次全大肠切除术治疗家族性腺瘤性息肉病21例疗效随访

目的:评价次全大肠切除术治疗家族性腺瘤性息肉病(FAP)的近、远期疗效.方法:回顾性分析我科1985～2000年21例FAP患者行次全大肠切除术后残留结肠或(和)直肠的结肠镜随访结果.结果:所有患者残留结肠、直肠内都有不同程度的腺瘤复发,发生率100%;残留直肠内腺瘤生长较近端的残留结肠密集;1例术后4年直肠腺瘤癌变,累积直肠癌的发生率4.8%.结论:采用保留直肠的手术方式操作简单,术后并发症少,但有残留直肠息肉癌变的危险.

Outcomes of subtotal proctocolectomy for familial adenomatous polyposis: a follow-up study of 21 clinical cases

Objective:To evaluate the short-and long-term outcomes of subtotal proctocolectomy for familial adenomatous polyposis(FAP).Methods: Twenty-one FAP patients who had undergone subtotal proctocolectomy during 1985-2000 in our department were followed up colonoscopically to observe whether there was any recurrence of polyps in postoperatively residual colon or/and rectum.Results: Adenomatous recurrence with variant degrees was detected in the residual colon or/and rectum in all 21 patients,the recurrence rate being 100%.Polypous growth was denser in the residual rectum than in the proximal residual colon.The adenomatous polyp in one patient cancerized 4 years after the initial operation.The cumulative occurrence of colorectal cancer was 4.8%.Conclusion: Subtotal proctocolectomy is a simple procedure for FAP with fewer complications,but there is a risk of polyps cancerization in the residual colon or/and rectum.