保留回盲瓣之盲肠经直肠肌鞘肛管吻合术在结直肠良性病变中的应用

Anastomosis of the cecum and anus preserving the ileocecal valve through the rectal muscular cuff for benign colorectal diseases

目的探讨保留回盲瓣之全结肠切除、直肠粘膜剥除,盲肠经直肠肌鞘肛管吻合术在溃疡性结肠炎、家族性腺瘤性息肉病患者中的应用及效果.方法回顾性总结1990年以来进行的8例保留回盲瓣之全结肠切除、直肠粘膜剥除,盲肠经直肠肌鞘肛管吻合患者,其中溃疡性结肠炎患者5例,家族性腺瘤性息肉病患者3例.结果随访5～10年无1例复发,无伤口感染、肛瘘形成,排尿及性功能无影响,8～10周排便次数恢复到3～5次/d,3～4月恢复正常(1～3次/d).结论保留回盲瓣之全结肠切除、盲肠经直肠肌鞘肛管吻合术治疗重症溃疡性结肠炎、家族性腺瘤性息肉病初步结果满意.

Objective To evaluate the effect of anastomosis of the cecum and anus preserving the ileocecal valve through the rectal muscular cuff in the treatment of benign colorectal diseases. Methods Eight cases including 5 ulcerative colitis and 3 familial adenomatous polyposis treated with this surgical procedure between 1990 to 2000 were retrospectively reviewed. Results During the 5 to 10 years of follow-up, no relapse, wound infection or anal fistula occurred in these patients, who had normal urination and sexual functions. The bowel movements decreased to 3 to 5 times a day within 8 to 10 weeks after the operation, and recovered to normal status (1 to 3 times a day) in 3-4 months. Conclusion This surgical procedure could produce clinically satisfactory result in the cases of ulcerative colitis and familial adenomatous polyposis.