腹腔鏡下手術を施行したS状結腸憩室炎による結腸膀胱瘻の検討

Clinical study of vesicosigmoidal fistula due to sigmoid colon diverticulitis treated laparoscopically

◆要旨：S状結腸憩室炎による結腸膀胱瘻に対して当科で腹腔鏡下手術を施行した14症例を報告する．年齢の中央値は61歳，男性13例，女性1例，術式は腹腔鏡下S状結腸切除術が12例，腹腔鏡下Hartmann術が2例であった．手術時間の中央値は172分で，出血量は50g，開腹移行率は0％であった．術後合併症は尿管狭窄1例，皮下膿瘍1例，遺残膿瘍2例であった．術後尿道カテーテル留置期間，および術後在院日数の中央値はそれぞれ7日，15日であった．本疾患に対しても腹腔鏡下手術はその拡大視効果を生かした正確な手術操作から，安全に施行可能である．

　We report 14 patients with vesicosigmoidal fistula due to sigmoid colon diverticulitis treated laparoscopically. The patients included 13 men and 1 woman. The median age was 61 years. Twelve patients underwent laparoscopic sigmoidectomy and 2 patients underwent Hartmann operation. The median operation time was 172 minutes and median estimated blood loss was 50g. There was no conversion to open surgery. Postoperative complications consisited of one ureterostenosis, one subcutaneous abscess and two intraabdominal abscesses. The median number for urinary drainage was 7 days and postoperative hospital stay was 15 days. Laparoscopic surgery can be safely performed even for vesicosigmoidal fistula due to sigmoid colon diverticulitis.