小腸病変に対する腹腔鏡補助下手術と術前ダブルバルーン小腸内視鏡検査の有用性

Laparoscopic surgery for small intestine disease

◆要旨：当科における小腸疾患に対する腹腔鏡補助下手術の検討を行った．【対象および方法】当科で腹腔鏡補助下手術を施行した15症例．腹腔鏡下操作は原則として2ポートで行った．【結果】14例は術前にダブルバルーン小腸内視鏡検査が施行され病変の確認と点墨がなされた．平均手術時間は88.4分（51～136分）で，平均出血量は29ml（0～120ml），平均創長は4.0cm（3～5cm）であった．手術関連合併症は認めなかった．【考察】小腸疾患に対する腹腔鏡補助下手術は，術前のダブルバルーン小腸内視鏡検査により，病変部の術中同定が容易となった．また，悪性疾患においても腹腔内の詳細な検索が可能であった．

　We examined laparoscopy-assisted surgery for disease of the small intestine in our department. Materials and method : Fifteen patients who underwent laparoscopy-assisted operation for the disease of small intestine were examined. The operations were performed through 2 ports. Results : Fourteen patients underwent preoperative double balloon enteroscopy, confirming and marking the lesion. The mean operation time was 88.4 minutes（51～136 minutes）, the bleeding 29 ml（0-120 ml）and the length of the wound 4 cm（3～5 cm）. There was no complication in relation to the operation. As for the laparoscopy-assisted surgery for small bowel disease, identification of the tumor became easy during the operation by performing preoperative double balloon enteroscopy. In addition, an intraabdominal detailed search was possible for malignant disease.