Steinberg D M, Allan R N, Cooke W T, Alexander-Williams J
Aust N Z J Surg. 1976 Feb;46(1):49-54. doi: 10.1111/j.1445-2197.1976.tb03193.x.
A study of 41 patients who underwent ileorectal anastomosis for Crohn's disease has shown this operation to be a relatively safe procedure with an immediate mortality of 2.5%. A defunctioning ileostomy may protect the patient against the consequences of anastomotic leakage. Ileorectal anastomosis is associated with a high early recurrence rate and on overall failure rate of up to 50% because of recurrence, intractable diarrhoea and exacerbation of perianal disease. However, half of the patients are able to retain the anastomosis and be restored to long-standing good health. The surgical philosophy in this Centre has largely evolved from treatment of small-bowel Crohn's disease, that is, resection of only the worst areas of involvement with the aim of symptomatic relief, and the results shown by this survey encourage us to pursue this policy by using ileorectal anastomosis for diffuse colonic disease, particularly if the rectum is uninvolved.
一项针对41例因克罗恩病接受回肠直肠吻合术的患者的研究表明，该手术是一种相对安全的术式，即刻死亡率为2.5%。暂时性回肠造口术可使患者免受吻合口漏的后果。回肠直肠吻合术的早期复发率较高，由于复发、顽固性腹泻和肛周疾病加重，总体失败率高达50%。然而，一半的患者能够保留吻合口并恢复长期的健康状态。该中心的手术理念很大程度上源于对小肠克罗恩病的治疗，即仅切除病变最严重的部位以缓解症状，本次调查结果鼓励我们对弥漫性结肠疾病采用回肠直肠吻合术来推行这一策略，尤其是在直肠未受累的情况下。
