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经视频辅助胸腔镜手术切除钙化性食管平滑肌瘤 1 例报告

A Right Video-Assisted Thoracoscopic Enucleation of a Calcified Esophageal Leiomyoma: A Case Report.

机构信息

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Department of Thoracic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

出版信息

Am J Case Rep. 2020 May 6;21:e922422. doi: 10.12659/AJCR.922422.

Abstract

BACKGROUND Benign esophageal tumors are considered rare, and most commonly are leiomyomas with the incidence of 0.005%. They arise intramurally in the distal two-thirds of the esophagus and are multiple in about 5% of patients. Leiomyoma lesions can mimic esophageal cancer making the diagnosis more challenging. Many cases are asymptomatic, up to 15%-50%, and most cases are discovered incidentally during esophagogastroduodenoscopy (EGD) and other procedures. The treatment of choice for symptomatic leiomyomas to relieve the compression is surgical enucleation with either an open thoracotomy, submucosal tunneling endoscopic resection, a video-assisted thoracoscopic approach (VATS), or with robotic techniques. CASE REPORT Here we report a case of a 53-year-old Saudi female patient who presented with dysphagia which had been ongoing for a long time. There were no other associated symptoms such as dyspepsia, nausea, or vomiting. She was diagnosed with a calcified leiomyoma of the esophagus based on a computed tomography (CT) scan and an endoscopic ultrasound (EUS) finding. After thorough investigations and workups, the management plan was taken at King Faisal Specialist Hospital and Research Centre by preforming a right video-assisted thoracoscopic enucleation. CONCLUSIONS The aim of this case report was to add to the literature by reporting the satisfactory outcomes of right video-assisted enucleation contrary to other surgical approaches that have been discussed in the literature.

摘要

背景

良性食管肿瘤较为罕见,最常见的是平滑肌瘤,发病率为 0.005%。它们起源于食管远端的 2/3 处,约 5%的患者为多发性。平滑肌瘤病变可模拟食管癌,使诊断更具挑战性。许多病例无症状,占 15%-50%,大多数病例在食管胃十二指肠镜(EGD)和其他检查中偶然发现。有症状的平滑肌瘤的治疗选择是手术切除,包括开胸手术、黏膜下隧道内镜切除术、电视辅助胸腔镜手术(VATS)或机器人技术。

病例报告

在这里,我们报告了一例 53 岁沙特女性患者,她因长期吞咽困难就诊。无其他相关症状,如消化不良、恶心或呕吐。根据计算机断层扫描(CT)和内镜超声(EUS)检查结果,她被诊断为食管钙化性平滑肌瘤。在彻底的检查和评估后,在法伊萨尔国王专科医院和研究中心制定了管理计划,采用右侧电视辅助胸腔镜切除术进行治疗。

结论

本病例报告的目的是通过报告右侧电视辅助切除术的满意结果来增加文献资料,与文献中讨论的其他手术方法形成对比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/deab/7226925/1b2207fe7526/amjcaserep-21-e922422-g001.jpg

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