Colorectal Department, Singleton Hospital, Sketty Lane, Swansea, UK.
Colorectal Dis. 2011 Oct;13(10):1148-52. doi: 10.1111/j.1463-1318.2010.02403.x.
The results including function and quality of life (QOL) of restorative proctocolectomy (RPC) performed in children and adolescents with ulcerative colitis (UC), familial adenomatous polyposis (FAP) and idiopathic megarectum were determined.
Twenty-one patients of a median age of 15 (10-17) years underwent RPC between 1995 and 2006. The indication, use of covering ileostomy, morbidity and mortality were recorded. A structured questionnaire was completed by telephone interview to assess long-term function. The Cleveland Clinic Scoring (CCS) System was used for the assessment of faecal incontinence and the modified McMaster proforma for QoL.
There was no mortality. At a median follow-up of 65.5 (26-168) months, all patients had an intact pouch. One had a long-standing ileostomy. Median daytime and nocturnal stool frequencies were 4 (2-16) and 0 (0-3). The mean CCS was 1.47, with only one patient scoring more than 10. Eighteen of 20 patients were satisfied with the result; two patients had a worse QoL (McMaster score >8). One patient had a permanent stoma following pouch sepsis and one had symptoms of pouchitis.
RPC can be performed in children and adolescents with good functional outcome and acceptable QoL.
评估儿童和青少年溃疡性结肠炎（UC）、家族性腺瘤性息肉病（FAP）和特发性巨结肠行直肠结肠切除术（RPC）后的功能和生活质量（QOL）结果。
1995 年至 2006 年间，21 例中位年龄为 15 岁（10-17 岁）的患者接受 RPC。记录适应证、覆盖性回肠造口术的使用、发病率和死亡率。通过电话访谈完成结构化问卷，以评估长期功能。采用克利夫兰诊所评分（CCS）系统评估粪便失禁，采用改良的麦克马斯特公式评估 QOL。
无死亡病例。中位随访 65.5 个月（26-168 个月）时，所有患者的袋均完整。1 例患者长期存在回肠造口。日间和夜间排便频率的中位数分别为 4（2-16）和 0（0-3）。CCS 的平均值为 1.47，只有 1 例患者的评分超过 10 分。20 例患者中有 18 例对结果满意；2 例患者的 QOL 较差（麦克马斯特评分>8）。1 例患者因袋感染性腹膜炎而永久造口，1 例患者出现袋炎症状。
RPC 可在儿童和青少年中进行，功能结果良好，生活质量可接受。
