• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.30-32
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• 2010

Tracheo-gastric fistula is a very rare late complication of total laryngopharyngoesophagectomy with gastric pull-up procedure. It usually occurs after transhiatal esophagectomy, but it has only rarely been reported after total laryngopharyngoesophagectomy with gastric pull-up procedure. Chronic irritation and gastric ulcer may be the cause of tracheogastric fistula. To prevent fistula formation, active management of gastric ulcer and avoidance of mucosal irritation are necessary. We report a case of a tracheogastric fistula which occurred two years after total laryngopharyngoesophagectomy with gastric pull-up procedure that maybe occurred by chronic irritation and gastric ulcer.

• Korean Journal of Bronchoesophagology
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• v.16 no.1
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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.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.112-115
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• 2000

A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7$\times$5$\times$5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.954-962
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• 1995

Extended lymph node dissection, which includes dissection of the cervical and superior mediastinal nodes[three-field dissection , has been performed to improve the long-term survival since 1982 in Japan. Recently, the 5-year survival rate after three-field dissection has been reported to be better than 40%. During the period, from April to June, 1995, 4 patients among 7 operable esophageal cancer patients underwent subtotal esophagectomy with systematic dissection of regional lymph nodes including superior mediastinal and cervical lymph nodes at St. Mary`s Hospital. The esophagogastric anastomoses were made in the neck and the ascending routes of gastric tube were posterior mediastinal route. The cancer stage of them were stage IIA & IIB and it was possible to operate on a curability II & III basis. The numbers of resected lymph nodes with the three field dissection were 40-55. Postoperative complications were transient recurrent laryngeal nerve paralysis and atelectasis in 2 patients respectively but there was no anastomotic leak nor stenosis.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.193-196
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• 2004

Benign gastrobronchial fistula (GBF) after Ivor Lewis operation is a very rare and serious complication. We describe a patient with GBF who was successfully managed on the single-stage repair, 15 months after the Ivor Lewis operation. After the division of the GBF, the bronchial and gastric defects were closed directly. The omental flap and the pedicled 5th. intercostal muscle flap were interposed between the closed defects. The literature of this subject is reviewed and discussed.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.601-604
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• 2000

Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism(usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.888-891
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• 2004

Basaloid-squamous cell carcinoma, a biologically high-grade variant of squamous cell carcinoma, is predominantly located at upper aerodigestive tract but it is extremely rare in the esophagus. Recently we experienced a case of basaloid-squamous cell carcinoma of esophagus. A 64 year-old man was referred to our hospital because of mucosal nodularity at 35 cm apart from the incisor in endoscopic examination. Result of Biopsy was squamous cell carcinoma. Left transthoracic esophagectomy was performed. Histologically, the lesion of tumor was basaloid-squamous cell carcinoma and no lymph node metastasis was found.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.932-934
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• 1995

Esophageal stenosis due to ectopic tracheobronchial remnants is an uncommon anomaly and only few cases were reported in the literature. We have experienced two case of esophageal stenosis due to ectopic tracheobronchial remnants and performed operative correction. The one patient was a five year old male with a chief complaint of swallowing difficulty from birth and the other was a twenty-three year old female with a slowly incresing symptom of dysphagia for twenty years. both of them were performed surgical correction by esophagectomy of the stenotic portion and esophago-gastrostomy with anti-reflux procedures. The resected specimens of the these two patients showed ectopic tracheobronchial chondroepithelial tissue withinthe esophageal wall histipathologically. Postoperative course was uneventful and have been in good condition without any problems.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.963-966
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• 2004

A rare case of schwannoma involving lower thoracic esophagus is presented. A 64-year-old male was seen with slowly progressing dysphagia for 2 years. Large sized submucosal tumor was found by endoscopy and chest CT. On surgery, tumor was very solid and tightly adherent to the adjacent tissue. Esophagectomy and esophagogastrostomy was done.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1060-1065
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• 1994

For most surgeons, stomach and colon are the first choice for reconstruction of the esophagus, as well as for bypass. When the esophagogastric or esophagocolonic anastomosis is made in the neck, cervical anastomosis site leakage is the main complication. In our most recent four patients who underwent a transhiatal & posterior mediastinal esophagogastric or esophagocolonic anastomoses following esophageal resection, we performed the cervical anastomoses with a circular EEA stapler. No leaks have developed at the anastomosis site. In these four patients the cancer was tiny and was located on the upper or middle third of the thoracic esophagus. A total esophagectomy was performed by blunt resection without thoracotomy. Surgical staplers have been used previously for esophagogastric anastomosis through a right thoracotomy with a very low rate of leakage. When the esophagogastric or esophagocolonic anastomosis is performed in the neck, the prevalence of leakage does not increase the postoperative mortality, but it can increase significantly the duration of hospitalization and morbidity. The use of the circular stapler allowed us to perform four consecutive cervical esophagogastric & esophagocolonic anastomoses without any leakage and to shorten the operating time.