胸腔鏡・腹腔鏡同時併用による食道平滑筋腫切除術の1例

A case of esophageal leiomyoma successfully removed by combination of thoracoscopic and laparoscopic surgery

　近年，良性食道腫瘍に対する手術は内視鏡下手術が標準術式となってきている．今回，われわれは胸腔鏡・腹腔鏡同時併用にて切除しえた食道平滑筋腫の1例を経験したので報告する．症例は50歳の女性，会社の検診で胸部異常影を指摘されて入院した．画像検査で胸腹部食道に長径10cmの大きさの粘膜下腫瘍を認め，食道平滑筋腫が疑われた．手術は右半側臥位とし，胸腔鏡下に胸腔内の腫瘍を剥離，腹部は気腹下に腹腔鏡で腫瘍を剥離して小開胸創より摘出した．腫瘍は馬蹄型に発育し，組織学的に平滑筋腫と診断された．術後6年経過し再発は認めていない．

Recently, endoscopic surgery has become the standard surgical procedure for patient with benign esophageal tumors. We report a patient with esophageal lieomyoma that was successfully removed by thoracoscopic and laparoscopic surgery.

A 50-year-old woman was referred to the hospital because of abnormal shadow in the chest X-ray performed for medical check-up. Examination revealed a 10cm-lengthed submucosal tumor, a continual lesion located from the lower thoracic esophagus to the abdominal esophagus. The tumor was suspected to be a leiomyoma arising from the muscle layer of the esophagus.