摘要
目的 探讨全大肠切除回肠贮袋肛管吻合术在治疗家族性腺瘤性息肉病(familial adenomatous polyposis,FAP)中的价值。方法 回顾性分析1995-2005年45例FAP患者行全大肠切除回肠贮袋肛管吻合术的手术方式、并发症以及结肠镜、肛肠测压等随访资料。结果 45例中发生吻合口漏1例;术后平均排便频率:3个月内每日9次,6个月后每日5次,12个月后每日4次;术后平均肛管慢波静息压为5cmH2O,频率为13次/min,肛管收缩压平均180cmH2O。37例术后结肠镜随访发现,14例有贮袋息肉(14/37,38%);4例术后发生小肠系膜硬纤维瘤。结论 全大肠切除回肠贮袋肛管吻合术是FAP理想的外科手术方式,回肠“J”型贮袋患者控便功能良好,术后应密切随访,预防发生大肠外肿瘤。
Objective To evaluate total proctocolectomy ileal pouch anal anastomosis (IPAA) for the treatment of familial adenomatous polyposis (FAP). Methods The operative modality, complications, follow-up data including colonoscopic findings and anorectal manometry in 45 patients with FAP ( 1995-2005) were retrospectively analyzed. Results One patient suffered from anastomotic leak. Patients' average postoperative defecation frequency was 9 times per day during the first 3 months; 5 times per day 6 months after; 4 times per day in 12 months. Average postoperative anal resting pressure was 5 cm H2O with a frequency of 13 times per min. The average squeeze pressure was 180 cm H2O. Regular colonoscopic follow-up made in 37 cases found polyps recurrence in the pouch in 14 cases (37.8%). Intestinal mesentery desmoid tumors developed in 4 cases. Conclusion The total proctocolectomy ileal J-Pouch anal anastomosis is an effective therapy for FAP. Patients with ileal J-Pouch have good continence function after proctocolectomy. Patients must be followed up closely for the occurrence of extracolonic tumors.
出处
《中华普通外科杂志》
CSCD
北大核心
2007年第3期187-189,共3页
Chinese Journal of General Surgery