回肠循环襻在次/全结肠切除术肠道重建中的临床应用

Application of ileum circulation loop in total or subtotal proctocolectomy: report of 31 cases

目的观察回肠循环襻在次/全结肠切除术治疗家族性息肉病(familiaradenomatous polyposis,FAP)和严重的溃疡性结肠炎(ulcerative colitis,UC)中的临床效果。方法1987年1月至2007年6月我科收治的因FAP和UC行次/全结肠切除术病例31例,并根据术式分为应用、未用回肠循环襻2组。分析其术后并发症及术后1个月和1年2组患者24h排便次数、夜间排便次数。结果31例病例中采用回肠循环襻术式组较未用组术后并发症明显减少(P<0.05),且1个月及1年后24h排便次数﹑夜间排便次数也有所减少(P<0.01)。结论次/全结肠切除术应用回肠循环襻肠道重建术后的临床效果优于传统回肠贮袋与肛管吻合术(ilealpouch-anal anastomosis,IPAA)。

Objective To investigate the clinical effectiveness of ileum circulation loop in the treatment of familial adenomatous polyposis （ FAP） and ulcerative colitis （ UC） by total proctocolectomy or subtotal colectomy. Methods Totally 31 FAP or UC cases who receiving total or subtotal proctocolectomy in our department from January 1987 to June 2007 were divided into 2 groups according to using the ileum circulation loop or not in the different operation methods. The postoperative complications and the times of defecation in 24-hour and during night after 1 month and 1 year of operation were observed and analyzed. Results In the 31 cases,the incidence of postoperative complications were obviously decreased in using the loop group than in those of the without （ P〈0. 05） ,meanwhile,the times of defecation in 24-hour and during night in 1 month and 1 year were lesser in the using ileum circulation loop group than those of the without （ P〈0. 01） . Conclusion Our results indicate that the clinical outcome of using ileum circulation loop in the treatment of FAP and UC is better than that of the traditional ileal pouch-anal anastomosis.