ID | 113614 |
Title Alternative | Utility of laparoscopic surgery for pelvic abscesses
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Author |
Yoshida, Kanako
The University of Tokushima
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Irahara, Minoru
The University of Tokushima
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Keywords | 付属器膿瘍
腹腔鏡
tubo-ovaruan abscess
laparoscopic surgery
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Content Type |
Journal Article
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Description | 骨盤内膿瘍に対する治療は,抗生剤による薬物療法が主体であるが,抗生剤無効例や,消化管から発生した膿瘍との鑑別を要する症例では外科的アプローチが必要となる。骨盤内膿瘍の場合,炎症による癒着が強いことが多く,手術は比較的難易度が高い。しかし,高度の炎症で疲弊した患者の負担を軽減するために,近年では腹腔鏡手術が積極的に導入されており,当院でも可能な限り腹腔鏡手術で対応している。抗生剤による治療が無効であった付属器膿瘍に対して腹腔鏡下手術を施行した4症例について報告する。4例とも輸血を要するような出血はなく,また他臓器損傷もなかった。術後は,速やかに炎症所見が改善し特に問題なく経過した。
骨盤内膿瘍に対する腹腔鏡手術は,ドレナージによりすみやかな炎症軽減が可能であり,かつ低侵襲であることから有用性は高い。一方で,(汎発性腹膜炎などで,)腸管麻痺を伴う症例では,腸管の膨隆のため腹腔鏡下の視野確保が困難であり,腹腔鏡手術の適応は慎重であるべきであると考える。 |
Description Alternative | Tubo-ovarian abscesses are classically treated with broad-spectrum antibiotics. Frequently, this approach fails, and surgical intervention becomes necessary. In recent years, laparoscopic surgery was positively introduced, and in our hospital, laparoscopic surgery, which is minimally invasive for patients, is selected as much as possible. We performed laparoscopy for four patients with tubo-ovarian abscess that did not improve with antibiotic treatment. No hemorrhage damage to other internal organs was noted in any of the patients. Inflammation was improved immediately, and postoperative progress was good. Usually, surgery for tubo-ovarian abscess is often technically difficult and associated with complications. For peritonitis accompanied with intestinal tract paralysis, it is difficult to secure the field of vision with the laparoscope, and therefore, the indications for laparoscopic surgery should be carefully considered before conducting the surgery.
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Journal Title |
Modern Trends in Obstetrics & Gynecology
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ISSN | 1882482X
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NCID | AA12291846
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Publisher | 中国四国産科婦人科学会
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Volume | 59
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Issue | 1
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Start Page | 59
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End Page | 63
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Published Date | 2010-09-28
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EDB ID | |
URL ( Publisher's Version ) | |
FullText File | |
language |
jpn
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TextVersion |
Publisher
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departments |
University Hospital
Medical Sciences
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