家族性腺瘤性息肉病13例诊治分析

Diagnosis and Treatment of Familial Adenomatous Polyposis of 13 Cases

目的探讨家族性腺瘤性息肉病的诊断、手术方式的选择,提高其诊治水平。方法回顾性分析近年来收治的13例家族性腺瘤性息肉病患者的临床资料。结果 13例患者根据病变累及范围,有3例行全结肠切除回直肠吻合术;3例行全结肠直肠切除回肠肛管吻合术,术后有1例并发吻合口瘘,保守治疗后治愈;3例全结肠切除直肠粘膜剥脱回肠储袋肛管成形术,术后1例并发储袋炎再次手术切除储袋改回肠造瘘;4例行全结肠直肠肛管切除回肠造瘘术。术后均随访,有2例肝转移死亡。结论家族性腺瘤性息肉病是一种癌前病变,需早期手术治疗,临床根据病人具体选择相应手术方式,术后要定期检查及时处理复发。

Objective To investigate the familial adenomatous polyposis diagnosis,surgical options,improve the diagnosis and treatment.Methods A retrospective analysis of 13 cases treated in recent years,familial adenomatous polyposis of the clinical data.Results 13 patients the lesion involved the area,3 patients had total colectomy back anastomosis;3 patients had total proctocolectomy ileal anal anastomosis,1 case of postoperative anastomotic leakage,and was cured with conservative treatment;3 Cases of total colectomy for colorectal sticky wax stripped ileal pouch anal plasty,1 case of postoperative inflammatory re-pouch surgery colostomy pouch change ileum;4 patients had total resection of the ileum colostomy colon rectum and anal canal.Patients were followed up,there are two cases of liver metastasis died.Conclusion Familial adenomatous polyposis is a precancerous lesion,need early surgical treatment,clinical select based on the patient specific surgical procedure,postoperative treatment to recurrence of regular inspections in a timely manner.