腹腔鏡下盲腸部分切除を施行した7例の検討

Case report:Study of seven cases of laparoscopic partial cecal resection

　腹腔鏡下盲腸部分切除を施行した7例からその適応を検討した．症例1は虫垂粘液嚢腫，症例2，3は虫垂粘液嚢胞腺腫で，いずれも虫垂根部は閉塞し，黄色ゼリー状の内容物を虫垂に含んでいた．症例4,5は術前診断が盲腸の腫瘤性病変で，虫垂根部の閉塞した虫垂炎であった．症例6,7は盲腸の管状腺腫と粘膜癌であった．症例1〜5は腹腔鏡のみで，症例6,7は小開腹を加え切除断端を確認して切除した．虫垂粘液嚢胞腺腫を含む良性虫垂閉塞性疾患，および盲腸に限局した腺腫と粘膜癌が腹腔鏡下盲腸部分切除のよい適応と考えられた．ただし虫垂粘液嚢胞腺腫の場合，腹膜偽粘液腫の予防のためにも術中の損傷を起こさないよう注意が必要である．

We reviewed seven cases in which laparoscopic partial cecal resection were performed. Case 1 was an appendiceal mucocele, and cases 2 and 3 were appendiceal mucinous cystadenoma. In each case, the appendiceal orifice was obstructed and the appendix was filled with yellow, jellied substance. Cases 4 and 5 were preopera-tively diagnosed as elevated lesion of the cecum, but was diagnosed as obstructive appendicitis after operation. Case 6 was cecal tubular adenoma, and case 7 was mucosal adenocarcinoma.