尿膜管遺残症に対する腹腔鏡下手術の経験

The experience of laparoscopic surgery for urachal remnant

◆要旨：【目的】東海大学医学部付属八王子病院で施行した腹腔鏡下尿膜管摘除術の術式と周術期成績を検討した．【対象と方法】2010年2月〜2014年3月に施行した腹腔鏡下尿膜管摘除術9例の術式と周術期成績について検討した．年齢中央値は31歳（20〜70歳）で，男性8例，女性1例であった．体位は仰臥位，ポートは腹直筋外縁に3ポートを設置した．臍を摘除した症例では一期的に臍形成術を行った．【結果】手術時間中央値は，107分（65〜143分），出血量は2ml（0〜30ml）であった．術後入院期間は，4日（3〜7日）であった．形成した臍の感染を1例に認めたが外来治療で治癒した．【結論】腹腔鏡下尿膜管摘除術は低侵襲で，整容性に優れた術式である．

　【Objective】The aim of this study was to evaluate laparoscopic surgical techniques and perioperative outcomes of laparoscopic management of urachal remnant patients at Tokai University Hachioji Hospital.【Method】A total of 9 patients with urachal remnant were treated using laparoscopic surgery between February 2010 and March 2014. The median patient age was 31 years（range, 20-70 years）, and there were 8 men and 1 woman. The procedure was performed with the patient in the supine position, and 3 trocars were inserted into the peritoneal cavity through the outer edge of the rectus abdominis muscle. For cases requiring umbilical excision, umbilicoplasty was performed.【Results】The mean operative time was 107 minutes（range, 65-143 minutes）. The median estimated total blood loss was 2ml（range, 0-30ml）. The median hospital stay was 4 days（range, 3-7 days）. We reported only 1 case of postoperative complication-an umbilical infection in a patient who had undergone umbilicoplasty. We treated this successfully with conservative measures.【Conclusion】Laparoscopic management for urachal remnant was determined to be noninvasive with good cosmetic results.