腹腔鏡下盲腸固定術が有効であった移動性盲腸の1例—本邦報告例の検討とともに

Laparoscopic cecopexy for mobile cecum syndrome : A case report and review of the Japanese literature

◆要旨：患者は35歳，男性．移動性盲腸の軸捻転にて入院となり，保存的に症状は改善したものの，便通異常を反復しており，外科的治療が選択された．腹腔鏡下盲腸固定術が施行され，術後経過は良好であった．移動性盲腸は，右側結腸が後腹膜へ固定されず，腹痛，腹部不快感，便秘，悪心・嘔吐など多彩な症状をきたす疾患である．保存的治療に抵抗性の場合，外科的治療が選択されるが，腹腔鏡下手術の報告例はまだ少ない．今回筆者らは，腹腔鏡下盲腸固定術を施行し，良好な結果が得られた移動性盲腸の1例を経験したため，本邦報告例の検討とともに，文献的考察を加えて報告する．

A 35-year-old male was admitted because of cecal volvulus. Barium enema examination showed mobility of the cecum. Although the patient's condition improved by conservative treatment, he requested radical treatment because he had frequently suffered from digestive symptoms. Therefore, laparoscopic cecopexy was performed. The cecum and the ascending colon were sutured to the lateral peritoneum laparoscopically with interrupted suture. The postoperative course was uneventful, and the patient was discharged from our hospital on the postoperative day 5. There are few reports of mobile cecum syndrome treated by laparoscopic surgery ; we report this case with a review of the Japanese literature.