论文信息 - FIVE CASES OF DIVERTICULITIS WITH COLOVESICAL FISTULA TREATED BY LAPAROSCOPIC SURGERY

FIVE CASES OF DIVERTICULITIS WITH COLOVESICAL FISTULA TREATED BY LAPAROSCOPIC SURGERY

S状結腸憩室炎に起因した結腸膀胱瘻は稀であり，多くは手術適応となる．以前は開腹手術が標準術式であったが，近年腹腔鏡下手術の報告がみられている．当院でも1998年以降，結腸膀胱瘻を伴ったS状結腸憩室炎5例に対して腹腔鏡下手術を施行している．成績は平均手術時間194分，開腹移行率0％，平均出血量72ml，平均術後在院日数14.6日，死亡例0例であり，術後合併症は尿管狭窄1例，皮下膿瘍1例であった．瘻孔剥離後の膀胱には手術操作を加えなかったが，尿道カテーテルを留置し膀胱内を減圧することで瘻孔は治癒した．高度の炎症による瘻孔形成性の憩室炎に対しても腹腔鏡下手術は実現可能であり，拡大視野を利用した手術操作によって安全で低侵襲に施行できる．

T. Sawada | S. Matoba | J. Moriyama | Tomoyuki Takaba | Tsuyoshi Yokoyama

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