• Title/Summary/Keyword: Esophageal

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Clinical Evaluation of Radionuclide Esophageal Transit Studies using Liquid and Solid Foods (유동식 및 고형식을 이용한 동위원소 식도통과검사의 임상적 의의에 대한 연구)

  • Choe, Jae-Gol;Lee, Min-Jae;Song, Chi-Wook;Hyun, Jin-Hai;Suh, Won-Hyuck
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.61-72
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    • 1995
  • The author performed radionuclide esophageal transit studies(RETS) with liquid and solid boluses using the same day protocol in 90 normal controls and 164 patients with various primary esophageal motility disorders who were diagnosed by manometric criteria and clinical courses. The authors calculated mean esophageal transit time(MTT) and mean residual retention(MRR) in each of the liquid and solid studies, and classified time-activity curve(TAC) patterns. The normal criteria of RETS with liquid bolus were MTT<24 sec, MRR<9%, and the TAC pattern that showed rapid declining slope and flat low residual(Type 1). The normal criteria of RETS with solid bolus were MTT<35 sec, MRR<9% and TAC of type 1. With these normal criteria, the sensitivity and the specificity of the liquid study were 62.2 % and 97.8%, respectively. The sensitivity increased to 75.4% with the solid study. The author also found that the RETS was highly reproducible. The achalasia typically showed no effective emptying of both liquid and solid boluses during the whole study period, and was well differentiated by its extremely long transit time and high retention from the other motility disorders. The diffuse esophageal spasm (DES) and nonspecific esophageal motility disorder(NEMD) showed intermediate delay in transit time and increased retention. In the groups of hypertensive lower esophageal sphincter(LES), hypotensive LES and nutcracker, there noted no significant difference with the normal control group in terms of MTT and MRR. The DES and NEMD could be more easily identified by solid studies that showed more marked delay in MTT and increased MRR as compared with the liquid study. In conclusion, esophageal scintigraphy is a safe, noninvasive and physiologic method for the evaluation of esophageal emptying.

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Result of Secondary Surgery after Primary Surgery for Esophageal Atresia Anomalies (선천성 식도 폐쇄 수술 후 시행한 재 수술의 성적)

  • Im, Soo-Chan;Moon, Suk-Bae;Jung, Sung-Eun;Lee, Seong-Cheol;Park, Kwi-Won
    • Advances in pediatric surgery
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    • v.13 no.2
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    • pp.105-111
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    • 2007
  • We reviewed the records of 25 patients who were re-operated upon after primary repair of esophageal atresia with or without fistula at the Department of Pediatric Surgery, Seoul National University Children's Hospital, from January 1997 to March 2007. Types of the esophageal atresia anomalies were Gross type A in 5 patients, C in 18, and E in 2. The indications for re-operation were anastomosis stricture (n = 14), tracheo-bronchial remnant (n = 4), persistent anastomosis leakage (n = 3), recurrent tracheo-esophageal fistula (n = 2) and esophageal web (n = 2). The interval between primary and secondary surgery was from 48 days to 26 years 5 months (mean: 2 years and 4 months). Four patients required a third operation. The interval between the second and third operation was between 1 year 1 month and 3 year 10 month (mean: 2 years 5 months). Mean follow up period after last operation was 35 months (1 years-8 years 6 months). The secondary surgery was end-to-end esophageal anastomosis in 15, esophagoplasty in 5, gastric tube replacement in 5. After secondary operation, 6 patients had anastomosis stricture (4 patients were relieved of the symptoms by balloon dilatation, 2 patients underwent tertiary operation). Five patients had leakage (sealed on conservative management in all). Two patients had recurrent tracheo-esophagel fistula (1 patient received chemical cauterization and 1 patient underwent tertiary operation). Currently, only one patient has feeding problems. There were no mortalities. Secondary esophageal surgery after primary surgery for esophageal atresia was effective and safe, should be positively considered when complications do not respond to nonoperative therapy.

