全结直肠切除并回肠储袋-肛管吻合术治疗溃疡性结肠炎

目的　探讨全结直肠切除、回肠储袋肛管吻合术治疗溃疡性结肠炎的疗效。方法　对１９８４ ～１９９８ 年间进行的９ 例全结直肠切除、回肠储袋肛管吻合的溃疡性结肠炎患者作回顾性总结。结果　“Ｓ”形储袋６ 例，“Ｊ”形储袋３ 例。９ 例均存活。手术后发生粘连性肠梗阻１ 例，经非手术治疗后缓解；１ 例发生储袋瘘导致盆腔感染，最终切除储袋，行回肠造瘘；伤口感染１ 例；切口疝１ 例。随访８ 例，随访时间１ ～１３ 年。排便次数中位数为５ 次／２４ 小时（４～１０ 次／２４ 小时） 。对排尿和性功能无影响。结论　全结直肠切除、回肠储袋肛管吻合手术治疗溃疡性结肠炎患者的初步结果基本满意。

The application of total proctocolectomy and ileal pouch-anal anastomosis in the treatment of ulcerative colitis

Objective To evaluate the effect of total proctocolectomy and ileal pouch anal anastomosisin the treatment of ulcerative colitis. Methods Nine ulcerative colitis patients with total proctocolectomy and ileal pouch analanastomosis werereviewed from 1984 to 1998 .Results Theilealpouches were constructed in 6 cases as Stype and 3 cases as Jtype. All9 cases survived . Adhesiveileus was occurred in 1 cases. There was one case ofincision infection .One case occurred leakage of pouch which resulted in pelvic infection ,and finally required removing ileal pouch and operating ileostomy . One case developedincision hernia. Eight patients were followed up from one yearto thirteen years.The median of bowelfrequency was five times per 24 hours (4 times to 10 times per 24 hours) . There was no disturbance of urinary and sexual function . Conclusion The primary result oftotalproctocolectomy andilealpouch analanastomosis appearsto besatisfactoryin treating patients with ulcerative colitis.