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Title Transcription
キズアト ヲ ノコサナイ タンコウシキ フククウキョウ ホジョカ チュウスイ セツジョジュツ ノ クフウ
Title Alternative
Single-Incision Laparoscopic-Assisted Appendectomy Without Visible Scars for Pediatric Appendicitis
File
language
jpn
Attribute
Original Article
Author
UKIDA, Asami Department of Digestive and General Surgery, Shimane University Faculty of Medicine / Chugoku-Shikoku Pediatric Surgical Partners Organization
Kumori, Kouji Department of Digestive and General Surgery, Shimane University Faculty of Medicine / Chugoku-Shikoku Pediatric Surgical Partners Organization
ISHIBASHI, Shuichi Department of Digestive and General Surgery, Shimane University Faculty of Medicine / Chugoku-Shikoku Pediatric Surgical Partners Organization
Tajima, Shinji Department of Digestive and General Surgery, Shimane University Faculty of Medicine
Description
We have performed single-incision laparoscopic-assisted appendectomy for pediatric appendicitis since 2015. When the tip of the appendix is free from adhesion, it is easily exteriorized through the umbilicus. In cases with difficulties in performing transumbilical appendectomy, needlescopic forceps is added. Between January 2015 and July 2018, 23 pediatric patients with appendicitis underwent single-incision laparoscopic-assisted appendectomy in our institute. Of these, single-incision laparoscopic-assisted appendectomy was completed in 19 cases(83%), and 4 cases(17%) required the use of one additional needlescopic forceps. This laparoscopic procedure was useful even for complicated appendicitis with an abscess and/or perforation. There were no cases of intraoperative complications, while one patient had a postoperative intra-abdominal abscess. Regardless of the degree of inflammation of the appendix, our surgical technique provided a high completion rate with a few intra- and postoperative complications. The present study suggested that our procedure is useful and has superiority in terms of safety and cosmetic perspective for appendicitis in pediatric patients.
当科では小児の虫垂炎において、2015年より単孔式腹腔鏡補助下虫垂切除術を行ってきた。この経臍的な虫垂切除が困難な症例には、穿刺型ディスポーザブル鉗子(以下、穿刺型鉗子)を追加し、腹腔内で虫垂を切除する。今回、2015年1月から2018年7月までに当科で単孔式腹腔鏡補助下虫垂切除術を企図した小児虫垂炎症例23例を対象に、単孔式での完遂率、虫垂の炎症の程度と術式の関連、膿瘍や穿孔の有無、手術時間、術後合併症について診療録より抽出し、後方視的に検討した。単孔式で完遂できた症例は19例(83%)、穿刺型鉗子の追加を要した症例は4例(17%)であった。高度炎症例でも、単孔式で完遂できた。術後合併症は腹腔内膿瘍1例のみであった。単孔式腹腔鏡補助下虫垂切除術は虫垂の炎症の程度に関わらず、完遂率は高く、術後合併症も少ない。単孔式で完遂できない症例も穿刺型鉗子を追加することで安全に施行でき、また整容性にも優れており、小児虫垂炎に対する術式として有用であると考える。
Subject
単孔式腹腔鏡補助下虫垂切除術
小児
穿刺型ディスポーザブル鉗子
single-incision laparoscopic-assisted appendectomy
children
mini lap percutaneous surgical system
Journal Title
Bulletin of Shimane University Faculty of Medicine
Volume
42
Start Page
11
End Page
14
ISSN
1880084X
Published Date
2020-03
NCID
AA12049432
Publisher
島根大学医学部
Publisher Aalternative
Faculty of Medicine, Shimane University
NII Type
Departmental Bulletin Paper
Format
PDF
Rights
島根大学医学部
Text Version
出版社版
OAI-PMH Set
Faculty of Medicine