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Treatment of Corrosive Esophageal Stricture by Transhiatal Esophagectomy and Esophagogastrostomy (경열공 식도절제술을 이용한 부식성 식도협착증의 치료)

  • Kim, Jae-Bum;Park, Chang-Kwon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.35-40
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    • 2009
  • Background: Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients raBackground Surgical treatment of corrosive esophageal stricture with colon interposition was very widely used. The colon interposition advantage is low reflux esophagitis risk and preservation of gastric capacity and peristalsis. This procedure was introduced by Orsoni and much improved. But, if stomach injury was minimal, gastric interposition is useful due to simple technique and low complication. Material and Method: Esophageal reconstruction by the transhiatal esophagectomy and intracervical esophagogastrostomy was done in 7 patients of corrosive esophageal stricture at Dong-San medical center from January 1998 to December 2007. Result: There were six female and one male patients ranging from 29 to 69 years of age. The complication was two anastomosis site leakage, one gastric necrosis and one mortality due to bowel strangulation and sepsis. Conclusion: Transhiatal esophagectomy and intracervical esophagogastrostomy is safety and useful method at selection case even though corrosive esophageal resection is debated.

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Glutathione-S-Transferase T1 Polymorphism is Associated with Esophageal Cancer Risk in Chinese Han Population

  • Weng, Yuan;Fei, Bojian;He, Ping;Cai, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4403-4407
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    • 2012
  • Background: Glutathione-S-Transferase T1 (GSTT1) gene has been shown to be involved in the development of esophageal cancer. However, the results have been inconsistent. In this study, the authors performed a meta-analysis to clarify the association between GSTT1 polymorphism and esophageal cancer risk among Chinese Han population. Methods: Published literature from PubMed, the China National Knowledge Infrastructure and Wanfang Data were searched. Pooled odds ratio (OR) and 95% confidence interval (95%CI) was calculated using a fixed- or random-effects model. Results: Eleven studies with a total of 2779 individuals were included in the meta-analysis. The results showed that GSTT1 null genotype was significantly associated with esophageal cancer risk in Chinese (OR = 1.31, 95%CI 1.12 to 1.53, p = 0.001). Further sensitivity analyses confirmed the significant association. The cumulative meta-analysis showed a trend of an obvious association between GSTT1 null genotype and esophageal cancer risk as information accumulated by year. Conclusions: This meta-analysis suggests a significant association of GSTT1 null genotype with esophageal cancer risk in the Chinese Han population.

Clinical Analysis of Esophageal Carcinoma (식도암의 임상적 고찰)

  • 임종수
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.122-127
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    • 1990
  • The management of esophageal carcinoma continues to be a difficult problem with most surgically treated patients under-going extensive operative procedures for palliation only. Although recent advances in preoperative and postoperative care have decreased the operative mortality rate, survival has not changed significantly. Twenty five patients with esophageal carcinoma who were treated with operative intervention at the Department of Thoracic and Cardiovascular Surgery in Kyung Hee University Hospital between January, 1980 and December, 1987 had been evaluated clinical manifestation and operative results. The stamm typed feeding gastrostomy and Celestin tube insertion were performed for the cases of nonresectable esophageal cancer. Also 14 cases with esophagogastrostomy and are case with esophagocologastrostomy were performed for the resectable cases. Two deaths with resectable cases occurred within 30days of operation, a hospital death rate of 8 per cent. There were significant differences in the survival rate between T.N.M. staging I, II, and III, IV group after the resection of the esophageal cancer. The former group revealed higher one year survival rate than the later group. [p< 0.05]. In conclusion, the clinical manifestations and operative results were similar to the western ones and the postoperative survival rate was very poor. So, the earlier the operation of the esophageal cancer was done, the better result will be achieved. To defect the early esophageal cancer; routine esophagoscopy should be recommended.

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Treatments of esophageal foreign body treated using Rigid esophagoscopy (강직형식도경술을 이용하여 치료한 이물에 대한 임상적 고찰)

  • Chung, Phil-Sang;Jung, Seung-Wan;Kim, Yun-Hwan
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.159-163
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    • 1999
  • OBJECTIVE : To study the management (diagnostic and therapeutic) of esophageal foreign bodies with rigid esophagoscopy. MATERIAL AND METHODS : All 100 patients admitted to the Dankook University Hospital for ingestion of foreign bodies between May 1994 and July 1999. The outcome for each patient was determined by examining hospital records of demographic information, identification of the foreign body and the removal procedure used. RESULTS : Rigid esophagoscopy was performed for suspected foreign bodies in 100 cases an impacted. The most frequent location was the upper third of the esophagus (68%). The most common type of foreign body was fish bones in adult(61%) and coins in children(70%). In 12 patients. flexible endoscopy had failed previously to remove the foreign body and 4 cases were migrated esophageal metal stent in esophageal stenosis. CONCLUSIONS : The rigid esophagoscopy is appropriate techniques for managing esophageal foreign bodies.

