Ault Glenn T, Nunoo-Mensah Joseph W, Johnson Laura, Vukasin Petar, Kaiser Andreas, Beart Robert W
Department of Colorectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
Dis Colon Rectum. 2009 Mar;52(3):538-41. doi: 10.1007/DCR.0b013e318199effe.
Restorative proctocolectomy with ileal pouch-anal anastomosis with or without mucosectomy has become the procedure of choice in patients with long-standing ulcerative colitis complicated by malignancy or medically refractory disease and for familial polyposis syndrome. Some reports have demonstrated the development of malignancy at the ileoanal anastomosis. We present a recent series of five patients who developed adenocarcinoma in the middle of their ileal pouch including the first case of pouch carcinoma in a patient who underwent pouch formation for ulcerative colitis. We discuss their presentation and management. Development of ileal pouch cancers, while rare, has been seen with increasing frequency in our practice. Patients with long-standing ileal pouches may benefit from routine surveillance of the pouch as often as every six months, which can be performed quickly and easily in the office using flexible endoscopy.
保留或不保留黏膜切除的回肠储袋肛管吻合术式的全直肠系膜切除术已成为长期溃疡性结肠炎合并恶性肿瘤或内科难治性疾病患者以及家族性息肉病综合征患者的首选术式。一些报告显示回肠肛管吻合处发生了恶性肿瘤。我们报告了最近一组5例在回肠储袋中部发生腺癌的患者，其中包括首例因溃疡性结肠炎接受储袋成形术的患者发生储袋癌的病例。我们讨论了他们的临床表现及治疗方法。回肠储袋癌虽然罕见，但在我们的临床实践中其发生率呈上升趋势。长期使用回肠储袋的患者可能受益于每6个月一次的常规储袋监测，这可以在门诊使用可弯曲内镜快速简便地进行。
