• Journal of Chest Surgery
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• v.15 no.2
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• pp.188-193
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• 1982

Between 1967 and 1980, a total of 99 patients with a benign stricture of esophagus, resulting from a chemical burn, underwent a reconstructive procedure in which various segments of colon were used to bridge the gap between the cervical esophagus and the stomach. There were 42 males and 57 females and most were in their twenties and thirties. The most frequent site of the stricture was upper 1/3 of the thoracic esophagus [48.5%] and the next most common site was the low cervical esophagus [23.2%]. In 89 cases, the right colon with or without the terminal ileum was used as the conduit in an isoperistaltic manner and in 10, the left colon was used in an antiperistaltic position, because the right colon was not suitable as the conduit. There was a higher incidence of regurgitation [90% vs 0%], leakage at cervical anastomosis [80% vs 27%] and stenosis at anastomotic site [70% vs 15%] in an antiperistaltic left colon anastomosis, as compared to isoperistaltic right colon anastomosis. This was felt to be due to the orad peristaltic motion of the transplanted colon which acted as a functional obstruction distal to the esophagocolic suture line, resulting in breakdown of the anastomosis, leakage and eventual stenosis at the site of anastomosis. In conclusion, colon is useful and effective conduit as an esophageal substitute. Either the right or the left colon can be used for this purpose, provided that it is placed in an isoperistaltic position to minimize some of the complications listed above.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.82-84
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• 2014

We report a case with dysphagia for solids. A 51-year-old man with benign esophageal stricture was transferred for endoscopic treatment. He had lye ingestion history at 9 years old and underwent esophagectomy with right colonic interposition for the treatment of the benign esophageal stricture. But his symptom was acting up 2 years ago and lasted afterward even though he had underwent endoscopic treatments for dysphagia several times, including balloon dilation and stent insertion. He had polypoid enhancing wall thickening around anastomosis site of stomach with perigastric soft tissue density and suspicious nodular extension to omentum on the small bowel computed tomography. So he had a surgical resection of small bowel and jejunojejunostomy, and the pathological result was adenocarcinoma, intestinal type with soft tissue infiltration. Later he underwent total gastrectomy with segmental resection of interpositional colon and segmental resection of duodenum and ileo-colic anastomosis revision. And recently he has been on chemotherapy.

• Korean Journal of Radiology
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• v.23 no.9
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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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.4
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• pp.211-215
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• 2017

Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification). Mytomycin-C application needs to be further evaluated. Stenting was reported to be successful in some refractory cases.

• Journal of Chest Surgery
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• v.53 no.4
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• pp.222-225
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• 2020

Owing to varying clinical definitions of anastomotic stricture following esophageal reconstruction, its reported incidence rate varies from 10% to 56%. Strictures adversely impact patients' quality of life. Risk factors, such as the anastomosis method, leakage, ischemia, neoadjuvant chemoradiotherapy, and underlying disease have been mentioned, but conflicting information has been reported. Balloon dilation is regarded as a safe and effective treatment method for patients with benign anastomotic strictures. Reoperations are seldom required. The etiology and management of anastomotic strictures are reviewed in this article.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.672-674
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• 1996

Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.225-230
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• 1973

Five cases of esophageal cancer developed at the site of esophageal lye stricture were reported. Duration of lye stricture was between 13 and 40years, and all 5 cases had taken normal diet without appreciable troubles after recovery from the acute stage of burn till the suspected onset of esophageal malignaney. Outstanding symptoms of this grave condition were rather acute progressive dysphagia and frequent episodes of esophageal foreign bodies, Diagnosis could be confirmed easily by endoscopic biopsy in suspected eases, and all were epidermoid carcinoma histopathologically. Curative resection of this condition was made in neither of the cases, and their prognoses were more grave than other esophageal malignancies in our experience. The development of esophageal carcinoma at the site of corrosive esophagitis with resulting benign stricture has now been suspected as a cause and effect relationship between these two conditions, and Kiviranta: stated that the incidence of esophageal cancer in patients with lye stricture of longer duration is a thousand times higher than normal population. During last one decade the authors experienced 5 cases of esophageal carcinoma developed at the site of lye stricture of the esophagus among about 350 cases of lye burned esophagus at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul, Korea. In Korea they still use lye as a detergent in rural area, and there are still many persons ingesting lye for suicidal attempt or on accident. Lye stricture of the esophagus is, therefore, the most common esophageal disease needing surgical procedures, and the authors believe that there will be much more eases of lye stricture complicated by esophageal eareinoma repoted in near future in this Country.

• 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.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.85-89
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• 1995

The early esophgeal carcinoma is limited to the mucosa or submucosa without lymph node metastsis which shows good 5-years survival rate. It is nearly 85-90% nowadays,if we just find and manage it.It is really helpful to use the endoscope in management and diagnosis, in addition the biopsy under the endoscopic finding.We experienced one case of early esophageal carcinoma. The patient was 57years old female,who ingested lye 27years ago for suicidal attempt, after 10years, the dysphagia was aggravated slowly. Before admission dysphagia was severely aggravated during 2months. Confirmation of diagnosis was made by endoscopic biopsy.Operation method was substernal colon bypass and total esophagectomy through right thoracotomy. Postoperative course was smooth.We report early esophgeal carcinoma related to lye stricture that was detected by the method of endoscopic examination and biopsy. It is important to screen the patients with longstanding history of benign esophageal stricture by the endoscopic biopsy.

• 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.