全结肠或全结直肠切除、回肠J-袋直肠或肛管吻合术

目的　评估全结肠或结直肠切除 (TC或PC)后 ,回肠J -袋直肠或肛管吻合术的效果。方法　回顾性总结分析 12例全结肠或结直肠切除后J -袋直肠或肛管吻合术的临床资料。结果　男性 5例 ,女性 7例手术经过顺利 ,除一例于术后第一天有肛门出血外 ,其余均顺利恢复 ,无手术死亡。肛门排便功能随时间推移 ,经三个月逐步改善 ,六个月后随访 ,大便多已成形 ,每天平均 3 -5次。有 2例加作短段回肠倒置术 ,术后第一个月不需口服肠蠕动抑制药 ,每天排便亦仅 4-6次。结论　该手术能保持良好的排便功能 ,病人生活质量感到满意 ,是全结肠或结直肠切除后的一种有效而理想的肠道重建方式 ,若再加作回肠倒置术效果更好

Total colectomy or proctocolectomy with ileal J pouch - rectal or anal anastomosis

Objective To evaluate the effect of total colectomy (TC) or proctocolectomy (TPC) with ileal J pouch-rectal or anal anastomosis. Methods The clinical data of total colectomy or protocolectomy with ileal J pouch-rectal or anal anastomosis in 12 cases were analyzed rectospectively. Results They were 5 male and 7 female, all recovery smoothly after operation, except that bleeding from anastomosis occurred in one patient on first day postoperation, and no other complication and dead was found. The defecative function was improved and recovered for 3 to 6 months gradully, and the bowel movement were 3-5 times per day. Ileal reversion were performed in 2 cases on the basis of this operation and defecation were 4-6 times per day only after 1 month postoperation without drug. Conclusions This procedure can maintain good defeccative function and quality of life and patients felt satisfied, so it is an effective and ideal reconstructive technique. It can obtain better effect if ileal reversion was performe in addition to this operation.