三浦, 康之, 鈴木, 隆, 吉田, 公彦, 大嶋, 陽幸, 谷島, 聡, 島田, 英昭, 船橋, 公彦, 三浦, 康之, 鈴木, 隆, 吉田, 公彦, 大嶋, 陽幸, 谷島, 聡, 島田, 英昭, and 船橋, 公彦
症例, 症例は40代男性.義歯誤飲後2日して,胸痛を主訴に受診した.内視鏡検査は切歯より21 cmに義歯が嵌頓し抜去困難と判断し緊急手術とした.術前画像検査では穿孔所見なく,胸腔鏡下で義歯摘出を行うこととし,食道切開し義歯摘出後に単閉鎖した.術後,縫合不全から膿胸併発したが,保存的加療で軽快した.胸腔鏡下食道異物摘出は発症からの経過時間,局所所見などを踏まえ,術後合併症を想定した対応を念頭に入れ手術に臨む必要がある.The patient was a 40-year-old man presenting with chest pain who was referred to our institution for examination 2 days after accidently swallowing a dental prosthesis. Emergency endoscopy revealed a prosthetic incisor trapped 21 cm deep into the esophagus. We concluded that its removal would be nearly impossible and performed emergency surgery. No perforation was found on preoperative imaging, so we decided to perform thoracoscopic surgery. Although thoracoscopy showed mild inflammation locally, we performed thoracoscopic esophagotomy, extracted the prosthesis, and closed the incision with a simple closure. Postoperative recovery was complicated by empyema resulting from suture failure, but it subsided with conservative treatment. Thoracoscopic extraction is considered to be minimally invasive for the surgical removal of a foreign object from the esophagus. If a complication such as postoperative suture failure occurs, however, the patient's condition often turns severe. Therefore, we believe it is important to approach surgery with a constant awareness of possible measures to manage postoperative complications depending on factors such as the time elapsed after onset and local findings.