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腹腔镜下正中弓状韧带松解术在食管癌合并正中弓状韧带综合征患者食管次全切除胃管重建术中的应用:一例报告

Laparoscopic Median Arcuate Ligament Release During Gastric Tube Reconstruction in Subtotal Esophagectomy for a Patient With Esophageal Cancer Complicated by Median Arcuate Ligament Syndrome: A Case Report.

作者信息

Yamakado Jin, Shibata Ryosuke, Watanabe Masato

机构信息

Surgery, Fukuoka University Chikushi Hospital, Fukuoka, JPN.

出版信息

Cureus. 2024 Jul 22;16(7):e65158. doi: 10.7759/cureus.65158. eCollection 2024 Jul.

Abstract

A 74-year-old man was diagnosed with squamous cell carcinoma of the lower thoracic esophagus following an upper gastrointestinal endoscopy during a health check-up, which revealed a type 0-IIc tumor. Biopsy confirmed squamous cell carcinoma, with suspicion of submucosal invasion. The patient was referred to our department. Contrast-enhanced computed tomography of the chest and abdomen showed no apparent lymph node or distant metastasis. Severe stenosis at the origin of the celiac artery, likely due to the median arcuate ligament, was observed. No abdominal symptoms were noted at rest or after meals, leading to the diagnosis of thoracic esophageal cancer with asymptomatic median arcuate ligament syndrome. Subsequently, laparoscopic median arcuate ligament release was performed during gastric tube reconstruction in subtotal esophagectomy.

摘要

一名74岁男性在健康检查期间进行上消化道内镜检查时被诊断为胸段下段食管鳞状细胞癌,检查发现为0-IIc型肿瘤。活检确诊为鳞状细胞癌,怀疑有黏膜下浸润。该患者被转诊至我科。胸部和腹部增强计算机断层扫描显示无明显淋巴结或远处转移。观察到腹腔干起始处严重狭窄,可能是由于正中弓状韧带所致。休息或进食后均未发现腹部症状,诊断为胸段食管癌合并无症状正中弓状韧带综合征。随后,在食管次全切除术中进行胃管重建时,实施了腹腔镜正中弓状韧带松解术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1668/11339579/803dcc116f16/cureus-0016-00000065158-i01.jpg

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