Little Li is 24 years old this year, and has been unable to eat for more than 10 years. Every meal needs to be swallowed with water, and special attention must be paid to diet. Unrelated to him. It turned out that as early as about 10 years old, the doctor gave him a diagnosis and considered esophageal leiomyoma, which required surgical treatment. However, due to her young age, school attendance and other reasons, she has not been treated. Recently, my colleagues had a dinner together for the new year, but I was not careful, my esophagus was blocked by a piece of unchewed beef, and I was admitted to Wuhan Central Hospital.
Gastroscopy found that the narrowest part of Xiao Li’s esophagus is only the thickness of the refill, and it is very difficult to expand. It took a lot of effort to push the blocked meat into the stomach, and the gastric tube could not be squeezed. past. In the next 2 days, due to the local edema of the esophagus, Xiao Li could not even saliva flow into his stomach, so he could only spit out saliva continuously. After the improvement, he could only eat a little liquid food, and his quality of life was completely lost. The eradication surgery is imminent. Before thoracic surgery, it was found by endoscopic ultrasonography and chest CT that compared with CT examination more than 10 years ago, the leiomyoma in the lower esophagus was the size of an apple, completely encasing the esophagus, and even partially compressing the inferior vena cava. And there is a new leiomyoma the size of a broad bean in the upper esophagus. It appears that esophageal leiomyomas are also slowly growing. After careful preoperative preparation, the thoracic surgery department carefully dissected and stripped the mass on the esophagus through a single-port thoracoscopic minimally invasive method, and carefully reinforced the weak part of the esophagus. One week after the operation, when Xiao Li felt that he no longer needed to eat with water, he smiled happily.
Director of Thoracic Surgery Chen Baojun introduced that esophageal leiomyoma is the most common benign tumor of the esophagus, and patients usually have a long course of disease because of their small impact on life. Once the tumor severely compresses the esophagus, there will be symptoms of dysphagia, eating obstruction, retrosternal pain, and nausea and vomiting. By removing the tumor, the integrity of the esophagus is guaranteed to achieve the purpose of treatment. Small esophageal leiomyomas can be resected through a gastroscopic submucosal tunnel with minimal trauma and quick recovery. Large tumors require thoracic surgery to remove. Through the minimally invasive incision of about 3cm, with the assistance of thoracoscopy, the anatomical identification is clearer, which can better avoid damage to the esophageal intima, eliminate the need for reconstruction of the digestive tract, and greatly improve the quality of life after surgery.
Zhao Ke, Department of Thoracic Surgery, Wuhan Central Hospital