肋骨すべり症候群に対する外科治療

Surgical Therapy of Slipping Rib Syndrome

本邦の胸部外科領域における肋骨すべり症候群（slipping rib syndrome：SRS）に対する認識は乏しく，主たる教科書への記載すらない．SRSは手術適応があるにもかかわらず誤診や見逃されやすい疾患のため，注意が必要である．われわれは，SRSに対し手術を施行した2例を提示し，その背景および術式について考察した．

We have operated on two cases of slipped ribs syndrome （SRS）. Both patients were men in their 40s with a history of right thoracic trauma who were referred to us because of unexplained lower thoracic pain. The left rib was positive for hooking maneuver （lift test）, and dynamic ultrasonography showed narrowing of the intercostal space, which led to the diagnosis of SRS. in the first case, the tip of the ninth rib cartilage was excised, and the ninth and tenth rib cartilages were sutured and fixed with No.2 fiber wire in two places with Z sutures. In the second case, the tip of the ninth rib cartilage was excised, the eighth and ninth ribs and the ninth and tenth ribs were fixed with No.2 fiber wire with Z sutures as in the first case, and a 0.7 mm thick poly-L-lactide （PLLA） plate was added between the eighth and tenth rib cartilages. In both cases, the postoperative course was good and the pain disappeared. SRS should be recognized as a disease and surgical treatment should be used as therapy.