回肠储袋肛管吻合术后排便生理改变及储袋功能评价  

Evaluations of pouch function after ileal pouch-anal anastomosis

作　　者：王健胜 龚剑峰 Wang Jiansheng;Gong Jianfeng(Department of General Surgery,Nanjing Jinling Hospital,Affiliated Hospital of Medicial School,Nanjing University,Jiangsu Nanjing,China)

机构地区：[1]南京大学医学院附属金陵医院普外科,江苏南京210002

出　　处：《腹部外科》2024年第6期459-466,共8页Journal of Abdominal Surgery

摘　　要：对于内科难治性溃疡性结肠炎以及家族性腺瘤性息肉病病人,回肠储袋肛管吻合术(ileal pouch-anal anastomosis,IPAA)是首选的手术方式。尽管关于储袋术后结构性和炎性并发症(包括储袋炎)已有较多文献报道,但功能性储袋疾病仍了解甚少。其复杂之处在于IPAA术后储袋功能结果变量定义的可变性,以及缺乏症状报告的标准化。部分病人的储袋功能较差,这可能是由于储袋生理未达最佳或病人特定因素(年龄、性别、体重指数和饮食习惯)所致。因此,探讨储袋正常的生理功能,进一步研究储袋功能性并发症,对于改善IPAA病人术后生活质量至关重要。Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)is preferred for patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).While many reports have discussed postoperative surgical and inflammatory complications of pouch,functional pouch disorders are poorly understood.Two complicating factors are a great variability of defining functional outcomes after IPAA and a lack of standardization for reporting symptoms.Normal pouch function has yet to be adequately defined.The underlying etiologies for poor functional outcomes are quite diverse,such as pelvic sepsis,pouchitis,anastomotic complications and pouch volvulus,etc.However,some patients manifest poor pouch function even without such complications.It is possibly due to non-optimal pouch physiology or such specific patient factors as age,gender,body mass index(BMI)and dietary habits.Therefore it is imperative to explore the normal physiological function of pouch and better manage the functional complications to enhance the postoperative quality-of-life.

关 键 词：回肠储袋肛管吻合术 储袋功能 溃疡性结肠炎 术后并发症 

分 类 号：R656.2[医药卫生—外科学]