単孔式腹腔鏡下虫垂切除術の検討―導入後1年間の経験

One year study of a single incision laparoscopic appendectomy

◆要旨：【目的】当科で施行した単孔式腹腔鏡下虫垂切除術（以下，SILA）と開腹虫垂切除術（以下，OA）との比較検討を行った．【対象】2010年11月～2011年10月の1年間に当科で施行した虫垂切除術97症例（SILA 41例，OA 56例）を対象とした．【結果】年齢はSILAで若い傾向にあった．性別，BMI，白血球値に差は認めなかった．手術時間はSILAが長く，術後在院日数はSILAで短い結果となった．術後創感染に関してはSILAでは認めなかった．【結論】SILAは手術時間が長いものの，術後の在院日数が短く，創感染の発生もなく，また臍部縦切開を用いることで術後の創部も目立たず整容性に優れており，有用な術式であると考えられた．

［Background］ Single-incision laparoscopic appendectomy（SILA） via a vertical incision in the umbilical region has been performed for acute appendicitis at our hospital since November, 2010. We herein report and compare the results of SILA and laparotomy-appendectomy（OA）. ［Methods］ A total of 97 patients underwent appendectomy at our hospital during the one-year period between November 2010 and October 2011. ［Results］ There were 41 patients in the SILA group and 56 patients in the OA group. There were no significant differences in the sex distribution, average body mass index, or preoperative peripheral blood leukocyte count between the two groups. Operative time was 69 minutes in the SILA group and 49minutes in the OA group; the mean operative time was longer in the SILA group. The mean length of hospital stay after surgery was shorter in the SILA group. While one patient in the OA group showed surgical site infection（SSI）, none of the patients in the SILA group developed postoperative SSI. ［Conclusion］ Although the operative time for SILA tended to be somewhat longer than that for the conventional abdominal operation, the postoperative length of hospital stay was shorter, and the postoperative wound condition was significantly superior in the group treated by SILA. Furthermore, there was also no postoperative SSI in the group treated by SILA. Therefore, SILA is considered to be a useful operative method for appendectomy.