回肠储袋与直肠肌管吻合术治疗家族性腺瘤性息肉病15例分析  

Application research of ileal pouch-rectal muscle sheath anastomosis for familial adenomatous polyposis

作　　者：刘连杰[1] 龚海峰[1] 王颢[1] 史晓辉[1] 徐晓东[1] 楼征[1] 孟荣贵[1] 傅传刚[1] 于恩达[1] 张卫[1] 王汉涛[1] 郝立强[1] 

机构地区：[1]长海医院肛肠医院肛肠外科,上海200433

出　　处：《中华普外科手术学杂志（电子版）》2009年第4期37-39,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨回肠储袋与直肠肌管吻合术在治疗家族性腺瘤性息肉病中的价值。方法回顾性分析15例FAP患者行全大肠切除回肠储袋与肛管或直肠肌管吻合术的手术方式、并发症以及结肠镜、肛肠测压等随访资料。结果回肠储袋与直肠肌管吻合术安全可靠,无严重并发症,较回肠储袋肛管吻合术术后排便频率明显降低,肛管静息压力和最大收缩压力明显增高,肛管长度明显延长。结论与传统的回肠储袋肛管吻合术相比,回肠储袋与直肠肌管吻合术简化了手术,减少了盆底肌肉和肛门括约肌损伤,保留了更多控便功能。Objective To explore the value ot ileal pouch-rectal muscle slaeath anastomosis m treatment of familial adenomatous polyposis （FAP）. Methods To analyze operation modes and complications in 15 patients of FAP treated with total proctoculectomy ileal pouch anal or rectal muscle sheath anastomosis retrospectively, as well as follow-up data such as cotonoscopy results and anal function and anal-pressure. Results Ileal pouch-rectal muscle sheath anastomosis is safe and reliable, without severe complication; it has a significantly lower defecation frequency, a higher anal canal rest pressure and maximum squeeze pressure, and a longer length of anal canal than the ileal pouch-anal anastomosis. Conclusions Compared with traditional ileal pouch-anal anastomosis, ileal pouch-metal muscle sheath anastomosis simplifies the operation, decreases the damage of pelvic diaphragm muscle and sphincter ani, and preserves more function of bowl control.

关 键 词：腺瘤息肉病 结肠 直肠结肠切除术 重建性 结肠袋 

分 类 号：R656.9[医药卫生—外科学] R735.3[医药卫生—临床医学]