Department of Surgery, Boston University Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA.
J Gastrointest Surg. 2010 Mar;14(3):562-9. doi: 10.1007/s11605-009-1099-9.
Colectomy with ileal pouch-anal anastomosis has become widely accepted and is now considered the procedure of choice for patients with ulcerative colitis (UC) as well as familial adenomatous polyposis (FAP).
The clear patient advantage of functional continence has pushed this procedure to the forefront in treating both UC and FAP. As a result, the procedure continues to evolve with recent debate centering on the question of whether to perform a double-stapled technique without rectal mucosectomy or a handsewn anastomosis following transanal mucosectomy. Although continence and complication rates continue to be hotly debated, it is understood that performing the stapled procedure does leave a rectal cuff, which carries with it the possibility of disease persistence or recurrence. As such, if the rectal cuff becomes symptomatic or dysplastic, it must be removed. This is accomplished by performing a transanal completion mucosectomy and reconstructing the ileal pouch-anal anastomosis.
回肠储袋肛管吻合术已被广泛接受，目前被认为是溃疡性结肠炎（UC）和家族性腺瘤性息肉病（FAP）患者的首选治疗方法。
该手术具有明显的控便优势，这使其在 UC 和 FAP 的治疗中处于领先地位。因此，该手术在不断发展，最近的争论集中在是否采用无直肠黏膜切除术的双吻合器技术，还是在经肛门黏膜切除术后行手工吻合。尽管控便率和并发症发生率仍存在争议，但人们认识到吻合器吻合术确实会留下直肠残端，这可能导致疾病持续存在或复发。因此，如果直肠残端出现症状或异型增生，必须将其切除。这可以通过经肛门完成黏膜切除术并重建回肠储袋肛管吻合术来实现。
