NHÂN MỘT TRƯỜNG HỢP PHẪU THUẬT NỘI SOI QUA ĐƯỜNG NGỰC ĐIỀU TRỊ TÚI THỪA 1/3 GIỮA THỰC QUẢN

Abstract

Introduction: Approximately 65% of esophageal diverticulum cases are asymptomatic and are found by endoscopic examination. Symptomatic middle esophageal diverticulum requiring surgery is rare. In recent years, laparoscopic surgery for middle esophageal diverticulum has been reported. Case presentation: A 60-year-old female patient with symptoms of chest pain when eating, was diagnosed endoscopically as having a middle esophageal diverticulum (30cm from from the incisor row) the diameter of the diverticulum is 5cm. We decided to perform a thoracoscopic diverticulectomy. The patient in a prone position via 4 ports, and intraoperative endoscopy was performed during the surgery. To achieve a complete resection of the diverticulum, threads were placed on the oral and anal sides of the diverticulum, the threads were pulled, and the diverticulum was resected using Stapler Endo GIA 60mm. A postoperative upper gastrointestinal contrast examination revealed no abnormalities. She was given oral food 7 days after surgery and discharged after 10 days. The results of endoscopic re-examination at 6 months, 1 year and 2 years after surgery did not show any abnormalities. Conclusion: Laparoscopic thoracoscopic surgery is a feasible and safe method for the treatment of middle esophageal diverticulum. The surgery combined with intraoperative flexible endoscopic tube to identify the hernia sac neck is very useful to reduce the risk of esophageal fistula complications and postoperative recurrence.