小児における腹腔鏡下虫垂切除術

Laparoscopic Appendectomy in Children

　小児領域における虫垂切除術は，急性虫垂炎はもとより慢性虫垂炎，生検目的の虫垂切除，incidentalな虫垂切除などさまざまな目的で行われているが，現在筆者らの施設では腹腔鏡下虫垂切除術を第一選択として行っている．腹腔鏡下虫垂切除術は，虫垂の同定および合併症の検索が短時間に，しかも正確にできる，膿性腹水を直視下で的確に洗浄・吸引ができる，美容的に優れている，術後の入院期間が短縮できる，などの利点がある．開腹虫垂切除術においても全身麻酔を必要とする小児では，腹腔鏡下虫垂切除術が開腹手術に取って代わる基本手技であると考えている．

The indication of appendectomy in children has been widespread. We have been performing laparoscopic appendectomy since 1992. The advantages of laparoscopic appendectomy are that detection of the appendix and evaluation of the condition within the abdominal cavity can be carried out, irrigation and aspiration can be performed under direct vision, cosmetic result is superior, and postoperative hospital stay is shorter. We believe that laparoscopic appendectomy will take over the conventional appendectomy in children who require general anesthesia even for open appendectomy.