溃疡性结肠炎的外科微创治疗

Minimally invasive treatment of ulcerative colitis

外科治疗是溃疡性结肠炎(ulcerative colitis,UC)的重要组成部分,全结直肠切除、回肠贮袋肛管吻合术(ileal pouch-anal anastomosis,IPAA)已成为标准术式.近年来在微创外科技术的迅猛发展与普及下,越来越多医疗中心开展腹腔镜IPAA手术.腹腔镜IPAA手术相比于开腹手术的在术后近、远期疗效中的优势逐渐突显,且其安全有效性已达成共识.目前更多更为微创的技术也陆续尝试应用于IPAA手术.但是由于UC患者自身疾病的特点和IPAA术式的复杂性,腹腔镜IPAA手术仍未达到标准化、规范化水平.本文主要针对UC微创外科术后疗效和合理应用的研究进展作一述评.

Surgical treatment is an important part of comprehensive treatment of ulcerative colitis（UC）, and restorative proctocolectomy with ileal pouch-anal anastomosis（IPAA） has become the standard surgical procedure for UC. In recent years, the rapid development and wide application of minimally invasivesurgical technology have made laparoscopic IPAA be adopted in more and more medical centres. The advantages of laparoscopic IPAA over open IPAA in terms of short-term and long-term effects have gradually been recognized, and there has been a consensus on its security and effectiveness. At present, surgeons are trying to apply more minimally invasive surgical techniques to IPAA. However, owing to the intrinsic characteristics of UC and the complexity of IPAA, laparoscopic IPAA has not yet achieved standardization and normalization. This article will update the reasonable applications and postoperative efficacy of laparoscopic IPAA.