食道鏡を併用した傍食道型気管支嚢胞に対する胸腔鏡下外科手術の1例  [in Japanese] THORACOSCOPIC SURGERY COMBINED WITH ESOPHAGOSCOPY FOR A PARAESOPHAGEAL BRONCHOGENIC CYST : A CASE REPORT  [in Japanese]

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Abstract

症例は39歳,女性. 7年前に検診にて胸部異常陰影を指摘され経過観察中であった.次第に増大傾向であるために手術目的で当科に入院した.胸部CT等の検査所見より後縦隔発生の良性腫瘤と考え,胸腔鏡下摘出術の適応と判断した.術中所見は,径3cm大の嚢胞で下行大動脈に接しており,食道の後外側に位置していた.摘出する際に食道の縦走筋との強い癒着が認められ剥離は困難であった.食道鏡を用いて食道を拡張・進展させ,腫瘤を胸腔鏡下に摘出した.腫瘤は内部に乳白色の液体が充満し,病理組織診断は気管支嚢胞であった.良性の縦隔腫瘍は胸腔鏡下外科手術の良い適応と考えられる.しかし,食道と強く癒着した腫瘤を胸腔鏡下に安全にかつ容易に摘出するために,食道鏡の併用が有用であった.

A 39-year-old woman was admitted to the hospital because of an abnormal shadow on chest roentgenogram, which became larger gradually since it was first detected at a medical check up 7 years before. Chest CT suggested that it was a benign posterior mediastinal tumor. Thoracoscopic surgery was performed. The tumor was cystic and 3cm in diameter, being adjacent to the descending aorta and esophagus. The tumor was extirpated by thoracoscopic procedure combined with esophagoscopy because the tumor severely adhered to the longitudinal muscle of the esophagus. The was milk-white fluid in the tumor and pathological diagnosis was bronchogenic cyst.<br> We think that benign paraesophageal bronchogenic cyst is a candidate for the thoracoscopic surgery. Combined use of esophagoscopy, however, is useful safely and easily to extirpate a tumor which severely adhered to the esophagus like this case.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 58(5), 999-1002, 1997-05-25

    Japan Surgical Association

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