Palanivelu C, Jani Kalpesh, Sendhilkumar K, Parthasarathi R, Senthilnathan P, Maheshkumar G
GEM Hospital, Tamilnadu, India.
JSLS. 2008 Jul-Sep;12(3):256-61.
Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review the literature on the topic.
This is a case series of 15 patients who underwent restorative proctocolectomy with ileo-anal pouch anastomosis for familial adenomatous polyposis between 2000 and 2007. The salient operative steps are described.
There were 9 males and 6 females, 32 to 52 years of age, with an average age of 44.8 years. The median body mass index was 21.5 (range, 17 to 28). Rectal cancer was already present in 4 patients at the time of diagnosis. The median operating time was 225 minutes. Mean blood loss was 60 mL, with none of the patients requiring perioperative blood transfusion. None of the surgeries required conversion to the open approach. Bowel function resumed on the second postoperative day in 12 patients and on the third postoperative day in 3 patients. The median hospital stay was 8 days. Postoperatively, there was no mortality and no serious morbidity.
Laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis is a feasible surgery for familial adenomatous polyposis, and considering its cosmetic benefit, is a desirable option for this group of predominantly young patients.
家族性腺瘤性息肉病是一种遗传性疾病，其特征是存在数千个结肠腺瘤，若不治疗，这些腺瘤必然会发生恶变。由于这种疾病在年轻时就会出现，考虑到其美容优势，采用腹腔镜手术方法较为理想。我们描述了我们在该手术中的经验，并回顾了关于该主题的文献。
这是一组15例患者的病例系列，这些患者在2000年至2007年间因家族性腺瘤性息肉病接受了保留直肠结肠切除术并回肠肛管吻合术。描述了主要的手术步骤。
患者中男性9例，女性6例，年龄在32至52岁之间，平均年龄为44.8岁。中位体重指数为21.5（范围为17至28）。4例患者在诊断时已患有直肠癌。中位手术时间为225分钟。平均失血量为60毫升，所有患者均无需围手术期输血。所有手术均无需转为开放手术。12例患者术后第二天恢复肠道功能，3例患者术后第三天恢复肠道功能。中位住院时间为8天。术后无死亡病例，也无严重并发症。
腹腔镜保留直肠结肠切除术并回肠贮袋肛管吻合术对于家族性腺瘤性息肉病是一种可行的手术，考虑到其美容优势，对于这组以年轻患者为主的人群是一个理想的选择。
