腹腔鏡下手術後に化学性腹膜炎を発症した2例

抄録

　Mature teratomas are benign tumors that usually affect young women and are commonly resected laparoscopically. We report two cases of chemical peritonitis that occurred after laparoscopic ovarian cystectomy performed for mature teratoma resection.

　Case 1: A 45-year-old woman underwent laparoscopic ovarian cystectomy for a mature teratoma. Intraoperatively, we observed tumor cell spillage into the abdominal cavity. The patient returned with lower abdominal pain a month postoperatively and underwent reoperation for suspected appendicitis. We detected intra-abdominal fat and hair remnants and performed peritoneal lavage. She was diagnosed with chemical peritonitis, and her symptoms improved after the procedure.

　Case 2: A 28-year-old woman underwent laparoscopic ovarian cystectomy for a mature teratoma with intraoperative tumor cell spillage into the abdominal cavity. She returned with lower abdominal pain a month postoperatively. Computed tomography revealed suspected peritonitis, and she was diagnosed with chemical peritonitis. Oral steroid administration led to improvement in symptoms.

　It is important to minimize intraoperative tumor cell spillage to prevent chemical peritonitis. Low-dose oral steroid administration may effectively prevent chemical peritonitis.