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高リスク患者における巨大縦隔下甲状腺腫切除術のための部分上部胸骨切開術
Nasim Kasiri1, Alexander Pohlman1,2,3, Andrea M Ziegler1,4
1Stritch School of Medicine, Loyola University Chicago, 2160 S 1st Ave, Maywood, IL 60153, United States.
Journal of surgical case reports
|January 22, 2026
まとめ
部分上部胸骨切開術は、縦隔に進展した甲状腺腫(SG)に対する安全な外科的アプローチであり、特に肥満患者において有効です。この手技は、完全胸骨切開術に伴う合併症を最小限に抑え、高リスク個人の転帰を改善します。
科学分野:
- 胸部外科学
- 内分泌学
- 腫瘍外科学
背景:
- 縦隔に進展した甲状腺腫(SG)は外科的な課題をもたらします。
- 肥満は、創部感染や離開などの胸骨切開術の合併症のリスクを高めます。
研究 の 目的:
- 病的肥満患者におけるSG切除のための部分上部胸骨切開術の安全性と有効性を評価すること。
- この低侵襲アプローチを示す症例を提示すること。
主な方法:
- 症候性の巨大SGと縦隔進展(BMI 47 kg/m²)を有する33歳女性の症例報告。
- 完全胸骨切開術の罹患性を回避するため、頸部と部分上部胸骨切開術を組み合わせた外科的アプローチ。
主要な成果:
- 患者は合併症なく、部分上部胸骨切開術を成功裏に受けました。
- この手技は十分な縦隔へのアクセスを提供し、患者は術後2日目に退院しました。
結論:
- 部分上部胸骨切開術は、高リスクの肥満患者における縦隔進展を伴う甲状腺腫の切除のための安全かつ効果的な代替手段です。
- このアプローチは、完全胸骨切開術に伴う罹患性を軽減します。
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