脳死小腸移植時にドナー腹直筋鞘を用いて一期的閉腹を施行した一例

抄録

Intestinal transplant cases may present with difficulties in abdominal wall closure during transplantation due to factors such as polysurgery, a reduced abdominal cavity volume, and decreased abdominal wall flexibility. The reported closure methods in such cases include staged surgery, mesh-assisted abdominal wall closure, and abdominal wall transplantation. However, in Japan, abdominal wall transplantation, as described in various overseas reports, cannot be performed. In this case, we performed abdominal wall reconstruction and closure using the rectus fascia harvested from the donor during a deceased donor intestinal transplantation, where preoperative difficulty in abdominal wall closure was anticipated. Harvesting the rectus fascia from deceased donors proved to be useful for recipient abdominal wall reconstruction and it is considered to be a technique worth considering when preoperative difficulty in abdominal wall closure is anticipated. Furthermore, as a future challenge, the necessity of abdominal wall transplantation in Japan also requires further discussion.