Laparoscopic dome resectionを施行した脾囊胞の1例

A case of splenic cyst treated by laparoscopic dome resection

患者は32歳，男性．背部痛と上腹部違和感を主訴に当院を受診した．画像所見より脾囊胞と診断した．約10か月の経過観察後も症状を持続するため手術を行った．手術は4本のポートを用いて，低圧気腹下に腹腔鏡下で施行した．囊胞は脾門部から横隔膜下にかけて脾前方に突出して存在しており，表面の観察は容易であった．内容液を穿刺吸引後，囊胞を開放し，脾実質移行部近傍を広範囲に切離した．囊胞は単房性で，内壁は平滑白色調，病理組織所見より仮性囊胞と診断された．脾温存術式として脾囊胞に対するlaparoscopic dome resectionは低侵襲，かつ安全に施行可能であり，有用な術式と考えられた．

　We present a case who underwent laparoscopic dome resection for a splenic cyst.

　The patient was a 32-year-old man who visited our hospital for chief complaints of dorsal pain and discomfort of the upper abdominal region. A splenic cyst was diagnosed by imaging. Since the symptoms persisted during observation for about 10 months, laparoscopic dome resection was performed. At first, 4 ports were inserted into his abdomen, and CO₂ insufflated to an intraabdominal pressure of 6～8 mmHg. The cyst protruded anterior and its surface was easily observed. After aspiration of fluid content, the cyst was opened, and the proximal region transitional to the parenchymal spleen was widely resected. The cyst was uniocular with a smooth whitish wall, and histopathologically diagnosed as pseudocyst. Laparoscopic dome resection is a safe and effective procedure for treating a splenic cyst.