咽頭食道憩室の1例  [in Japanese] A RESECTED CASE OF PHARYNGOESOPHAGEAL DIVERTICULUM  [in Japanese]

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Author(s)

    • 尾方 章人 OGATA Akihito
    • 大阪市立総合医療センター消化器外科 Department of Gastroenterological Surgery, Osaka City General Medical Center
    • 谷村 愼哉 TANIMURA Shinya
    • 大阪市立総合医療センター消化器外科 Department of Gastroenterological Surgery, Osaka City General Medical Center
    • 福長 洋介 FUKUNAGA Yosuke
    • 大阪市立総合医療センター消化器外科 Department of Gastroenterological Surgery, Osaka City General Medical Center

Abstract

症例は72歳,女性. 10年来,軽度の嚥下困難を認め食道憩室の存在を指摘されていた.近年,症状の増悪と憩室の増大を認めたため手術適応となった.術前の食道造影検査において,第4, 5頸椎の高さで左方に突出する憩室の茎を認めることから非Zenker憩室が疑われた.術中所見においても,輪状咽頭筋の尾側で食道壁左側の縦走筋の間から突出する憩室を認めた.また術前の食道内圧測定においても嚥下による協調運動は保持されていたため,術式としては憩室切除術にとどめ輪状咽頭筋切離術を加えなかった.<br>術後1年を経過しているが,憩室の再発は認められていない.しかしながら今後も再発の有無を注意深く観察してゆくべきである.

A 72-year-old woman with a ten-year history of an esophageal diverticulum presented with mild dysphagea was admitted to the hospital for surgery because of recent exacerbation of the symptom and enlargement of the diverticulum. Non-Zenker's diverticulum was suspected from a preoperative esophagoscopy that disclosed a pedicle of the diverticulum projecting to the left side at the height of the 4<sup>th</sup> and 5<sup>th</sup> cervical vertebrae. During surgery, we confirmed the diverticulum projecting from between longitudinal muscles on the left side of the esophageal wall at the tail side of cricopharyngeal muscle. Furthermore, preoperative examination of esophageal intraluminal pressure revealed that the cooperative movement during swallowing was kept intact. Thus only a diverticulectomy was performed and no incision in the cricopharyngeal muscle was made.<br>There have been no signs of a relapse of esophageal diverticulum, as of one year after the operation, but we have to follow the patient carefully for probable relapse.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 64(3), 620-623, 2003

    Japan Surgical Association

Codes

  • NII Article ID (NAID)
    130003603514
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • Data Source
    J-STAGE 
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