• Korean Journal of Bronchoesophagology
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• v.9 no.2
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• pp.69-73
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• 2003

Various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the oncologic needs of the situation. If the entire esophagus or significant part of the thoracic esophagus is involved by tumor, then total esophagectomy and gastric pull-up or colon transposition is indicated. But for most hypopharyngeal tumors, laryngopharyngeal tumors, and cervical esophageal tumors, segmental resection of these area and replacement with a jejunal fee or forearm free flap has become the standard technique. The authors have experienced a case of total pharyngo-laryngo-esophago-gastrectomy and colon transposition in a patient of esophageal cancer following partial esophagectomy and gastic pull-up due to corrosive esophageal stricture. We report this case with brief review of the literatures.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.190-195
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• 2010

Ileovesical fistula is a rare condition in children. A case of 13 year-old female with ileovesical fistula caused by an ingested foreign material is presented. She had dysuria and lower abdominal pain for one month. There was no history of medico-surgical illness such as Crohn's disease or diverticulitis. Preoperative imaging study showed a movable calcified object in the pelvic cavity and air bubbles in the bladder. At laparotomy a bezoar-like mass was found at the antimesenteric border of the terminal ileum adherent to the dome of bladder. Segmental resection of the ileum and partial cystectomy were performed.

• Journal of Gastric Cancer
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• v.10 no.3
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• pp.137-140
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• 2010

Gastrointestinal stromal tumors (GISTs) constitute the most common primary mesenchymal tumors of the digestive tract and characteristically express c-kit (CD117). GISTs are the most common non-epithelial tumor of the GI tract and frequently originate from the stomach and small bowel. Specifically, the synchronous occurrence of a GIST with other epithelial tumors is rarely reported. Recently, we discovered one case of a concurrent gastric cancer and a small bowel GIST that was initially suspected to be peritoneal seeding from gastric cancer. The patient was initially admitted with epigastric pain. Gastric cancer with peritoneal seeding was suspected after an evaluation. Following a laparoscopic examination, a distal gastrectomy with D2 lymph node dissection and small-intestine segmental resection was performed. The final pathologic diagnosis was early gastric cancer and high-risk small bowel GIST. The patient refused adjuvant therapy for the GIST, and currently shows no other marked indisposition. He has been disease-free for 14 months.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.42-44
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• 2022

Chronic invasive aspergillosis is a life-threatening disease, especially in immunocompromised patients. The diagnosis and treatment of tracheal aspergillosis (TA) are challenging because of its rarity and nonspecific clinical presentations. The treatment standard of TA has been medical treatment like other forms of invasive aspergillosis, but patients with medically resistant TA require surgical intervention. We demonstrated a successful surgical outcome of chronic invasive TA in a 16-year-old patient with immunocompromised status related to acute myelocytic leukemia.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.117-125
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• 2010

Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.

• Journal of Chest Surgery
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• v.37 no.7
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• pp.617-621
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• 2004

End-to-end anastomosis for benign esophageal stricture (BES) is technically easier and relatively lower in morbidity than esophago-enterostomy. We performed segmental resection and end-to-end anastomosis in 2 cases of short segmental BES who were failed repeated endoscopic dilatation. A 13-month-old female with postoperative stricture was treated successfully. However, a 27-year-old female with corrosive stricture required second operative management of esophago-colo-gastrostomy following end-to-end anastomosis. Our experiences suggested that end-to-end anastomosis for BES could be used as a valid procedure for well selected patients. However, further studty is needed to compare with esophago-enterostomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.120-127
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• 2021

Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.

• Journal of Chest Surgery
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• v.51 no.5
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• pp.344-349
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• 2018

Background: We report our surgical technique for nonintubated uniportal video-assisted thoracoscopic surgery (VATS) pulmonary resection and early postoperative outcomes at a single center. Methods: Between January and July 2017, 40 consecutive patients underwent nonintubated uniportal VATS pulmonary resection. Multilevel intercostal nerve block was performed using local anesthesia in all patients, and an intrathoracic vagal blockade was performed in 35 patients (87.5%). Results: Twenty-nine procedures (72.5%) were performed in patients with lung cancer (21 lobectomies, 6 segmentectomies, and 2 wedge resections), and 11 (27.5%) in patients with pulmonary metastases, benign lung disease, or pleural disease. The mean anesthesia time was 166.8 minutes, and the mean operative duration was 125.9 minutes. The mean postoperative chest tube duration was 3.2 days, and the mean hospital stay was 5.8 days. There were 3 conversions (7.5%) to intubation due to intraoperative hypoxemia and 1 conversion (2.5%) to multiportal VATS due to injury of the segmental artery. There were 7 complications (17.5%), including 3 cases of prolonged air leak, 2 cases of chylothorax, 1 case of pleural effusion, and 1 case of pneumonia. There was no in-hospital mortality. Conclusion: Nonintubated uniportal VATS appears to be a feasible and valid surgical option, depending on the surgeon's experience, for appropriately selected patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.458-463
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• 2006

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.