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Korean Journal of Thoracic and Cardiovascular Surgery最新文献

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Endoscopic Resection for the Treatment of Superficial Esophageal Neoplasms. 内镜下切除治疗浅表性食管肿瘤。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.172
Ga Hee Kim, Hwoon-Yong Jung
{"title":"Endoscopic Resection for the Treatment of Superficial Esophageal Neoplasms.","authors":"Ga Hee Kim,&nbsp;Hwoon-Yong Jung","doi":"10.5090/kjtcs.2020.53.4.172","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.172","url":null,"abstract":"<p><p>Superficial esophageal neoplasms (SENs) are being diagnosed increasingly frequently due to the screening endoscopy and advances in endoscopic techniques. Endoscopic resection (ER) is a relatively noninvasive treatment method with low morbidity and mortality that provides excellent oncologic outcomes. Endoscopic submucosal dissection is associated with higher rates of en bloc, complete and curative resections and lower rates of local recurrence than endoscopic mucosal resection. The most serious complication of ER is stricture, the treatment and prevention of which are crucial to maintain the patient's quality of life. ER for SEN is feasible, effective, and safe and can be considered a first-line treatment for SENs in which it is technically feasible.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"172-177"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/c4/KJTCV-53-172.PMC7409883.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fistulas between the Esophagus and Adjacent Vital Organs in Esophageal Cancer. 食管癌中食道与邻近重要器官间的瘘。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.211
Sukki Cho
{"title":"Fistulas between the Esophagus and Adjacent Vital Organs in Esophageal Cancer.","authors":"Sukki Cho","doi":"10.5090/kjtcs.2020.53.4.211","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.211","url":null,"abstract":"<p><p>Esophageal fistulas may occur in an advanced stage or as a potentially life-threatening complication of treatment. They can be divided into esophageal-respiratory and esophageal-aorta fistulas. The diagnosis is confirmed with fluoroscopy using dilute barium oral contrast, followed by thin-section computed tomography, which defines the precise location and extent of the fistula. Flexible esophagoscopy and bronchoscopy are required for confirmation and anatomic assessment of the suspected fistula and provide additional information for treatment planning. Contamination is traditionally controlled by surgical exclusion, along with a jejunal feeding tube. Currently, fully covered self-expanding metal stents are the primary treatment option.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"211-216"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/16/KJTCV-53-211.PMC7409885.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Chyle Leakage after Esophageal Cancer Surgery. 食道癌手术后的糜烂渗漏
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.191
Young Ho Yang, Seong Yong Park, Dae Joon Kim
{"title":"Chyle Leakage after Esophageal Cancer Surgery.","authors":"Young Ho Yang, Seong Yong Park, Dae Joon Kim","doi":"10.5090/kjtcs.2020.53.4.191","DOIUrl":"10.5090/kjtcs.2020.53.4.191","url":null,"abstract":"<p><p>Surgeons recommend dissecting lymph nodes in the thorax, abdomen, and neck during surgery for esophageal cancer because of the possibility of metastasis to the lymph nodes in those areas through the lymphatic plexus of the esophageal submucosal layer. Extensive lymph node dissection is essential for accurate staging and is thought to improve survival. However, it can result in several complications, including chyle leakage, which refers to continuous lymphatic fluid leakage and can occur in the thorax, abdomen, and neck. Malnutrition, fluid imbalance, and immune compromise may result from chyle leakage, which can be potentially life-threatening if it persists. Therefore, various treatment methods, including conservative treatment, pharmacological treatment such as octreotide infusion, and interventions such as thoracic duct embolization and surgical thoracic duct ligation, have been applied. In this article, the risk factors, diagnosis, and treatment methods of chyle leakage after esophagectomy are reviewed.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"191-199"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/ec/KJTCV-53-191.PMC7409880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer. 现代放疗技术在食管癌治疗中的作用。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.184
Sung Ho Moon, Yang-Gun Suh
{"title":"The Role of Modern Radiotherapy Technology in the Treatment of Esophageal Cancer.","authors":"Sung Ho Moon,&nbsp;Yang-Gun Suh","doi":"10.5090/kjtcs.2020.53.4.184","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.184","url":null,"abstract":"<p><p>Radiation therapy (RT) has improved patient outcomes, but treatment-related complication rates remain high. In the conventional 2-dimensional and 3-dimensional conformal RT (3D-CRT) era, there was little room for toxicity reduction because of the need to balance the estimated toxicity to organs at risk (OARs), derived from dose-volume histogram data for organs including the lung, heart, spinal cord, and liver, with the planning target volume (PTV) dose. Intensity-modulated RT (IMRT) is an advanced form of conformal RT that utilizes computer-controlled linear accelerators to deliver precise radiation doses to the PTV. The dosimetric advantages of IMRT enable better sparing of normal tissues and OARs than is possible with 3D-CRT. A major breakthrough in the treatment of esophageal cancer (EC), whether early or locally advanced, is the use of proton beam therapy (PBT). Protons deposit their highest dose of radiation at the tumor, while leaving none behind; the resulting effective dose reduction to healthy tissues and OARs considerably reduces acute and delayed RT-related toxicity. In recent studies, PBT has been found to alleviate severe lymphopenia resulting from combined chemo-radiation, opening up the possibility of reducing immune suppression, which might be associated with a poor prognosis in cases of locally advanced EC.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/66/KJTCV-53-184.PMC7409878.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reflux Following Esophagectomy for Esophageal Cancer. 食管癌切除术后食管反流
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.217
Jong Ho Cho
