• 제목/요약/키워드: fundoplication

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위저추벽성형술(Nissen Fundoplication) 시행 후 발생한 덤핑(Dumping)증후군 1례 (A Case of Dumping Syndrome Following Nissen Fundoplication in an Infant)

  • 문진수;양혜란;배선환;김재영;고재성;서정기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제4권1호
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    • pp.92-98
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    • 2001
  • 덤핑증후군은 소아에서 위식도역류의 치료로 위저추벽성형술을 시행하는 경우에 잘 발생하는 질환으로 당 부하 검사를 통하여 식사 직후에 나타나는 고혈당과 뒤이어 나타나는 저혈당을 보임으로써 진단될 수 있으며, 생 옥수수 전분을 포함한 식이 요법으로 효과적으로 치료될 수 있다. 저자들은 위저추벽성형술을 시행 받은 뒤에 덤핑증후군이 발생한 1례를 경험하였고, 본 질환이 소아에서 위저추벽성형술과 같은 위 수술 후에 수유장애가 있을 경우 반드시 의심해보아야 할 질환이라고 사료되어 문헌 고찰과 함께 보고하는 바이다.

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Achalasia 의 외과적 치료 (Result of modified Heller operation with gastric fundoplication in esophageal achalasia)

  • 오봉석
    • Journal of Chest Surgery
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    • 제15권4호
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    • pp.451-455
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    • 1982
  • For recently 2 years, 3 cases of esophageal achalasia were surgically treated by modified Heller operation with gastric fundoplication. Esophageal achalasia is functional disorder of lower esophagus of which symptoms are dysphasia, regurgitation, and weight loss. Preoperative diagnosis was made by clinical manifestations and radiologic examination, esophagoscopy and confirmed at operative table. Operative procedures are variable, but modified Heller operation is common method to handicap reflux esophagitis and postoperative esophageal stricture. Now, our patients who were surgically treated were well alive without complaining of specific symptoms for followed period.

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Safe implementation of transoral incisionless fundoplication as a new technique in a tertiary care center

  • Shivanand Bomman;Sofya Malashanka;Adil Ghafoor;David J. Sanders;Shayan Irani;Richard A. Kozarek;Andrew Ross;Michal Hubka;Rajesh Krishnamoorthi
    • Clinical Endoscopy
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    • 제55권5호
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    • pp.630-636
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    • 2022
  • Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution's programmatic allocation of resources during the safe implementation of TIF as a new procedure. Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was performed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and outcomes were evaluated during transition. Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure duration was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effective transition to a fully outpatient procedure.

Laparoscopic Hiatal Hernia Repair and Roux-en-Y Conversion for Refractory Duodenogastroesophageal Reflux after Billroth I Distal Gastrectomy

  • Park, Joong-Min;Yoon, Sung Jin;Kim, Jong Won;Chi, Kyong-Choun
    • Journal of Gastric Cancer
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    • 제20권3호
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    • pp.337-343
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    • 2020
  • Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

식도이완불능증에시 복강경을 이용한 식도근절개술 및 전방위저주름술 - 1예 보고 - (Laparoscopic Heller Myotomy with Dor Fundoplication in Achalasia -One case report -)

  • 김연수;류지윤
    • Journal of Chest Surgery
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    • 제38권3호
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    • pp.258-262
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    • 2005
  • 환자는 18세 여자로 6년 전부터 연하곤란 및 식사 후 빈번하게 구토가 발생하였으며, 최근 6개월 동안 15 kg의 체중 감소가 있었다. 식도 계측검사에서 식도이완불능증으로 진단되었다. 약물치료를 하였으나 증상이 호전되지 않아 복강경을 이용한 수술을 결정하였다. 복부에 5개의 트로카용 소절개를 시행하였고, 복강경을 이용하여 근절개술과 전방위저부주름술을 시행하였다. 수술 후 1일째 식도조영술을 시행하였다. 조영제가 누출 없이 원활하게 통과되었다. 수술 후 2일째 식이를 시행하였으며, 술 후 9일째 특별한 문제없이 퇴원하였다.

복강경을 이용한 니센 위저추벽성형술 및 콜리스 위성형술 (Laparoscopic Nissen Fundoplication and Collis Gastroplasty)

  • 송상윤;박정민;정인석;안병희;나국주
    • Journal of Chest Surgery
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    • 제39권9호
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    • pp.733-738
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    • 2006
  • 위식도역류질환은 서구에선 매우 유병률이 높으며 우리나라에서도 식생활의 서구화로 인해 유병률이 증가하고 있다. 최근 최소침습수술이 발달함에 따라 복강경을 이용하여 수술할 경우 미용효과, 단기재원기간 및 일상생활로의 조기복귀 등의 장점이 있어 장기적인 약물치료보다는 최소침습법에 의한 수술의 시행이 늘어날 것으로 예상된다. 저자들은 복강경을 이용하여 횡격막 탈장 및 탈장을 동반한 위식도역류성 질환에 대해 시행한 니센 위저추벽성형술 및 콜리스 위성형술 치험을 바탕으로 수술수기를 중심으로 문헌고찰과 함께 보고하는 바이다.

위식도역류질환의 수술 (Antireflux Surgery)

  • 나국주
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.105-108
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    • 2010
  • The prevalence of gastroesophageal reflux disease(GERD) has been increased recently in Korea. Most patients who have GERD are well treated by medication. But patients who have suboptimal disease control under medical therapy are needed further treatment. Nowadays minimally invasive surgery using laparoscopy and thoracoscopy has become popular in the operation of GERD although antireflux surgery is vary. Antireflux surgery is a well-documented, effective therapeutic alternative to control GERD.

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식도천공의 치료 (Treatments of Esophageal Perforation - A Report of 14 cases -)

  • 구자홍;조갑호;김공수
    • Journal of Chest Surgery
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    • 제24권11호
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    • pp.1107-1114
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    • 1991
  • We have experienced fourteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Chonbuk National University Hospital during the period from mar. 1980 to Oct. 1990. The ratio between male and female patients was 5 : 9, and their age ranged from 22 years to 69 years. The causes of th eesophageal perforation were iatrogenic in 6 cases, foreign body 5 cases, diverticulitis 2 cases, and postpneumonectomy 1 case. The locations were cervical esophagus in 2 cases, upper thoracic in 2 cases, mid-thoracic 4 cases, and lower thoracic 6 cases. The underlying diseases associated with perforation were lye stricture, diverticulum, achalasia, and postpneumonectomy empyema. The treatments were supportive in 6 cases and combined with surgical measures in 8 cases. surgical measurs were as follows : incision and drainage in 2 cases, esophagectomy with esophagogastrostomy 3 cases, esophagocardiomyotomy with partial fundoplication in 1 case, simple closure with myoplasty and thoracoplasty 1 case, and empyema drainage and gastrostomy 1 case. There was no mortality.

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Upper Gastrointestinal Cancer and Reflux Disease

  • Kim, Jin-Jo
    • Journal of Gastric Cancer
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    • 제13권2호
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    • pp.79-85
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    • 2013
  • There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.