Miyagi Hisayuki, Honda Shohei, Hamada Hiromi, Minato Masashi, Ara Momoko W, Taketomi Akinobu
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Kita-ku, Kita 15, Nishi 7, Sapporo, Japan.
Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Teine-ku, Kanayama 1-1, Sapporo, Japan.
European J Pediatr Surg Rep. 2018 Jan;6(1):e11-e14. doi: 10.1055/s-0037-1612611. Epub 2018 Jan 8.
We herein report a case of one-stage laparoscopic surgery for extralobar pulmonary sequestration (EPS) and hiatal hernia. Our patient was a 2-year-old girl who was diagnosed as a mediastinal mass lesion. Postnatal computed tomography revealed that the mediastinal mass was an EPS. Two weeks after birth, the patient developed gastroesophageal reflux (GER), and esophagography showed a hiatal hernia. At 2 years of age, she underwent one-stage laparoscopic Nissen's fundoplication for GER with resection of the EPS in the posterior mediastinum. The sequestrated lung was grasped via the esophageal hiatus; three aberrant blood vessels were dissected to allow removal of the sequestration through the umbilical port site. The esophageal hiatus was repaired and Nissen's fundoplication was performed laparoscopically. The patient's postoperative course was uneventful, with no recurrence of GER symptoms for 1 year. We conclude that one-stage laparoscopic surgery is useful for patients with EPS and hiatal hernia.
我们在此报告一例关于肺叶外型肺隔离症（EPS）合并食管裂孔疝的一期腹腔镜手术病例。我们的患者是一名2岁女童，被诊断为纵隔肿块病变。出生后的计算机断层扫描显示纵隔肿块为EPS。出生后两周，患者出现胃食管反流（GER），食管造影显示有食管裂孔疝。在2岁时，她接受了一期腹腔镜尼氏胃底折叠术治疗GER，并切除后纵隔的EPS。通过食管裂孔抓住隔离肺；解剖三条异常血管，以便通过脐部端口部位切除隔离肺。修复食管裂孔并腹腔镜下进行尼氏胃底折叠术。患者术后病程平稳，1年内GER症状未复发。我们得出结论，一期腹腔镜手术对EPS合并食管裂孔疝患者有用。
