家族性腺瘤性息肉病的外科治疗  

Surgical treatment of familial adenomatous polyposis

作　　者：廖国庆[1] 晏仲舒[1] 

机构地区：[1]中南大学湘雅医院普外科,湖南长沙410008

出　　处：《中国普通外科杂志》2004年第4期276-278,共3页China Journal of General Surgery

摘　　要：目的　分析大肠家族性腺瘤性息肉病 (FAP)的临床特点 ,探讨其手术治疗方法。方法　回顾性分析近 14年多来收治的 2 8例大肠FAP患者的临床特点和治疗方法。 2 8例中 2 0例有家族史 ,6例已发生癌变。结果　 2 8例均行手术治疗 ,行全结肠切除直肠黏膜剥除回肠造袋肛门吻合术 2 5例 ( 89.3 % ) ,其他术式 3例。手术后无严重并发症发生。术后辅以非甾体类抗炎药 ,或他莫西酚治疗。 2 8例均得到随访 2～ 14年 ,4例死亡 ( 14 .3 % )。余者术后生存质量满意 ,排便功能良好。未发现回肠粪袋息肉形成。结论　手术是治疗家族性腺瘤性息肉病的主要方法 ,它可预防肠息肉癌变。术后使用非甾体类抗炎药 ,或他莫西酚治疗对家族性腺瘤性息肉病的复发有预防作用。Objective To study the clinical characteristic and the surgical treatment of the patients with familial adenomatous polyposis(FAP). Methods Retrospective analysis was made on the clinical feature and operative procedures of 28 patients with FAP in our hospital in recent 14 years. Of the 28 patients, 20 patients had familial history, 6 had cancerization. Results All the patients received operation, ileal pouch- anal anastomosis(IPAA) were performed on 25 cases(89.29%) , 3 cases underwent other operations. No severe complications had taken place postoperatively. All the patients received non-steroid anti-inflammatory drugs(NSAIDs) or tamoxifen treatment. All the patients were followed-up for 2-14 years, 4 patients died(14.29%) during follow-up period. Life quality and bowel function after operation were good in the aliving patients. No polyp in ileum pouch was seen. Conclusions Surgical treatment is the main methods for FAP, it can prevent bowel polyp carceration. Use of NSAIDs or tamoxifen as an adjuvant treatment of FAP is useful in the prevention of FAP recurrence.

关 键 词：息肉病综合征 家族性/外科学 

分 类 号：R730.269[医药卫生—肿瘤]