Tanaka Hideharu, Uemura Norihisa, Abe Tetsuya, Higaki Eiji, Kawakami Jiro, Hosoi Takahiro, An Byonggu, Komori Koji, Ito Seiji, Shimizu Yasuhiro
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
Gen Thorac Cardiovasc Surg. 2018 Feb;66(2):116-119. doi: 10.1007/s11748-017-0852-3. Epub 2017 Oct 24.
Tracheal diverticulum, a benign entity characterized by single or multiple invaginations of the tracheal wall, is commonly asymptomatic and detected incidentally. We report the case of a 76-year-old man with a tracheal diverticulum who underwent thoracoscopic esophagectomy with a three-field lymphadenectomy for middle thoracic esophageal cancer. The tracheal diverticulum was located at the right posterolateral region of the trachea, which overlapped the region of dissection of the right recurrent laryngeal nerve lymph nodes. Paratracheal lymph node dissection is an important surgical procedure for thoracic esophageal cancer. In such cases, there is a risk of misidentifying a tracheal diverticulum as an enlarged lymph node and injuring it. Injury of a tracheal diverticulum causes serious complications such as mediastinal emphysema, mediastinitis, and pulmonary fistula. It is important to recognize its existence preoperatively and perform accurate lymph node dissection by taking full advantage of the magnified visual effect provided by thoracoscopic surgery.
气管憩室是一种良性病变，其特征为气管壁出现单个或多个内陷，通常无症状，多为偶然发现。我们报告一例76岁男性气管憩室患者，该患者因胸段中段食管癌接受了胸腔镜下食管切除术及三野淋巴结清扫术。气管憩室位于气管右后外侧区域，与右侧喉返神经淋巴结的清扫区域重叠。气管旁淋巴结清扫是胸段食管癌的一项重要手术操作。在此类病例中，存在将气管憩室误认成肿大淋巴结并造成损伤的风险。气管憩室损伤会导致严重并发症，如纵隔气肿、纵隔炎和肺瘘。术前识别其存在并充分利用胸腔镜手术提供的放大视觉效果进行准确的淋巴结清扫非常重要。
