Stoian M, Dolinescu C, Dăscălescu C, Stoica S C, Pădureanu S
Facultatea de Medicină, Universitatea de Medicina şi Farmacie Gr. T. Popa, Iaşi.
Rev Med Chir Soc Med Nat Iasi. 1997 Jan-Jun;101(1-2):179-86.
Familial adenomatous polyposis (FAP) syndromes are well recognized entities that benefit from surgical treatment which should not be delayed. Screening of first degree relatives is important. The aim of removing the colorectal mucosa with significant potential of malignant transformation can be achieved by means of three distinct procedures: panproctocolectomy and ileostomy, subtotal colectomy with ileorectal anastomosis, restorative proctocolectomy with ileoanal anastomosis. In a series of eight patients with FAP we performed mostly subtotal colectomy with ileorectal anastomosis. Of five patients who underwent a form of subtotal colonic resection, one was lost from follow up and two developed carcinoma in the remaining rectal mucosa, which necessitated completion of the resection with proctectomy and permanent ileostomy. Nevertheless, in the increasing number of patients amenable to regular outpatient supervision, there are strong points for recommending sphincter-saving operations.
家族性腺瘤性息肉病（FAP）综合征是公认的疾病实体，手术治疗对其有益且不应延迟。对一级亲属进行筛查很重要。通过三种不同的手术方法可以实现切除具有显著恶变潜能的结直肠黏膜的目的：全直肠结肠切除术及回肠造口术、结肠次全切除术及回肠直肠吻合术、保留肛门的直肠结肠切除术及回肠肛管吻合术。在一组8例FAP患者中，我们大多实施了结肠次全切除术及回肠直肠吻合术。在接受某种形式结肠次全切除术的5例患者中，1例失访，另外2例在剩余的直肠黏膜中发生了癌，这使得有必要完成直肠切除术及永久性回肠造口术。然而，对于越来越多适合定期门诊监测的患者，推荐保留括约肌的手术有充分的理由。
