臍部子宮内膜症に対して臍形成術を施行した5例

Five Cases of Umbilicoplasty Using Two Flaps for Umbilical Endometriosis

はじめに

　子宮内膜症は，子宮内膜組織が異所性に増殖する非腫瘍性疾患である。その発生部位は卵巣をはじめ下腹部に多く見られる。しかし，臍部などの皮膚子宮内膜症は比較的まれである。皮膚子宮内膜症の治療は手術が推奨されており，臍部子宮内膜症は切除の際に臍欠損が問題となる。

　今回われわれは臍部の腫瘤の切除時に梶川第1法による臍形成術を行い，良好な結果を得た症例を5例経験したので報告する。

　Endometriosis is a disease in which the endometrium and/or similar tissue grows and proliferates outside the uterus. Most cases of endometriosis occur within the pelvis, including the ovaries; endometriosis in the umbilical region is rare. Endocrine therapy and surgery is used to treat endometriosis. Surgical therapy is recommended for umbilical endometriosis because umbilical tumors are easily resected, but their resection requires that the umbilicus be reconstructed. We describe the cases of five patients whose umbilical endometrial tumors were resected, together with an umbilicoplasty with two skin flaps. In four of the patients, the reconstructed umbilicus was deep and naturally shaped. In the remaining patient, the scar became hypertrophied but was improved after a Z-plasty. The tumors were completely resected in all cases, and no postoperative recurrence was observed. The technique that we describe is useful because predesigning the skin flaps can lead to safe and complete tumor resection while obtaining a natural shape of the umbilicus.