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首页> 外文期刊>Revista do Colégio Brasileiro de Cirurgies >Leiomioma do es?fago removido por videolaparoscopia
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Leiomioma do es?fago removido por videolaparoscopia

机译:腹腔镜切除食管平滑肌瘤

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This report describes a leiomyoma of the inferior third section of the esophagus removed during laparoscopic cholecystectomy. The patient is a woman 55-years-age, carrying esophageal myoma of 40 mm in diameter wide, situated in the posterior wall of the lower esophagus. Indications for surgery were based mainly on the growth of the mass (6 mm when discovered 7 years previously, increased to 40 mm). Recently the patient returned suffering from pain, which could be attributed to his litiasic cholecystopaty. A small degree of low disphagia could also be observed. Radiologic imaging, direct endoscopic examination and endoscopic ultrasound showed that the mioma protruded on to the oesophagic lumen, discreetly diminishing there. A laparoscopic esophageal myomectomy was indicated at the same session of the laparoscopic cholecystectomy. Once the pneunoperitoneum was installed, five ports were placed as if for a hiatus hernia surgery. The cholecystectomy was uneventful. Next, an esophagoscopy was performed so as to determine the precise area covering the base of the tumour; at the right-lateral site. Longitudinal and circular fibres of the esophagus was severed over the lesion and the enucleation of the tumour was performed alternating the monopolar dissection, bipolar and hidrodisection. Control-endoscopy was carried out to verify mucosa integrity. Four suture points with poliglactine 3-0 string so as to close the musculature followed this. One suture was placed in for diminution of the size of the esophagean hiatus. Total time of intervention: two hours (30m for the cholecystectomy and one hour and thirty minutes for the myomectomy). Postoperative period: uneventful. Disappearance of the disphagia was observed. Radiologic transit control with water-soluble contrast at 4th post-operative day: good passage. Diagnosis from laboratory of pathology: conjunctive tumour formed by muscle non-striated cells: leiomyoma. The patient was re-examined on the two-month postoperative follow-up. General conditions were good and there were no complain of dysphagia. Neither there were any symptoms of gastro-esophageal reflux.
机译:该报告描述了在腹腔镜胆囊切除术中切除的食管下第三节的平滑肌瘤。患者是一名55岁的女性,患有食管肌瘤,直径40毫米,位于下食道的后壁。手术指征主要基于肿块的生长(7年前发现时为6毫米,增至40毫米)。最近,患者因疼痛而返回,这可能归因于他的胆总管结石症。还可以观察到少量的低吞咽度。影像学检查,直接内窥镜检查和内窥镜超声检查显示,mioma突伸至食管腔,在此逐渐减少。在同一次腹腔镜胆囊切除术中,建议进行腹腔镜食管肌瘤切除术。一旦安装了气腹膜,就放置了五个端口,就好像进行了裂口疝气手术一样。胆囊切除术顺利进行。接下来,进行食道镜检查以确定覆盖肿瘤根部的精确区域;在右侧站点。食管的纵向和圆形纤维在病变处被切断,并且肿瘤的摘除是通过单极解剖,双极解剖和虹膜切开交替进行的。进行对照内窥镜检查以验证粘膜完整性。随后用四聚乳酸3-0线缝合四个缝合点以闭合肌肉组织。放置一根缝合线以减小食管裂孔的大小。干预总时间:2小时(对于胆囊切除术为30m,对于子宫肌瘤切除术为1小时30分钟)。术后时期:平稳。观察到食指消失。术后第4天采用水溶性造影剂进行放射运输控制:良好的通过。病理实验室诊断:肌肉非横纹肌形成的结膜瘤:平滑肌瘤。在术后两个月的随访中对该患者进行了重新检查。总体状况良好,没有吞咽困难的症状。胃食管反流均无任何症状。

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