{"created":"2023-06-19T08:46:51.114493+00:00","id":2518,"links":{},"metadata":{"_buckets":{"deposit":"f4890aa6-7ed4-4997-8fd8-829e7a36ec95"},"_deposit":{"created_by":25,"id":"2518","owners":[25],"pid":{"revision_id":0,"type":"depid","value":"2518"},"status":"published"},"_oai":{"id":"oai:ycu.repo.nii.ac.jp:00002518","sets":["4:71:468:469"]},"author_link":["4992","4990","4993","4995","5001","609","5002","4987","4997","4989","4998","4999","4988","4994","4985","5000","4986","604","592","5003","4991","4996"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-04-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"12","bibliographicPageStart":"7","bibliographicVolumeNumber":"73","bibliographic_titles":[{"bibliographic_title":"横浜医学"},{"bibliographic_title":"YOKOHAMA MEDICAL JOURNAL","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は58歳の男性．前医にて嚥下時つかえ感の精査のため施行された上部消化管内視鏡検査で扁平上皮癌の診断となり，当科紹介受診となった．精査の結果，胸部下部食道癌（T3N1M0，cStage III）の診断となり，非開胸縦隔鏡下食道亜全摘術， 3 領域郭清，胸骨後経路胃管再建および腸瘻造設を施行した．術後11日目に発熱があったためCT検査を施行したところ，気管背側に液体貯留像を認めた．縦隔鏡下で緊急ドレナージ術を施行し，乳白色の液体がドレナージされ，術後気管支背側ドレーンから，連日多量の排液を認めたためリンパ漏が疑われた．術後36日目にリピオドールを用いた両側鼠径リンパ節からのリンパ節穿刺法によるによるリンパ管造影を施行したところ，気管分岐部付近でリンパ漏が確認され，胸管の静脈角における排出障害と頸部リンパ管への逆流を認めた．また，静脈造影で，無名静脈の血栓閉塞を認め，この無名静脈閉塞によりリンパの灌流障害が生じ，リンパ漏が増強しているものと考えられた．同日に無名静脈をバルーン拡張し，後負荷の低減を図ったところ，翌日から気管支背側ドレーンの排液が減少した．術後 45 日目のリンパ管造影では胸管からのリンパ漏は消失しており術後72日に退院となった．無名静脈の血栓閉塞を伴う術後リンパ漏は，閉塞を解除することにより，本来のリンパ流を残したまま治癒し得ることが示唆された．","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"横浜市立大学医学会"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0372-7726","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"中山, 雄太"},{"creatorName":"ナカヤマ, ユウタ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"渥美　, 陽介"},{"creatorName":"アツミ, ヨウスケ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西村, 潤一"},{"creatorName":"ニシムラ, ジュンイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"青山, 徹"},{"creatorName":"アオヤマ, 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