• 제목/요약/키워드: Esophageal

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Application of Bayesian Multilevel Space-Time Models to Study Relative Risk of Esophageal Cancer in Iran 2005-2007 at a County Level

  • Rastaghi, Sedigheh;Jafari-Koshki, Tohid;Mahaki, Behzad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5787-5792
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    • 2015
  • Background: Reported age standardized incidence rates for esophageal cancer in Iran are 0.88 and 6.15 for females and males, at fifth and the eighth ranks, respectively, of cancers overall. The present study aimed to map relative risk using more realistic and less problematic methods than common estimators. Materials and Methods: In this ecological investigation, the studied population consisted of all esophageal cancer patients in Iran from 2005 to 2007. The Bayesian multilevel space-time model with three levels of county, province, and time was used to measure the relative risk of esophageal cancer. Analyses were conducted using R package INLA. Results: The total number of registered patients was 7,160. According to the results, the three-level model with adjustment for risk factors of physical activity and smoking had the best fit among all models. The overall temporal trend was significantly increasing. At county level, Ahar, Marand, Salmas, Bojnoord, Saghez, Sarakhs, Shahroud and Torbatejam had the highest relative risks. Physical activity was found to have significant direct association with risk of developing esophageal cancer. Conclusions: Given to great variation across geographical areas, many different factors affect the incidence of esophageal cancer. Conducting further studies at the individual level in areas with high incidence could provide more detailed information on risk factors of esophageal cancer.

Iatrogenic Large Esophageal Perforation Caused by Sengstaken-Blackmore Tube (식도 정맥류 출현 환자에서 Sengataken-Blackmore관에 의한 의인성 거대 흉부식도 파열)

  • 윤영철;조광현;권영민;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.51-54
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    • 2003
  • This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers(TA stapler 60 $\times$ 4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.

A Case of Esophageal Achalasia Misconceived as Laryngopharyngeal Reflux Disease (인후두 역류질환으로 오인된 식도 이완불능증 1예)

  • Noh, Seung Ho;Lee, Yong Woo;Park, Jin Su;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.1
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    • pp.43-47
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    • 2017
  • Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.

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Transhiatal Esophagectomy after Instrumental Esophageal Perforation (식도확장술 후 발생한 식도천공의 식도 열공을 통한 식도적출술 치험 1례)

  • 정일영
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.714-716
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    • 1994
  • Perforation of the esophagus, with any of its possible consequences, consetitutes an emergeny. We are reporting one case of transhiatal esophagectomy with esophagogastrostomy. The cause of esophageal perforation was baloon dilatation with underlying stricture. We recognized immediately intrathoracic perforation through routin check of Chest PA and confrormed dye leakage through esophagogram. She underwent emergency operation.

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Esophageal Reconstruction with Isoperistaltic Interposition of Left Colon (동연동성 좌측결장을 이용한 식도재건술)

  • 성시찬
    • Journal of Chest Surgery
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    • v.24 no.9
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    • pp.895-902
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    • 1991
  • The surgical experience on 18 patients with benign or malignant stricture of the esophagus who underwent isoperistaltic interposition of left colon from April 1989 to July 1991 was reviewed. During same period 22 esophageal reconstructions with colon were performed, but 3 patients who had intraabdominal adhesion in the left upper quadrant and one patient who had uncertainty of blood supply of left colic artery could not undergo iso-peristaltic interposition of left colon. There were 12 male and 6 female patients ranging from 16 to 65 years of age. 12 patients had corrosive esophageal stricture, two had cancer of esophagus, and another two had hypopharyngeal cancer. The postoperative complications developed in 7 patients [38.8%] and most frequently encountered complication was cervical anastomotic leakage, which was successfully managed with simple drainage in all cases but one malignant patient. There was no operative mortality. The esophageal reconstruction with isoperistaltic left colon resulted in good function in 14 patients[77.8%], fair in 3 patients[16.7], and poor in 1 patient[5.6%]. In this experience esophageal reconstruction using isoperistaltic left colon is a satisfactory method that can be accomplished with acceptable morbidity and mortality.

