@article{oai:shiga-med.repo.nii.ac.jp:00003541,
 author = {児玉, 創太 and 内藤, 弘之 and 八木, 俊和 and 辰巳, 征浩 and 長澤, 芳信 and 木田, 睦士 and 来見, 良誠},
 issue = {1},
 journal = {滋賀医科大学雑誌},
 month = {May},
 note = {69歳女性. 食思不振を主訴に入院となった. 精査にて, IV型食道裂孔ヘルニア及び肝外側区域に長径13cmの巨大肝嚢胞を認め, これらによる複合的な通過障害が原因と考えられた. 内視鏡的整復を試みたが不成功で, 症状継続するため, 手術目的で外科紹介となった. 巨大な肝嚢胞は, 手術時に視野の妨げとなることが予想されたので, まず経皮経肝的に肝嚢胞の穿刺後, 嚢胞内エタノール注入を行い, 続いて腹腔鏡下に食道裂孔ヘルニア根治術を施行した. 食道周囲のヘルニア嚢を剥離, 迷走神経の肝枝を温存し, 非吸収糸によりヘルニア門を縫縮後, メッシュによる補強を施行した. 術後10日目に退院され, 経過は良好であり, 栄養状態が改善した. 本症例では, 肝嚢胞の術前治療が良好な術野展開に有効であった., A 69-year-old woman　admitted with complaints of appetite loss. Careful examination revealed esophageal hiatal hernia typeIV(complex type) and huge liver cyst. The huge liver cyst was predicted to be an obstacle to the operation when performing an esophageal hiatal hernia operation. The operation was performed after reduction of the large cyst in the outside of the liver. The hernia sac around the esophagus was peeled off, the hepatic branch of the vagus nerve was preserved, and the hernia hiatus was crimped with non-absorbable thread. Thereafter, reinforcement with collagen coated mesh was performed. This patient was discharged 10 days after operation without any complications. When performing the laparoscopic radical surgery for esophageal hiatus hernia, it is necessary to take measures to obtain the good operative field., Departmental Bulletin Paper},
 pages = {23--26},
 title = {術前に巨大肝嚢胞に対してドレナージ術を施行した食道裂孔ヘルニアの1例},
 volume = {33},
 year = {2020}
}