Kimura Tomo, Shibata Masahiko, Ohhara Moritaka
First Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan.
Dis Colon Rectum. 2005 Feb;48(2):397-9. doi: 10.1007/s10350-004-0846-y.
The usefulness of the laparoscopic approach for massive intra-abdominal abscesses is controversial. We report two patients who underwent laparoscopic abscess drainage for massive intra-abdominal abscesses not amenable to the percutaneous approach that were suspected to be caused by acute appendicitis.
In both patients, four ports were placed at their abdominal walls under general anesthesia. Intra-abdominal abscess cavities were punched out, and the purulent exudates that spilled out from the cavities were aspirated completely. Copious irrigation was performed under direct vision. These procedures were completed laparoscopically.
The postoperative clinical courses of the patients were uneventful. The intra-abdominal abscesses did not recur, and no wound complications were recognized. The patients were discharged from our hospital in excellent condition within two weeks.
Laparoscopic drainage for massive intra-abdominal abscess is a minimally invasive and useful procedure compared with the open method or the percutaneous approach. It offers the advantage of being able to explore of the abdominal cavity without an unnecessary wide incision, and aspiration of a purulent exudate is possible under direct vision.
腹腔镜手术用于治疗巨大腹腔内脓肿的有效性存在争议。我们报告了两名因急性阑尾炎疑似导致巨大腹腔内脓肿而接受腹腔镜脓肿引流术的患者，这些脓肿无法通过经皮途径治疗。
两名患者均在全身麻醉下于腹壁置入四个端口。在腹腔内脓肿腔打孔，将从腔内溢出的脓性渗出物完全吸出。在直视下进行大量冲洗。这些操作均通过腹腔镜完成。
患者术后临床过程平稳。腹腔内脓肿未复发，未出现伤口并发症。患者在两周内康复出院，身体状况良好。
与开放手术或经皮途径相比，腹腔镜引流巨大腹腔内脓肿是一种微创且有效的手术方法。它具有能够在无需进行不必要的大切口的情况下探查腹腔的优势，并且可以在直视下吸出脓性渗出物。
