当院における腸閉塞例に対する腹腔鏡下手術症例の検討

Laparoscopic surgery for bowel obstruction: analysis of surgical outcome in our hospital

◆要旨：2010年9月～2011年12月に当院にて腹腔鏡下にアプローチした腸閉塞例25症例（単純性癒着性腸閉塞15例，複雑性腸閉塞10例）を対象に，臨床学的側面から検討した．単純性癒着性腸閉塞例に対しては13例で完全腹腔鏡下で完遂でき，2例は小開腹術を要した．術中合併症は3例に小腸損傷を併発したが，体内結紮にて修復した．術後合併症はなく，再発例は1例のみであった．複雑性腸閉塞例は6例で完全腹腔鏡下に完遂でき，2例は小開腹を要し，2例は開腹術へ移行した．術中合併症は小腸損傷を2例に併発し，体内結紮および開腹術にて修復した．術後合併症は2例で，1例は麻痺性腸閉塞を併発し，1例は術後癒着性腸閉塞を併発して，開腹術にて修復した．

　The clinical aspects of 25 patients with ileus （15 with simple adhesion ileus and 10 with complex ileus） who were treated laparoscopically at our hospital between September2010 and December 2011 were evaluated. Of those with simple adhesion ileus, 13 patients were treated completely with a laparoscopic procedure, but partial enterectomy with a small abdominal incision was necessary in 2 patients. Regarding intraoperative complications, 3 patients suffered damage to the small intestine, but repair was achieved in all by intracorporeal ligation. Recurrence was observed in 1 patient who was managed by re-operation. Of those with complex ileus, 6 patients were treated completely by laparoscopic surgery, 2 patients required a small abdominal incision, and 2 patients underwent open surgery. As intraoperative complications, the small intestine was damaged in 2 patients, and repair was facilitated by intracorporeal ligation in 1 patient and by open surgery in the other.