El Muhtaseb Mohammad Sami H, Duncan Andrew, Talwar Dinesh K, O'Reilly Denis St J, McKee Ruth F, Anderson John H, Finlay Ian G
Department of Coloproctology, Lister Department of Surgery, Glasgow Royal Infirmary, Glasgow, G31 2ER, United Kingdom.
Dis Colon Rectum. 2007 Oct;50(10):1553-7. doi: 10.1007/s10350-007-9003-8.
Panproctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with ulcerative colitis and familial polyposis. The long-term nutritional consequences after pouch surgery are unknown. We have assessed the nutritional status of the essential trace elements-zinc, copper, manganese, and selenium-in patients several years (median, 10 (range, 2-15) years) after surgery.
Fifty-five patients with uncomplicated ileal pouch-anal anastomosis and 46 healthy control subjects were studied. A dietary assessment of trace element intake was undertaken by using a semiquantitative food frequency questionnaire. The patients' trace elements status for zinc, copper, manganese, and selenium was assessed by measuring their concentrations in blood.
The dietary intake of individual trace elements was similar in both groups (all P values > 0.4). There was no significant difference in the concentrations of plasma copper, zinc, and selenium between patients and healthy control subjects (all P values > 0.07). The concentration of whole blood manganese was significantly higher (P = 0.004) in patients (median, 178.5 nmol/l; range, 59-478 nmol/l) compared with healthy control subjects (median, 140 nmol/l; range, 53-267 nmol/l). Four (7 percent) patients had manganese concentrations more than three standard deviations of the mean of control group (>255 nmol/l).
This study shows that patients who have had uncomplicated pouch surgery have a normal dietary intake of trace elements and do not develop deficiencies in copper, zinc, manganese, and selenium. However, these patients may be at increased risk of manganese toxicity.
全直肠结肠切除术及回肠储袋肛管吻合术是溃疡性结肠炎和家族性息肉病患者的首选手术方式。储袋手术后的长期营养后果尚不清楚。我们评估了手术后数年（中位数为10年，范围为2至15年）患者体内必需微量元素——锌、铜、锰和硒的营养状况。
研究了55例接受单纯回肠储袋肛管吻合术的患者和46名健康对照者。通过使用半定量食物频率问卷对微量元素摄入量进行饮食评估。通过测量血液中锌、铜、锰和硒的浓度来评估患者的微量元素状况。
两组个体微量元素的饮食摄入量相似（所有P值>0.4）。患者与健康对照者之间血浆铜、锌和硒的浓度无显著差异（所有P值>0.07）。与健康对照者（中位数为140 nmol/l；范围为53至267 nmol/l）相比，患者全血锰的浓度显著更高（P = 0.004）（中位数为178.5 nmol/l；范围为59至478 nmol/l）。4名（7%）患者的锰浓度超过对照组平均值的三个标准差（>255 nmol/l）。
本研究表明，接受单纯储袋手术的患者微量元素饮食摄入量正常，且不会出现铜、锌、锰和硒缺乏。然而，这些患者可能有锰中毒风险增加的情况。