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Minimally Invasive Approach to Esophageal Perforation after Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Report of 2 Cases

  • Geraedts, Anna C.M.;Broos, Pieter P.H.L.;Gronenschild, Michiel H.M.;Custers, Frank L.J.;Hulsewe, Karel W.E.;Vissers, Yvonne L.J.;de Loos, Erik R.
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.313-316
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    • 2020
  • Esophageal perforation after endoscopic ultrasound-guided fine-needle aspiration for mediastinal staging is a rare but severe complication. We report 2 cases of patients with esophageal perforation who were treated using video-assisted thoracoscopic surgery in combination with esophageal stenting. Through these cases, the feasibility of minimally invasive thoracic surgery was evaluated.

Esophageal Atresia with Distal Tracheoesophageal Fistula in Both Members of Monozygotic Twins (일란성 쌍둥이 모두에서 발생한 식도무공증)

  • Kim, Seong-Chul;Nam, So-Hyun;Kim, Dae-Yeon;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.15 no.2
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    • pp.157-160
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    • 2009
  • Although the incidence of esophageal atresia (EA) is higher in twins than in singletons by two to three times, EA usually affects only one member of twins. We report one pair of twins concordant for EA. A 31-year-old healthy woman bore monozygotic female twins at 36 weeks of gestation. They weighed 2,216 and 2,480 g, respectively. They had EA with distal tracheoesophageal fistula and underwent primary esophageal anastomosis on the birth day and the $2^{nd}$ day of life, respectively. Twin A also had suspicious antral obstruction and pyloroplasty was done simultaneously with esophageal repair. She needed antral web excision for continued gastric stasis one month after $1^{st}$ operation and three balloon dilatations of the esophagus. Twin B recovered uneventfully.

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Surgical Treatment of Esophageal Atresia with Tracheoesophageal Fistula; Report of One Case (선천성 식도폐쇄및 기관식도루;수술치험 1례)

  • Lee, Jeong-Hui;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.333-336
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    • 1993
  • Esophageal atresia and tracheoesophageal fistula may occur as separate entities but usually occur in combination.The first report of esophageal atresia with tracheoesophageal fistula was done by Thomas Gibson in 1696.In1941, Haight and Towlseg performed the first successful primary repair,recently we were experienced a case of esophageal atresia with distal tracheoesophageal fistula in infant patient who presented the symptoms of dyspnea and vomiting.The operation was performed transpleurally through right 4th intercostal space.Patient tolerated all the operative procedure and recovered uneventflly.He was well-being without other problem.

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Surgical Treatment of Benign Esophageal Stricture (양성 식도 협착의 외과적 치료)

  • 박창권
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.107-114
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    • 1990
  • During a ten-year period from August, 1978 to September, 1989 45 patients with benign esophageal stricture were surgically evaluated. The results are as follows; l. Out of 45 patients, there were 26 males and 19 females ranging from 2 to 70 years of age with a mean of 31.9 years. 2. The most common cause of benign esophageal stricture was corrosive burn due to caustic agents[40 cases, 88.9 %]. Corrosive agents were 15 cases of lye, 22 cases of acid and 3 cases of other agents. Other causes were two cases of esophageal web and each one case of previous surgical result, inflammation and idiopathic mediastinal fibrosis respectively. 3. The most frequent stricture site was whole esophagus as 21 cases[46.7 %] and the next was lower a third thoracic esophagus[10 cases, 25.0%]. 4. In 33 of total 45 cases, colon interposition with right colon was performed without resection of the strictured esophagus except one case which was complicated esophageal cancer. Other procedures were 4 cases esophagogastrostomy with segmental resection, 2 cases of plastic repair and so on. 5. Major postoperative complications which were needed for secondary operation were 5 cases[11.1 %]. [2 cases of stenosis, ileus and ulcer bleeding respectively] Overall mortality rate was 4.4 %.

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Intramural Esophageal Cyst with Ciliated Epithelium -A Report of Case- (식도 벽내에 발생한 식도 낭종)

  • 신화균
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.812-814
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    • 1994
  • The esophageal cyst result from a wrong cleavage of the primitive gut in the 4 weeks embryo. In embryo and after seperation of the tracheal diverticulum, the esophagus is lined with ciliated cells which are able cover a "cystic duplication". It is often difficult to distinguish between the bronchogenic and the esophageal cyst. Pathological findings showed the presence of a ciliated epithelium without cartilage which was diagnosed as an esophageal cyst. The patient was 21 year old man for evaluation of the cyst in the posterior mediastinum. The cyst was located the intramural esophagus. Microscopically, the cyst was lined with ciliated columnar epithelium and there was no evidence of cartilage. The cyst was confirmed as the intramural esophageal cyst.geal cyst.

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