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Clinical and Histo-Pathological Analysis for Recurrence after Curative Surgery of Esophageal Cancer (식도암의 근치적 절제술 후 재발에 대한 임상적 및 병리조직학적 분석)

  • 박재길;이재광;곽문섭
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.570-575
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    • 2000
  • Background; Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. Material and Method; A retrospective review of recurrent patte군 of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. Result; Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. Conclusion; Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.

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Esophageal Stent Insertion at the Esophagogastrostomy Site Stenosis - Report of 3 cases - (식도 재건술후 발생한 식도-위 문합부 협착의 식도스텐트를 이용한 치험 -3례 -)

  • 정성철;배윤숙;유환국;정승혁;이정호;김병열;이명준
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.55-58
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    • 2003
  • Although postanastomosis of esophageal reconstruction is rare but it is a very unwelcome complication. Previously, the problem was solved by balloon dilatation, reoperation, and feeding jejunostomy. However, balloon dilatation is not effective because of high recurrence rate, reoperation is difficult due to its operative approachableness and also jejunostomy is inconvenient for patients. Therefore, we inserted esophageal stent as a method of relieving postanastomosis stenosis, From Jan, 2001 to Dec, 2001, there were three patients with postanastomosis stenosis, who received esophageal stent insertion, one had case is benign esophageal stenosis, two had esophageal carcinoma. We followed up them over 12 months after inserting the stent, Dysphagia was improved, so we report that the clinical performance was satisfactory

Physical Therapy for Esophageal Cancer Patient With Long Thoracic Neuropathy After Esophagectomy: A Case Report

  • Do, Junghwa;Lim, One-bin;Kim, Ja-young;Jeon, Jae Yong;Cho, Young-ki
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.220-226
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    • 2020
  • Esophageal cancer is a representative cancer that occur physical deterioration but, physical problems after surgery were not well reported. The purpose of this study is to report on the long thoracic neuropathy after surgery, and to identify the symptoms and effects of physical therapy after esophageal cancer surgery. This is a case of a 61-year-old man who showed winging of the scapula with long thoracic nerve injury on the results of electromyography after an esophageal cancer surgery. Physical therapy programs were implemented 8 sessions during hospitalization. The quality of life, fatigue, shoulder range of motion (ROM), numeric rating scale (NRS), 6-minute walk test, and 30-second chair stand test were assessed. The quality of life, fatigue, shoulder ROM, NRS (pain), 6-minute walk test, and 30-second chair stand test were improved. However, the esophageal-specific symptom was not different after physical therapy program. As esophageal cancer suffers from physical difficulties after surgery, physical therapy programs are thought to be helpful.

Spectral and Cepstral Analyses of Esophageal Speakers (식도발성화자 음성의 spectral & cepstral 분석)

  • Shim, Hee-Jeong;Jang, Hyo-Ryung;Shin, Hee-Baek;Ko, Do-Heung
    • Phonetics and Speech Sciences
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    • v.6 no.2
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    • pp.47-54
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    • 2014
  • The purpose of this study was to analyze spectral versus cepstral measurements in esophageal speakers. The comparison between the measurements in thirteen male esophageal speakers was compared with the control group of thirteen normal speakers using the sustained vowel /a/. The main results can be summarized as below: (a) the CPP and L/H ratio of the esophageal group were significantly lower than those of the control group (b) the CPP was significantly correlated with the spectral parameters such as jitter, shimmer, NHR and VTI, and (c) the ROC analysis showed that the threshold of 10.25dB for the CPP achieved a good classification for esophageal speakers, with 100% perfect sensitivity and specificity. Thus, it was known that cepstral-based acoustic measures such as CPP, may be more reliable predictors than other spectral-based acoustic measures such as jitter and shimmer. And it was found that cepstral-based acoustic measures were effective in distinguishing esophageal voice quality from normal voice quality. This research will contribute to establishing a baseline related to speech characteristics in voice rehabilitation with laryngectomees.