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患者は55歳,女性.嚥下困難および体重減少(7kg/2か月)を主訴に来院した.食道造影で中部食道左側に径5cmの憩室を認めた.消化管内視鏡検査では切歯より28〜31cm左壁に憩室を認め,超音波内視鏡検査で真性憩室と診断した.食道内圧測定では運動機能異常は認めなかった.以上より憩室切除のみで治癒可能と考え,気管鉤用に5cmの小開胸を置き,3か所にポートを留置して,胸腔鏡下に憩室切除を行った.手術時間は230分,出血量は110gであった.術後6日目に経口摂取を開始し,嚥下困難は消失した.対側からのアプローチが必要となる中部食道左側の憩室に対し,胸腔鏡下切除は有用であった.
A 55-year-old woman was referred to us for further evaluation of dysphagia and weight loss of 7 kg in two months. Barium study showed a diverticulum of 5 cm in diameter, located on the left wall of middle thoracic esophagus and no other lesion in the upper GI tract. Endoscopy revealed a diverticulum 28 to 31 cm from the incisor. Endoscopic ultrasonography revealed that the lesion was a true diverticulum and manometry was nor-mal. She was thought to be a candidate for diverticulectomy.
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