回肠储袋肛管吻合术后并发症防治研究进展  

Advances in the prevention and treatment of complications after ileal pouch anal anastomosis

作　　者：徐艺 龚剑峰 XU Yi;GONG Jian-feng(School of Medicine,Southeast University,Nanjing 211189,China;不详)

机构地区：[1]东南大学医学院,江苏南京211189 [2]东部战区总医院普通外科,江苏南京210002

出　　处：《中国实用外科杂志》2021年第10期1181-1185,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81970469)。

摘　　要：全结肠、直肠切除术联合回肠储袋肛管吻合术(IPAA)作为溃疡性结肠炎(UC)和家族性腺瘤性息肉病(FAP)的首选手术方式,保留了正常消化通路,极大程度上改善了病人的长期生活质量。然而,IPAA不可避免地会带来相关并发症(如储袋炎等)。认识这些并发症并进行早期积极的处理,是提高IPAA治疗效果的关键。术后发生的近远期并发症可能归因于直肠黏膜残留或回肠储袋结构的改变,机制尚未明确,而慢性储袋炎和其他慢性炎症可增加储袋失败的风险,影响病人术后生活质量。通过不断更新的随访数据,临床医生须意识到储袋的建立并不意味UC治疗的终结,应更加关注术后长期随访监测。Total proctocolectomy with ileal pouch-anal anastomosis(IPAA),as the first choice for surgery way of ulcerative colitis(UC) and familial adenomatous polyposis(FAP),retains the normal digestive pathway and greatly improves the long-term quality of life of patients.However,IPAA inevitably brings related complications(such as pouchitis,etc).Recognizing these complications and dealing with them at the early stage is the key to improve the therapeutic effect of IPAA surgery.The short-term and longterm complications may be attributed to the residual rectal mucosa or the change of ileal pouch structure,and the mechanism is unclear.Chronic pouchitis and other chronic inflammation can increase the risk of pouch malformation and affect the quality of life in patients after surgery.Through constantly updated follow-up data, clinicians need to be aware that the formation of pouch does not mean the end of UC treatment,and they should pay more attention to the long-term follow-up monitoring after operation.

关 键 词：回肠储袋肛管吻合术 储袋炎 溃疡性结肠炎 术后并发症 

分 类 号：R6[医药卫生—外科学]