Lien B, Løtveit T
Det medisinske fakultet Universitetet i Oslo 0316 Oslo.
Tidsskr Nor Laegeforen. 2001 Jan 30;121(3):295-7.
Patients suffering from severe ulcerative colitis often receive emergency colectomy at vital indication. Some of them are offered an ileal pouch-anal anastomosis a few months later.
All patients (n = 80) from May 1985 to August 1998 who were subjected to emergency colectomy at the National Hospital of Norway because of severe ulcerative colitis were studied prospectively. 40 patients later underwent a successful ileal pouch-anal anastomosis operation; 36 of them were sent a questionnaire assessing anal function.
No patients died during admission or within 30 days of emergency colectomy. Five patients (6%) developed postoperative complications requiring reoperation. 31 patients returned the questionnaire. All reported full bowel control, although two used pads during night. Mean number of evacuations per 24 hours was six. 14 patients (45%) usually had evacuations during night. All patients would prefer ileal pouch-anal anastomosis if they were given the choice between this and permanent ileostomy again. 87% were satisfied with the operation result, 10% were moderately satisfied, 3% were not satisfied.
The results of urgent colectomy are good, and patients aged < 50 may expect good anal function after receiving ileal pouch-anal anastomosis.
患有严重溃疡性结肠炎的患者常在生命指征危急时接受急诊结肠切除术。其中一些患者会在数月后接受回肠储袋肛管吻合术。
对1985年5月至1998年8月期间在挪威国家医院因严重溃疡性结肠炎接受急诊结肠切除术的所有患者(n = 80)进行前瞻性研究。40例患者后来成功接受了回肠储袋肛管吻合术;其中36例患者收到了一份评估肛门功能的问卷。
住院期间或急诊结肠切除术后30天内无患者死亡。5例患者(6%)出现术后并发症,需要再次手术。31例患者返回了问卷。所有患者均报告排便完全自控,尽管有2例患者夜间使用护垫。每24小时平均排便次数为6次。14例患者(45%)通常在夜间排便。如果再次在回肠储袋肛管吻合术和永久性回肠造口术之间做出选择,所有患者都更倾向于回肠储袋肛管吻合术。87%的患者对手术结果满意,10%的患者中度满意,3%的患者不满意。
急诊结肠切除术的效果良好,年龄小于50岁的患者在接受回肠储袋肛管吻合术后可能会有良好的肛门功能。