全结肠直肠切除分期重建直肠及肛门功能的临床研究

The Clinical Study of Total Proctocolectomy and Staged Recto-anofunctional Reconstruction

自1979年以来,采用全结肠直肠切除、回肠代结肠、分期重建直肠及肛门功能的手术方式,治疗慢性溃疡性结肠炎及结肠息肉症20例。手术方式有四种类型,分两期完成。第一期手术都同时行回肠造瘘,两期手术间隔时间平均9.7个月,已完成两期手术的16例,均未发生严重并发症。这种术式既完全切除了病变肠段,又保留了肛门控制排便的功能,保证了较好的生活质量。但尚存在的问题是夜间污粪。3例作了回肠造袋的患者污粪现象较轻,回肠储存袋的作用尚须进一步研究。

Abstract Since 1979, the total proctocolectomy and recto-anofunctional recons-truction with ileal-anal anastomosis were performed on 20 patients with chronic ulcerative colitis and with multiple pqlyposis. The operative procedure can he di-vided into 4 types and completed by two stages. In the first stage operation the il-eostomy must be carried out. The mean time between the first and second stage operation was 9.7 monthes. No severe complication occurred in 16 patients after the completion of two-stage operation. This operative procedure preserved the anal function for good continence machanism so that to ensure the batter quality of life. Some of the patients had noctural soiling. In 3 cases having preanastomotic ile-al pouch, the noctural soiling was mild. The function of ileal reservoir is under further incestigation.