家族性腺瘤性息肉病的外科治疗

Surgical Treatment of Familial Adenomatous Polyposis

为了提高家族性腺瘤性息肉病（ＦＡＰ）的外科治疗效果，对１６例ＦＡＰ患者的外科治疗情况进行了回顾性总结。１６例中除１例行全结肠直肠切除、回肠造口外，其余１５例均行全结肠直肠切除、回肠贮袋肛管吻合术。贮袋式中Ｊ型３例、Ｈ型１例，Ｓ型１１例，术后全部患者获１～５年随访，随访结果表明，病人排便功能均较满意，其中以Ｓ型贮袋者为好。笔者认为全结肠直肠切除是治疗ＦＡＰ唯一彻底有效的方法，而回肠贮袋肛管吻合则是减少术后排便次数、提高术后生活质量的良好术式，并讨论了手术方式的选择。

In order to improve the surgical effect of familial adenomatous polyposis (FAP), the authors retrospectively summarized the data of surgical treatment in 16 cases of FAP. All of the cases, except one that had undergone ileostomy, subjected to the ileal pouch anal anastomosis (IPAA), including J pouch in 3 patients, H poach in 1 and S pouch in 11. All of the patients were followed up for 1 5 years. The result showed that the function of defecation in all patients was satisfactory, among which, S pouch had the best function. The authors hold that total coloproctectomy is the only thorough successful procedure for FAP, and IPAA is the best to reduce the frequency of defecation and to improve the quality of life. The selection of procedure, operative manipulation, etc are discussed in this article.