소장 무공증 환아에서 GIA stapler를 이용한 Tapering Enteroplasty 임상경험

송영택,Song, Young-Tack 대한소아외과학회 1995 소아외과 Vol.1 No.1

Jejunal and ileal atresias are the most common cause of congenital intestinal obstruction and accounts for about 1/3 of all cases of intestinal obstruction in newborns. Despite the relative frequency of this anomaly, its survival rate was less than 10% up to 1950, more recently the survival rate has risen rapidly to 90% with the introduction of modern surgical techniques and the use of total parenteral nutrition. In 1969 Thomas described a tapering jejunoplasty to manage the discrepancy in the size of the proximal dilated lumen & contracted distal lumen, and to preserve absorptive surface when the dilated jejunum involved a long length, and Grosfeld et al.(1979) facilitated this method by using GIA staplers. Author have also used GIA stapler to resect the antimesenteric portion of the dilated proximal bowel in 8 cases of jejunoileal atresias with good results. The following results were obtained ; 1. There we 3 jejunal atresias & 5 ileal atresias, and male to female sex ratio was 5 : 3. 2. The type of atresia was as follows ; type IIIa was 3 cases, type IIIb was 4 cases, type IIIb+IV was 1 case. 3. In non-complication cases(5 cases), the mean hospital day was 16 days, and oral feeding was feasible from 6.2 days after operation. 4. The complications(anastomotic leakage, pneumonia) were frequently occurred in type IIIb cases and in low birth weight cases(75%). 5. Mortality rate was 25% including DAMA(discharge against medical advice) discharge case.

신생아에서 회장의 분절 확장증

송영택,Song, Young-Tack 대한소아외과학회 1995 소아외과 Vol.1 No.2

Segmental intestinal dilatation is rare, which causes symptom of bowel obstruction and requires resection. The resection is not only diagnostic but also curative procedure. Recently, author experienced 2 cases of segmental dilatation of the ileum due to focal agenesis of the intestinal muscularis in 7 day & 4 day-old female neonates. The post operative recovery was excellant in the first case after resection of dilated ileum(15cm in length) and end to end anastomosis, and discharged at 20th day. But in the second case, the passage disturbance was not relieved after resection of dilated ileum (30cm in length), and author re-resected 80cm more of dilated proximal ileum at 2 weeks after the first operation. This baby discharged after diarrhea control with Loperin on 1 month after the second operation. Final histologic examination showed 1) normal population of ganglion cells in both narrowed & dilated ileum in both cases. 2) focal abscence of muscularis propria in both cases. 3) relative hypertrophy of inner circular muscle layer and thinned, multiple fragmented outer longitudinal muscle layer in case 2.

남아에서 종양에 의한 성조숙증 치험

송영택,Song, Young-Tack 대한소아외과학회 1995 소아외과 Vol.1 No.1

Precocious puberty is difficult to define because of the marked variation in the age at which puberty begins normally, onset of puberty before 8 years of age in girls and 9 years in boys may be considered precocious. The etiology of precocious puberty in boys is usually idiopathic, but can result from adrenal and testicular tumors. The hepatoblastoma that produces hCG is a very rare functioning tumor known to cause precocious puberty in boys. Recently, author experienced one case of virilizing adrenal cortical adenoma in 22 month-old boy, one case of adrenal cortical carcinoma in 28 month-old boy, and one case of virilizing hCG-producing hepatoblastoma in 7 year-old boy and reviewed literatures.

비정형적 중배엽성 신종

김영신(Young Sin Kim),이승하(Seung Ha Lee),송영택(Young Tack Song) 대한외과학회 1999 Annals of Surgical Treatment and Research Vol.56 No.5

태변성 복막염을 동반한 회장무공증

문석일,송영택,Moon, Seok-II,Song, Young-Tack 대한소아외과학회 1996 소아외과 Vol.2 No.2

Meconium peritonitis is a primarily aseptic, chemical peritonitis caused by the spill of meconium into the abdominal cavity through an intestinal perforation during the intrauterine or perinatal period. The perforation is known to be related to intrauterine vascular compromise. Recently, the authors experienced 4 cases of ileal atresia complicated by meconium peritonitis. The male to female sex ratio was 1 : 3, and age at operation was 1 day(2 cases), 3 days(2 cases). Three cases had generalized peritonitis, and one the cystic type of meconium peritonitis. The types of ileal atresia were IIIa(2 cases), IIIb(1 case), and II(1 case). The proximal blind ileal end was perforated in 3 cases, and distal end perforation was in 1 case of cystic type. Postoperative recovery was excellent in all cases.

이물섭취에 의한 드문 소화관 합병증

임재수,송영택,Lim, Jai-Soo,Song, Young-Tack 대한소아외과학회 1996 소아외과 Vol.2 No.1

Children tend to ingest foreign bodies. The majority present in children between the ages of 6 months and 3 years. We experienced 2 cases of unusual gastrointestinal complications caused by ingested foreign bodies. First case was a 10-month-old male with intestinal perforation due to two pieces of ingested magnetic heads. Second case was a 7-month-old girl with esophageal stricture due to an ingested particle of plastic toy.

