갑상선전절제술 후 발생한 식도천공에서 진공을 이용한 치료 1예

김성용; 한선욱; 박래경; 이진형; 이지현; 우희두; 임철완; 이민혁

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자료유형: 학술저널

저자정보: 김성용 한선욱 박래경 이진형 이지현 우희두 임철완 이민혁

저널정보: 대한갑상선-내분비외과학회 The Journal of Endocrine Surgery The Journal of Endocrine Surgery 제10권 제2호

발행연도: 2010.1

수록면: 106 - 109 (4page)

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A careful approach is required for managing esophageal perforation after thyroidectomy, and esophageal perforation can cause serious infectious complications. However, reports on the treatment and management of esophageal perforation after thyroidectomy are lacking. We report here on a case of esophageal perforation that was successfully managed using vacuum-assisted closure. A patient underwent total thyroidectomy for papillary carcinoma. Near the lower pole of the left thyroid, a metastatic lymph node with direct invasion to the esophagus was detected. The esophageal wall, which was injured during lymph node dissection, was repaired. An esophageal leak occurred on the 5th postoperative day, and a 1 cm sized esophageal wall defect was identified. After irrigation, the defect was primary repaired, and the wound was closed using a vacuum assisted closure system. The patient was kept in a oral-fasting state, and subsequent wound dressing with vacuum change was repeated every 3∼4 days. During this period, gradual formation of granulation tissue was noted. After negative leakage was confirmed by an esophagogram on the 18th postoperative day, the patient resumed an oral intake. The wound was closed successfully on the 22nd postoperative day, and the patient was safely discharged one week later. In conclusion, vacuum assisted wound closure could reduce the risk of infection and also induce granulation tissue. We think this could be an alternative treatment strategy for esophageal perforation after thyroidectomy. (Korean J Endocrine Surg 2010;10:106-109)

#진공 #갑상선 절제술 #식도 천공 #Vacuum #Thyroidectomy #Esophageal perforation

참고문헌 (10)

참고문헌 신청

Argenta LC / 1997 / Vacuum-assisted closure: a new method for wound control and treatment: clinical experience / Ann Plast Surg 38 : 563 ~ 577

Bergamaschi R / 1998 / Morbidity of thyroid surgery / Am J Surg 176 : 71 ~ 75

Dhir K / 2009 / Vacuum-assisted closure therapy in the management of head and neck wounds / Laryngoscope 11 : 54 ~ 61

Fleischmann W / 1993 / Vacuum sealing as a treatment of soft tissue damage in open fractures / Unfallchirurg 96 : 488 ~ 492

Fleischmann W / 1996 / Vacuum assisted wound closure after dermatofasciotomy of the lower extremity / Unfallchirurg 99 : 283 ~ 287

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