当院における腫瘤形成性虫垂炎に対するinterval appendectomyプロトコルの有用性の検討

Clinical outcomes for ‘Interval Appendectomy Protocol' in the treatment of acute appendicitis with an appendiceal abscess or mass

◆要旨：［目的］近年腫瘤形成性虫垂炎に対するinterval appendectomy（IA）が有効との報告が小児外科を中心になされている．そこで当科でもIAプロトコルを作成し，小児成人，糞石の有無，にかかわらず適応症例にIAを行っている．当院でのIAの成績を報告するとともにその有用性を検討する．［方法］プロトコルに適応しIAを行った20例につき経過を検討した．［結果］プロトコル逸脱は2例で，残り18例でプロトコルを完遂し待機的に腹腔鏡下虫垂切除術を行った．またこれら症例の術後合併症は表層SSI2例のみであった．［結論］筆者らの行っているIAプロトコルは，腫瘤形成性虫垂炎に対し安全かつ低侵襲な治療法である．

　【Aims】 Recently, the benefit of ‘Interval Appendectomy' （IA） for appendiceal abscess or mass have been reported in several papers, especially by pediatricians. In our hospital, we have also designed the IA protocol for appendiceal abscess or mass. We have performed IA strategy, regardless of the age or the presence of coprolites. Here we report clinical outcomes for IA and discuss the efficacy of IA protocol. 【Methods】 We have treated 20 cases according to the protocol. We analyzed their outcomes. 【Results】 In two cases, there were deviations of protocol. In 18 cases, the protocol was completed and in all of them, we could perform laparoscopic appendectomy. Complication: only superficial incisional SSI 2 cases. 【Conclusions】 Our protocol of interval appendectomy for appendiceal abscess or mass is a safe and minimally invasive method of treatment.