;Yeon, Seong-Mo;Park, Kuhn;Kwack, Moon-Sub;Kwak, Seung-Soo
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.418-421
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    • 1998
  • Thoracoscopic esophagectomy can be performed in esophageal diseases to reduce the postoperative complications. Recently, We encountered a case of esophageal cancer and successfully treated it by thoracoscopic esophagectomy with gastric pull-up. A 59-year-old male was presented with swallowing difficulty and an esophagogram, esophagoscopy, and chest CT showed an ulcerating tumor on the lower esophagus. The operation was performed in three stages: mobilization of the esophagus by thoracoscopic surgery, construction of a gastric tube through a laparotomy, and cervical anastomosis between the esophagus and the gastric pull-through. Hoarseness developed postoperatively, and the postoperative esophagogram showed leakage at the esophagogastric anastomotic site. The anastomotic leakage was healed following surgical drainage and the patient was discharged in good health. Hoarseness subsided spontaneously two months after surgery.

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The Role of Surgery for the Treatment of Upper Esophageal Cancer (상부 식도암에서 수술적 치료의 유용성)

  • Park, Jae-Kil;Sa, Young-Jo;Nam, Sang-Yong;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.685-690
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    • 2007
  • Background: In the past, radiotherapy was the gold standard for the treatment of upper esophageal cancer, but the long-term follow-up was disappointing. There is still ongoing debate on the surgical management of these patients. This study was undertaker to update our experience with upper esophageal carcinoma and to evaluate the effectiveness of surgery. Material and Method: From May 1995 to December 2005, 147 patients with esophageal cancer underwent surgery at our hospital. They were divided into two groups: one group consisted of 23 patients with upper esophageal (cervical and upper thoracic) cancer and another group consisted of 424 patients with lower esophageal (middle thoracic, lower thoracic and abdominal) cancer. We evaluated the effectiveness of surgical treatment between the 2 groups by measuring the rate of complete surgical resection, the postoperative complications, the postoperative mortality, tumor recurrence, the average life expectancy and the long-term survival. Result: On comparing both groups, there was no significant difference in the distribution of the pathological stage and no significant difference in the percentage of performing complete surgical resection. The percentage of post-operative complications was 39.1% (9 out of 23 patients) in the upper esophageal cancer group, and this was significantly higher than 16.9% (21 out of 124 patients) in the lower esophageal cancer group (p<0.05). However, there was no significant statistical difference between the groups for the percentages of postoperative mortality, tumor recurrence or the postoperative average life expectancy. Conclusion: There was no significant difference in operative mortality or surgical effectiveness between the 2 groups. Therefore, we thought that surgical treatment is also effective for treating upper esophageal cancer, but further investigation with large patient populations will be required.