術後癒着性イレウスに対する腹腔鏡下癒着剥離術の試み

Laparoscopic Adhesiolysis for Postoperative Adhesive Ileus

　われわれは，術後癒着性イレウスと診断した7例に対し，腹腔鏡下癒着剥離術を試みた．腹腔鏡による観察で全症例に腹壁と腸管の癒着を認め，6例では単純性癒着性イレウスと診断した．このうち5例では腹腔鏡下に癒着剥離し，イレウスを解除できた．広範な癒着により小腸が一塊となっていた1例では，開腹術に移行し小腸部分切除術を行った．軸捻転によるイレウスであることが判明した1例は，捻転を解除できず開腹に移行した．広範な小腸の癒着をみる症例や捻転によるイレウスである症例を除き，腹腔鏡下癒着剥離術は癒着性イレウスに対し有効であると思われた．

Laparoscopic adhesiolysis was applied for 7 patients who were diagnosed as having postoperative adhesive ileus. Adhesions were seen between abdominal walls and intestines in all cases by laparoscopic observation. Among 6 patients with the diagnosis confirmed as adhesive ileus, 5 patients were successfuly treated by laparoscopic adhesiolysis. In a patient the procedure was converted to laparotomy, because adhesions between small intestines were severe and partial resection of the small intestine were necessitated.