Sengul N, Wexner S D, Hui S M, Baig M K, Thomas N, Connor J, Weiss E G, Nogueras J J, Berho M
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Tech Coloproctol. 2006 Mar;10(1):29-34; discussion 34-6. doi: 10.1007/s10151-006-0247-4. Epub 2006 Mar 15.
Pouchitis is a common complication following restorative proctocolectomy with ileal pouch anal anastomosis (RPC-IPAA) for mucosal ulcerative colitis (MUC). The aim of this study was to determine if perioperative anatomic extent and severity of disease are predictors of pouchitis.
All consecutive patients who underwent RPC-IPAA for MUC between 1988 and 2002 were retrospectively studied. Pouchitis was classified as acute, recurrent or refractory. Colectomy specimen slides were histopathologically evaluated by a single blinded pathologist (MB), who assessed extent and severity of disease.
Of 112 patients assessed, 70 (62.5%) had some form of pouchitis at a median follow-up of 38 months (range, 1-204 months). No association was found between the extent or severity of disease and subsequent development of acute or chronic pouchitis. A positive correlation was found between the histopathologic score and the occurrence of clinical pouchitis (p=0.014). The presence of colonic metaplasia in the pouch biopsy was significantly correlated with a histopathologic diagnosis of pouchitis (p<0.0001, r=-0.449).
Following RPC for MUC, the extent and severity of disease do not predict the subsequent development of pouchitis.
对于黏膜溃疡性结肠炎（MUC）患者，行回肠储袋肛管吻合术（RPC - IPAA）的直肠结肠切除术后，储袋炎是一种常见并发症。本研究旨在确定围手术期疾病的解剖范围和严重程度是否为储袋炎的预测因素。
回顾性研究1988年至2002年间所有因MUC接受RPC - IPAA手术的连续患者。储袋炎分为急性、复发性或难治性。由一位单盲病理学家（MB）对结肠切除标本切片进行组织病理学评估，评估疾病的范围和严重程度。
在评估的112例患者中，70例（62.5%）在中位随访38个月（范围1 - 204个月）时出现某种形式的储袋炎。未发现疾病的范围或严重程度与急性或慢性储袋炎的后续发生之间存在关联。发现组织病理学评分与临床储袋炎的发生呈正相关（p = 0.014）。储袋活检中结肠化生的存在与储袋炎的组织病理学诊断显著相关（p < 0.0001，r = -0.449）。
对于MUC患者行RPC术后，疾病的范围和严重程度不能预测储袋炎的后续发生。