{"title":"Reflux Following Esophagectomy for Esophageal Cancer.","authors":"Jong Ho Cho","doi":"10.5090/kjtcs.2020.53.4.217","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.217","url":null,"abstract":"<p><p>Gastroesophageal reflux is a common problem after gastroesophageal resection and reconstruction, despite the routine prescription of proton pump inhibitors (PPIs). Resection of the lower esophageal sphincter and excision of the vagus nerve are generally thought to be the main factors that interfere with gastric motor function. However, physiological studies of reflux symptoms after esophagectomy are still lacking. Gastroesophageal reflux occurs frequently after esophagectomy, but there is no known effective method to prevent it. Therefore, in order to manage gastroesophageal reflux after esophagectomy, strict lifestyle modifications and gastric acid suppression treatment such as PPIs are needed, and further clinical studies are required.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"217-221"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/e5/KJTCV-53-217.PMC7409890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Current Issues in Minimally Invasive Esophagectomy. 微创食管切除术的当前问题。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.152
Kwon Joong Na, Chang Hyun Kang
{"title":"Current Issues in Minimally Invasive Esophagectomy.","authors":"Kwon Joong Na,&nbsp;Chang Hyun Kang","doi":"10.5090/kjtcs.2020.53.4.152","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.152","url":null,"abstract":"<p><p>Minimally invasive esophagectomy (MIE) was first introduced in the 1990s. Currently, it is a widely accepted surgical approach for the treatment of esophageal cancer, as it is an oncologically sound procedure; its advantages when compared to open procedures, including reduction in postoperative complications, reduction in the length of hospital stay, and improvement in quality of life, are well documented. However, debates are still ongoing about the safety and efficacy of MIE. The present review focuses on some of the current issues related to conventional MIE and robot-assisted MIE based on evidence from the current literature.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"152-159"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/40/KJTCV-53-152.PMC7409881.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
The Optimal Pyloric Procedure: A Collective Review. 幽门最佳手术:一项集体回顾。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.233
Dohun Kim
{"title":"The Optimal Pyloric Procedure: A Collective Review.","authors":"Dohun Kim","doi":"10.5090/kjtcs.2020.53.4.233","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.233","url":null,"abstract":"<p><p>Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"233-241"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/f5/KJTCV-53-233.PMC7409877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Interventional Radiology Treatment for Postoperative Chylothorax. 术后乳糜胸的介入放射治疗。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.200
Hoyong Jun, Saebeom Hur
{"title":"Interventional Radiology Treatment for Postoperative Chylothorax.","authors":"Hoyong Jun,&nbsp;Saebeom Hur","doi":"10.5090/kjtcs.2020.53.4.200","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.200","url":null,"abstract":"<p><p>Postoperative chylothorax is a rare occurrence after various thoracic surgical procedures, but it poses a substantial risk of morbidity and mortality. Thoracic duct embolization (TDE) is currently deemed the optimal treatment due to its safety and efficacy. This review offers an introduction to interventional options in this setting, detailing the steps of TDE for the edification of those engaged in postoperative care.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"200-204"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/5e/KJTCV-53-200.PMC7409884.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Stricture Following Esophageal Reconstruction. 食管重建术后狭窄。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.222
Hyeong Ryul Kim
{"title":"Stricture Following Esophageal Reconstruction.","authors":"Hyeong Ryul Kim","doi":"10.5090/kjtcs.2020.53.4.222","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.222","url":null,"abstract":"<p><p>Owing to varying clinical definitions of anastomotic stricture following esophageal reconstruction, its reported incidence rate varies from 10% to 56%. Strictures adversely impact patients' quality of life. Risk factors, such as the anastomosis method, leakage, ischemia, neoadjuvant chemoradiotherapy, and underlying disease have been mentioned, but conflicting information has been reported. Balloon dilation is regarded as a safe and effective treatment method for patients with benign anastomotic strictures. Reoperations are seldom required. The etiology and management of anastomotic strictures are reviewed in this article.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"222-225"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/8f/KJTCV-53-222.PMC7409887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38271735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
The Current Evidence on Neoadjuvant Therapy for Locally Advanced Esophageal Squamous Cell Carcinoma. 局部晚期食管鳞状细胞癌新辅助治疗的最新证据。
Korean Journal of Thoracic and Cardiovascular Surgery Pub Date : 2020-08-05 DOI: 10.5090/kjtcs.2020.53.4.160
Dongryul Oh, Jong Hoon Kim
{"title":"The Current Evidence on Neoadjuvant Therapy for Locally Advanced Esophageal Squamous Cell Carcinoma.","authors":"Dongryul Oh,&nbsp;Jong Hoon Kim","doi":"10.5090/kjtcs.2020.53.4.160","DOIUrl":"https://doi.org/10.5090/kjtcs.2020.53.4.160","url":null,"abstract":"<p><p>Surgical resection is the mainstay of treatment for locally advanced esophageal cancer. Neoadjuvant therapy is recommended to improve survival, based on the results of several randomized trials and meta-analyses. However, controversy remains regarding how to combine surgery, radiotherapy, and chemotherapy. Moreover, in East Asia, the predominant histological type is esophageal squamous cell carcinoma, which has a different epidemiology and tumor biology from esophageal or gastroesophageal junctional adenocarcinoma. As such, the management of esophageal cancer in East Asia seems to be different from that in Western countries. Thus, this article reviews the current evidence on neoadjuvant therapy and considers the optimal combinations and ongoing strategies of multimodal therapy for esophageal squamous cell carcinoma.</p>","PeriodicalId":38678,"journal":{"name":"Korean Journal of Thoracic and Cardiovascular Surgery","volume":"53 4","pages":"160-167"},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/dc/KJTCV-53-160.PMC7409882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38263323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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