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장태수,나순기,남영섭 대한소화기학회 1992 대한소화기학회지 Vol.24 No.6
The clinical experience in 65 feeding jejunostomies is reviewed in Masan Goryo General Hospital during period from 1980 to 1989. For the better postoperative nutritional supply, the feeding jejunostomy was added to the major upper abdominal operation and reoperation due to leakage of anastomosis. The mean age of the cases was 49.8 years and 47 were male. The 61 cases out of 65 were major upper gastrointestinal procedures including pancreatic, hepatobiliary and esophageal procedures. Mean time of beginning of the jejunostomy feeding was 2.8 days, and mean duration of the jejunostomy feeding was 15.7 days and mean of maximum daily total calorie intake by the jejunostomy was 1548 kcal. The untoward reaction to feeding jejunostomy was diarrhea (18 cases), abdominal pain (8 cases) and abdominal distension (3 cases). Most of them were mild in severity and temporary in duration, but three cases were failed to feed through the feeding jejunostomy. The rate of significant complication from tube jejunostomy itself was 4%; two cases of intestinal obstruction and one enterocutaneous fistula. We could support the nutrition well of the 9 cases of enierocutaneous fistula by jejunnstomy feeding but failed in the other 3 cases. Therefore we believe that the feeding jejunostomy is a safe & feasible additional procedure to the major upper gastrointestinal operation such as gastric cancer and hepatobiliary & pancreatic operation that is predicted liable to leak. Also, the early postoperative jejunostomy feeding combined with peripheral parenteral nutrition could suffice most postoperative nutritional requirement.
한상철,장태수,나순기 대한소화기학회 1992 대한소화기학회지 Vol.24 No.3
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. It is known that its cause is absence or loss of ganglion cells in Auerbachs plexus. The classic triad of presenting symptoms in achalasia includes dysphagia, regurgitation and weight loss. The diagnosis of esophageal achalasia can be estabilished by history, radiologic examination, esophagoscopy, and manometric studies. Since introduction of Hellers operation, esophagomyotomy has been the procedure of choice for treatment of esophageal achalasia. Four cases of esophageal achalasia were treated with transabdominal esophagomyotomy and the clinical results were satisfactory.