大肠切除回肠贮袋肛管吻合术  

Proctocolectomy and ileal pouch-anal anastomosis

作　　者：徐加鹤[1] 林建江[1] 张宏志[1] 

机构地区：[1]浙江医科大学附属第一医院,310003

出　　处：《实用肿瘤杂志》1992年第1期22-24,共3页Journal of Practical Oncology

摘　　要：1984年12月至1990年3月作者连续实施大肠切除回肠贮袋肛管吻合术11例治疗大肠腺瘤病和溃疡性结肠炎,其中6例为 S 型贮袋,5例为 S-J 型贮袋。无1例作近端回肠保护性造瘘。无手术死亡,无术后严重并发症。随访2月至6年,排便及控便功能以 S·J 型贮袋优于 S 型贮袋。文中讨论了避免手术并发症的各项细节。作者认为回肠贮袋手术没有必要常规地作近端保护性回肠造瘘,但应注意:(1)防止腹腔污染,(2)避免吻合张力,(3)贮袋输出肠袢宜短或免用,(4)贮袋充分减压引流。Eleven ileal pouch-anal anastomosis were performed after proctocolectomy in the treatment of adenomatosis or ulcerative colitis during the period from December 1984 to March 1990.The pouch in 6 patients was S-shaped and 5 S-J shaped.No proximal diverting ileostomy was conducted for any patient.No operative mortality and severe postoperative complications were recorded,2-month to 6-year follow-up study showed the S-J pouch restored better function in evacuation and continence than the S pouch.Specific details on the prevention of operative complications were presented.-The authors believe it unnecessary to perform a routine proximal diverting ileostomy to protect an ileal pouch if(1)peritoneal contamination could be avoided,(2)no tension on the anastomosis exists,(3)short or no outlet limb is utilized for the pouch and,(4)the pouch is sufficiently depressed through drainage.

关 键 词：大肠 红肠 直肠 切除 吻合术 

分 类 号：R657.105[医药卫生—外科学]