• Journal of Chest Surgery
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• 제22권3호
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• pp.514-517
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• 1989

Congenital esophageal stenosis is a rare disease in childhood. By virtue of its complex embryological development, the esophagus is the site of many congenital abnormalities. Congenital Esophageal stenosis is one tenth as rare as tracheoesophageal fistula with esophageal atresia and is very rare in the cervical esophagus, which mostly occurred below mid-esophagus. Congenital esophageal web may be caused by the resorption failure of the epithelium following the vacuolization stage in embryonic development in the esophagus. Recently, we experienced 1 cases of congenital esophageal web, as the symptoms of life-long dysphagia. According to her history of dysphagia, radiologic and clinical findings, her esophageal stenosis was considered as congenital. For dilatation and relief of dysphagia, she underwent the Heineke-Mikulicz type of esophagoplasty. The results of surgical treatment were relatively good without any clinical events. So we reported it with its literature review.

• Journal of Chest Surgery
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• 제28권10호
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• pp.939-941
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• 1995

Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis.A 19-month-old male was presented an appearence of underdevelopment and mild dehydration state due to persistent vomiting since 5 months after his birth. Esophagogram revealed an abrupt narrowing of lower esophagus with dilatation above it. The operation method was aesection of esohageal stenosis and end to end anastomosis through left seventh thoracotomy. The postoperative course was uneventful.

• 대한기관식도과학회지
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• 제16권1호
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• pp.64-67
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• 2010

Congenital esophageal stenosis due to tracheobronchial remnants is a rare anomaly, resulting in dysphagia and recurrent pneumonia, We have experienced three cases of csophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. Two patients were 20 months and five year old male with a chief complaints of swallowing difficulty from birth and the other was a twenty three year old female with a slowly increasing symptom of dysphagia for twenty years. Esophagogram of the patient with tracheobronchial remnants shows abrupt narrow segment at distal esophagus with marked proximal dilatation, and linear barium collections perpendicularly projecting from the stenotic esophagus. All of them were performed surgical correction by esophagectomy of the stenotic portion and esopahgo-gastrostomy with anti-reflux procedures, The resected specimens of these patients showed ectopic tracheobronchial chondroepithelial tissue within the esophageal wall histopathologically. Postoperative course was uneventful and have been in good condition without any problems.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.52-56
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• 2012

Congenital esophageal stenosis (CES) can be classified into three types based on the etiology of stenosis: tracheobronchial remnants (TBRs), fibromuscular hypertrophy (FMH), and membranous diaphragm (MD). It is important to make a differential diagnosis because the therapeutic plan for CES is determined by its etiology. Most cases of FMH and MD can be managed with balloon dilatation, whereas cases of TBRs require resection and anastomosis. Thus, the preoperative distinction of TBRs is critical. Recently miniprobe endoscopic ultrasonography (EUS) with a maximum diameter of 2.5 mm has been useful for distinguishing TBRs from FMH in pediatric patients with CES. EUS shows hyperechoic lesions indicating TBR cartilage. Miniprobe EUS is recommended for choosing the correct therapeutic method for CES. We report a case of CES due to TBRs in which a preoperative diagnosis was made in a child using miniprobe EUS without any difficulties.

• Advances in pediatric surgery
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• 제6권1호
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• pp.40-44
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• 2000

Congenital esophageal stenosis (CES) is a narrowing of the esophageal lumen from birth. Three types of CES have been described; tracheobronchial remnants (TBR), membranous web (MW), and fibromuscular stenosis (FMS). We reviewed the clinical features and the surgical outcome of 14 patients, pathologically confirmed as CES. Nine patients had TBR, 3 FMS, and 2 MVV. The mean age at operation was 3.8 years. Five patients were boys and 9 girls. Four patients had other congenital anomalies. Segmental resection of the lesion and end to end anastomosis was utilized in all cases except one who underwent myotomy. The stenotic segment was located at the distal esophagus in all patients. There were 8 complications in 6 patients, but no mortality. The mean follow-up period was 68 months. There were no feeding problems but 3 patients had minor gastroesophageal reflux. Our result indicates that segmental resection and anastomosis is a satisfactory surgical procedure in the management of CES.

• Advances in pediatric surgery
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• 제7권1호
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• pp.54-58
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• 2001

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

• Journal of Chest Surgery
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• 제29권4호
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• pp.466-471
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• 1996

기관식도루를 동반한 식도폐 쾌는 식도의 선천성 기 형중 흔한 형태로서 분만직후 이학적 검사상 간과 되는 것이 보통이다. 기관식도루를 동반한 식도폐쇄는 1696년에 Thomas Gibson이 처음 발표하였다. 본 원에서 4례의 선천성 하부기 관식도루를 동반한 식도폐쇄에서 우측 제 4늑간을 통하여 후흥막 접근법으 로 일차적 교정 술을 시 행하였다. 모든 환자에서 Haight 단단문합술을 시 행하였다. 수술후 2례의 환자에 서 문합부위의 심한 첩착소견을 보였고 1례의 환자에서 경한 협착소견을 보였다. 문합부위의 심한 협 착 이 있는i례의 환자에서 풍선식 식도확장술을시행하였다.

• Journal of Chest Surgery
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• 제16권2호
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• pp.231-242
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• 1983

A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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• pp.79-86
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• 2017

Purpose: Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES. Methods: A total of 31 patients underwent operations for CES were reviewed retrospectively. The patients were divided into two groups according to the association with EA-TEF, and compared the differences. Results: Sixteen boys and 15 girls were included. The mean age at symptom onset was 8 months old, and the mean age at diagnosis was 21 months old. Nine patients with EA-TEF were included group A, whereas the other 22 patients were assigned to group B. There were no differences in sex, gestational age, associated anomalies and pathologic results between the groups. In group A, the age at diagnosis and age at surgery were younger than in group B despite the age at symptom occurrence being similar. Postoperative complications occurred only in group A. Conclusion: In this study, symptoms occurred during the weaning period, and vomiting was the most frequent symptom. CES patients with EA-TEF tended to be diagnosed and treated earlier despite the age at symptom occurrence being similar. CES patients with EA-TEF had more postoperative complications; therefore, greater attention should be paid during the postoperative period.

• Journal of Chest Surgery
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• 제29권2호
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• pp.248-250
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• 1996

기관기관지 잔유조직에 의한 선천성 식도협착은 드문 질환으로 주로 중·하부 식도에 혼히 발생한다. 발생원인은 태생기 원시 전장에서 식도와 기도가 정상적인 분리를 못하여 식도벽내에 기관지 연골조직이 존재하며, 이로 인하여 연하곤란이 생후 직후부터 서서히 생기게 된다. 4세의 여아가 최근 2년간 악화된 연하곤란을 주소로 입원하였다. 식도이완 불능증의 진단하에 수술을 시행하였으며, 식도-위 경계부 상방 4cm부위에서 백색의 단단한 결절성의 종괴를 발견하였다. 수술은 종괴를 제거하고 식도의 확장 성형술을 시행하였으며, 술후 조직 소견상 기관연골과 기관지점 막 상피로 밝혀졌다.