小児直腸脱に対し腹腔鏡下直腸固定術を施行した1例

Laparoscopic rectopexy performed on a child with rectal prolapse

◆要旨：患者は3歳，女児．排便時に直腸脱を認めるようになり，当科外来へ紹介となった．徐々に脱出が頻回となり，疼痛を伴うようになったため，腹腔鏡下直腸固定術を施行した．術中所見では，Douglas窩にたるんだ直腸を認めていた．直腸を剝離，挙上し，仙骨前面と直腸後壁を縫合固定した．術後2日目に退院し，現在も再発は認めていない．小児の直腸脱には保存的加療が優先されることが多いが，無効時には外科的加療が選択される．腹腔鏡下直腸固定術は成人で広く行われている術式であるが，小児においても，安全に施行することは可能であり，有用な術式であると考えられた．

　A three-year-old girl was admitted to our hospital for rectal prolapse. Laparoscopic rectopexy was performed because her rectal prolapse developed frequently and accompanied pain. Laparoscopic examination showed that her flabby rectum was in the Douglas pouch. We pulled up the rectum and sutured her rectum to the anterior surface of the sacrum. She was discharged on the 2nd postoperative day, and still has not experienced recurrence. For rectal prolapse in children, conservative treatment is first performed, but surgical treatment is selected when it is ineffective. Laparoscopic rectopexy can be performed safely not only in adults but also in children, which is a useful technique for rectal prolapse in children.