腹臥位にて施行した胸腔鏡下中部食道憩室切除の1例

A case of middle esophageal diverticulum resected by thoracoscopic surgery in the prone position

◆要旨：患者は72歳，女性．嘔気，嘔吐を主訴に近医を受診し，食道憩室を指摘され，精査加療を目的に当院を紹介され受診した．上部消化管造影検査では，胸部中部食道に造影剤の停滞を伴う直径約5cmの憩室を認めた．症状を伴う中部食道憩室と診断し，手術を施行した．体位は半腹臥位を取り，ローテーションで腹臥位とし施行した．憩室の基部を確認し，内視鏡にて内腔を確保して自動縫合器で憩室を切除し，切除部は筋層縫合にて埋没した．術後は9日目に軽快退院となった．今回，腹臥位にて施行した胸腔鏡下食道憩室切除の1例を経験したので，若干の文献的考察を加え報告する．

A 75-year-old woman with dysphagia was referred to our hospital with a diagnosis of esophageal diverticulum. Gastrointestinal radiography revealed a diverticulum of the middle thoracic segment of the esophagus and stagnation of the contrast media. We made a diagnosis of middle esophageal diverticulum with symptoms and the patient underwent diverticulectomy by thoracoscopic surgery in the prone position. We confirmed the diverticular base, and with an endoscope, we secured the lumen and resected the diverticulum with automatic suture instruments. The sutured wall was covered by suturing the muscularis layer. She was discharged on the 9th postoperative day with no complications. We report this case of middle esophageal diverticulum that was successfully resected by thoracoscopic surgery in the prone position