Xゲートを用いた胃内手術にて摘出した毛髪胃石の1例  [in Japanese] Laparoscopic Intra-gastric Surgery Using an X-Gate^【○!R】 for a Gastric Trichobezoar in a Child  [in Japanese]

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Author(s)

    • 宗崎 良太 SOUZAKI Ryota
    • 九州大学大学院医学研究院小児外科学分野 Department of Pediatric Surgery, Graduate School of Medical Science, Kyushu University
    • 家入 里志 IEIRI Satoshi
    • 九州大学大学院医学研究院小児外科学分野 Department of Pediatric Surgery, Graduate School of Medical Science, Kyushu University
    • 近藤 琢也 [他] KONDO Takuya
    • 九州大学大学院医学研究院小児外科学分野 Department of Pediatric Surgery, Graduate School of Medical Science, Kyushu University
    • 橋爪 誠 HASHIZUME Makoto
    • 九州大学病院先端医工学診療部 Department of Advance Medicine and Innovative Technology, Kyushu University Hospital
    • 田口 智章 TAGUCHI Tomoaki
    • 九州大学大学院医学研究院小児外科学分野 Department of Pediatric Surgery, Graduate School of Medical Science, Kyushu University

Abstract

胃石には柿胃石,繊維胃石などがあり,小児では毛髪胃石がもっとも多く,治療は外科的に摘出されることが多い.我々は,X ゲート<sup>®</sup>を用いた胃内手術および腹腔鏡補助下手術にて巨大毛髪胃石を摘出しえたので報告する.症例は13 歳,女児.腹部腫瘤と腹痛を主訴に来院.CT,上部消化管内視鏡で胃内に18 cm 大と空腸内に8 cm 大の毛髪胃石を認めた.内視鏡的摘出は困難であり,外科的摘出術を施行した.臍部より小開腹を行い,胃壁を切開し,X ゲート<sup>®</sup>を胃内に挿入した.5 mm カメラと5 mm 鉗子2 本を用いて,毛髪胃石をほぐしてはX ゲート<sup>®</sup>のカバーを外して摘出する操作を繰り返し摘出した.空腸の胃石は,X ゲート<sup>®</sup>を用いて単孔式内視鏡手術にて空腸を一部切開,毛髪胃石を袋に回収し,袋の中で破砕しながら臍の創から摘出した.胃内胃石は554 g,胃内手術のみでは1 時間47 分であった.毛髪胃石は,内視鏡による摘出や開腹手術,胃内手術の報告があるが,我々の術式は,手術時間も短く整容性に優れており,非常に有用であると考えられた.

Several types of bezoars, including diospyrobezoars and trichobezoars, have been reported. Among them, trichobezoar is most common in children, and most children with a trichobezoar undergo laparotomy for removal. We herein report on the use of laparoscopic intra-gastric surgery employing an X-Gate<sup>®</sup> for a child with a gastric trichobezoar. A 13-year-old female was admitted to our department due to an abdominal mass and stomachache. A CT scan and endoscopy revealed two trichobezoars in the stomach and jejunum; they were 18 and 8 cm in diameter, respectively. Because endoscopic removal of these trichobezoars was impossible, we attempted laparoscopic intra-gastric surgery using an X-Gate<sup>®</sup> from an umbilical wound made in the stomach; the gastric trichobezoar was successfully removed. After closing the gastric wall, we cut the jejunum wall with the single port surgical technique using the X Gate<sup>®</sup>, and collected the jejunal trichobezoar in a bag. It was removed via the umbilical wound attached to the X-Gate<sup>®</sup>. The total weight of the bezoars was 554 g. The removal of the gastric trichobezoars took only one hour and 47 minutes. Our technique shortens the operation, and is superior to the conventional operation in terms of the cosmetic results. This approach could be a very useful technique for the removal of gastric trichobezoars.

Journal

  • Journal of the Japanese Society of Pediatric Surgeons

    Journal of the Japanese Society of Pediatric Surgeons 49(5), 1018-1021, 2013-08-20

    The Japanese Society of Pediatric Surgeons

References:  12

Codes

  • NII Article ID (NAID)
    10031185851
  • NII NACSIS-CAT ID (NCID)
    AN00192281
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    0288609X
  • NDL Article ID
    024854396
  • NDL Call No.
    Z19-244
  • Data Source
    CJP  NDL  J-STAGE 
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