The Danish Polyposis Register, Department of Surgery, Hvidovre University Hospital, Copenhagen, Denmark.
Colorectal Dis. 2012 Jan;14(1):68-70. doi: 10.1111/j.1463-1318.2010.02509.x.
In familial adenomatous polyposis, a restorative proctocolectomy with an ileo-anal pouch may be performed either with a mucosectomy and a hand-sewn anastomosis or as a stapled anastomosis without a mucosectomy. The disadvantage of the former is suboptimal bowel function and the disadvantage of the latter is a high risk of recurrent adenomas in the rectal mucosal remnant.
A procedure is presented that combines the advantages of mucosectomy and stapled ileo-anal anastomosis.
No severe complications were seen in 14 patients. After a median follow up of 29 (range 7-144) months, 13 (93%) patients were fully continent day and night with a median frequency of defecation of 5 (range 2-8)/24 h. No adenomas were found at the annual endoscopic follow up.
Mucosectomy with a stapled ileo-anal pouch has few complications. Short-term results show good function and a very low risk of recurrent adenoma development.
在家族性腺瘤性息肉病中，可进行恢复性直肠结肠切除术和回肠肛管吻合术，其可以采用黏膜切除术和手工吻合，也可以采用吻合器吻合而不进行黏膜切除术。前者的缺点是肠道功能不理想，后者的缺点是直肠黏膜残端的腺瘤复发风险较高。
提出了一种结合黏膜切除术和吻合器回肠肛管吻合术优点的手术方法。
14 例患者均无严重并发症。中位随访时间为 29 个月（范围 7-144 个月），13 例（93%）患者日间和夜间完全控便，中位排便频率为 5 次/24 小时（范围 2-8 次/24 小时）。在每年的内镜随访中均未发现腺瘤。
吻合器回肠肛管吻合术联合黏膜切除术并发症较少。短期结果显示功能良好，腺瘤复发风险非常低。