총담관낭 환아에서의 담즙성 복막염

정재희,송영택,Jung, Jae-Hee,Song, Young-Tack 대한소아외과학회 1998 소아외과 Vol.4 No.2

저자들은 1983년 1월부터 1998년 1월까지 총담관낭 환아 28례 중 4례(14.2 %)에서 자연적으로 발생한 총담관낭 천공에의한 담즙성 복막염을 경험하였고 이 중 3례에서 일차적인 낭종 절제와 간관공장 문합술을 시행하였으며 이 모든 예에서 합병증 없이 회복되었기에 문헌 고찰과 함께 보고하는 바이다. 총담관낭 천공에의한 답즙성 복막염치료는 일차적 낭종 절제와 간관 공장 문합술이 안전하고 효과적인 방법이라고 생각된다. Choledochal cyst is rare in the western countries, but common in oriental countries. Complicatioins include ascending cholangitis, recurrent pancreatities, progressive biliary cirrhosis, portal hypertension, stone formation and later malignant transformation. Bile peritonitis secondary to rupture is one of the rarest complications, with an incidence of 1.8 % to 18 %. The anomalous arrangement of the pancreatobiliary ductal system with a long common channel may cause inflammation leading to perforation of the cyst. The authors found 4 cases (14.2 %) of bile peritonitis among 28 cases of choledochal cyst treated from Jan. 1983 to Jan. 1998. The patients ages ranged from 6 months to 3 years and three were female. The perforation sites were located on the common bile duct at its junction with the cystic duct in 2 cases, the distal cyst wall in 1 case and the left hepatic duct at its junction with cyst in 1 case. The types of choledochal cysts by Todani's classification were Type IVa in 3 cases and type I in 1 case. By the new Komi's classification utilizing operative cholangiogram there were 2 cases of Type Ia, 1 case of type IIb and 1 case of type III. One stage cyst excision and hepaticojejunostomy(Roux-en Y type) was done in 3 cases, and two staged operation in 1 case. All patients had an uneventful course postoperatively. The average day of discharge was 9.8th postoperatively. In conclusion, primary excision of the choledochal cyst and biliary reconstruction is a safe and effective treatment of ruptured choledochal cyst in infants.

Pe$\tilde{n}$a 씨 'Total Urogenital Mobilization" 법을 이용한 총 배설강 기형 교정 경험

정재희,송영택,Jung, Jae-Hee,Song, Young-Tack 대한소아외과학회 2000 소아외과 Vol.6 No.2

Persistent cloaca in a female newborn is one of the most complex and challenging anorectal malformation. The incidence is about 10% of all anorectal anomalies. Treatment of cloacal malformations has evolved during the past 40 years. However, it still remains one of the most difficult operations. In 1997, Pena reported a new procedure called "Total urogenital mobilization". We have repaired 3 cases of cloacal anomaly using "Total urogenital mobilization". The operations were performed between age 15 and 28 months. The length of the common channels was 2.5 - 3.0 cm. Two cases had double vaginas and one of them also had double uterus. The operation time was 4-5 hours and no major complications occurred. Functional and cosmetic results were satisfactory.

선천성 담도폐쇄증으로 Kasai 수술 후 장기 치료성적(10년 이상 생존자 대상으로)

임병훈,송영택,정재희,Yim, Byung-Hun,Song, Young-Tack,Chung, Jae-Hee 대한소아외과학회 2008 소아외과 Vol.14 No.2

To evaluate the long-term prognosis of biliary atresia after Kasai operation, a total of 14 patients (of the 41 patients operated upon from 1982 to 1997), who had been followed up for more than 10 years, were included in this retrospective study. Eleven out of 14 patients survived with their native livers, and their data analyzed for age at operation, clearing time of jaundice, histological outcome, postoperative complications, effectiveness after the application of an intussusception anti-reflex valve, and quality of life. Average age at surgery was 62.8 days. Serum bilirubin was normalized within three months in all patients. Six among the eleven long-term survivors had ascending cholangitis as one of the postoperative complications. The application of an intussusception anti-reflux valve did not show any statistical significance in long-term survival. Most of long-term survivors appeared to enjoy good quality of life. Kasai operation might not be the definitive treatment for biliary atresia; however, Kasai operation made it possible to achieve long-term survival for patients with biliary atresia when the patients were detected and treated as early as possible.

경부 결핵성 임파선염에 대한 임상적 고찰

김영길(Young Kil Kim),이종찬(Jong Chan Lee),송영택(Young Tack Song) 대한외과학회 1987 Annals of Surgical Treatment and Research(ASRT) Vol.32 No.3