家族性结肠息肉病保留全直肠肌鞘的意义与旋转剥离直肠粘膜的技巧

目的探讨家族性结肠息肉病（FPC）保留全直肠肌鞘的意义与旋转剥离直肠粘膜的技巧。方法分析23例家族性结肠息肉病患者采用离断肠系膜上动、静脉，全直肠肌鞘内回肠襞一肛管吻合术治疗的效果，并探讨旋转剥离直肠粘膜的技巧。结果23例FPC患者均完整剥离直肠粘膜，直肠肌鞘内不遗留残膜，无手术失败病例，无近期感染病例，无息肉复发，近期与远期疗效均满意。结论对FPC患者手术中实施旋转剥离直肠粘膜方法，可完整剥离直肠粘膜，保留全直肠肌鞘，从而就保存了储便排便的肌性器官及附着的骶神经丛，使患者术后大便正常，小便及性功能亦未受损伤，具有临床推广应用价值。

Significance of reserving whole rectus muscle sheath and technique of rotationally-striping rectum mucous membrane in treatment of familial polyposis Coli

Objective To explore the significance of reserving the whole rectus muscle sheath and the technique of rotationally-striping the rectum mucous membrane in treatment of familial polyposis coli （FPC） for retaining the FPC patients＇ urinating, defecating, and sexual functions to improve the life quality of the postoperative patients. Methods We reviewed the related operations performed by us for the FPC patients using the technique of rotationally-stripping the rectum mucous membrane to reserve the whole rectus muscle sheath in treatment of FPC. We evaluated the effectiveness of this kind of operation and the its effects on improving the patients＇ life quality, especially on the young patients. Results After the rectum mucous membrane was completely stripped, the whole rectus muscle sheath had no residual membrane tissues left within the sheath; thus, the membrane secretion would not develop and the postoperative infection would not occur; therefore, the operation was successful. In addition, the long-term operative effect was good as proctopolypus and canceration would not take place. Conclusion The reservation of the whole rectus muscle sheath and the rotationally-striping method for the rectum mucous membrane in treatment of FPC can retain the postoperative FPC patienfs urinating, defecating, and sexual functions and can improve the patient＇s life quality, especially the young patient＇s life quality.