Folaranmi S, Rakoczy G, Bruce J, Humphrey G, Bowen J, Morabito A, Kapur P, Morecroft J, Craigie R, Cserni T
Department of Pediatric Surgery, Royal Manchester Children's University Hospital, Manchester, UK.
Pediatr Surg Int. 2011 Jun;27(6):613-5. doi: 10.1007/s00383-010-2841-9.
Our aim was to investigate the importance of the ileocaecal valve and its reconstruction in patients that are not suffering from short bowel syndrome and Crohn's disease.
Casenotes of 99 children with hemicolectomy and 24 children with terminal ileal resection were reviewed and sorted into three groups. Group 1: ileocaecal valve resection (limited hemicolectomy), Group 2: hemicolectomy, Group 3: terminal ileal resection between 10 and 25 cm. Patients with Crohn's, short bowel syndrome and incomplete follow-up were excluded.
Chronic diarrhoea was documented in 7/26 cases (27%) in Group 1, 6/23 patients (26%) in Group 2, and none of the 13 patients had diarrhoea in Group 3. Pearson Chi-square test showed significant difference between Group 1 and Group 3 (p = 0.038) and between Group 2 and Group 3 (p = 0.043). But there was no significant difference between Group 1 and Group 2 (p = 0.947).
Chronic diarrhoea is a significant complication after limited hemicolectomy not only in Crohn's disease and short bowel syndrome. This is likely to originate from the loss of the ileocaecal valve itself rather than the loss of the ileal or colonic segment. Our results justify attempts to reconstruct the ileocaecal valve.
我们的目的是研究回盲瓣及其重建在非短肠综合征和克罗恩病患者中的重要性。
回顾并整理了99例行半结肠切除术的儿童和24例行回肠末端切除术的儿童的病历，并将其分为三组。第1组：回盲瓣切除术（有限半结肠切除术）；第2组：半结肠切除术；第3组：回肠末端切除10至25厘米。排除患有克罗恩病、短肠综合征及随访不完整的患者。
第1组26例中有7例（27%）记录有慢性腹泻，第2组23例中有6例（26%），第3组13例患者均无腹泻。Pearson卡方检验显示第1组和第3组之间有显著差异（p = 0.038），第2组和第3组之间有显著差异（p = 0.043）。但第1组和第2组之间无显著差异（p = 0.947）。
慢性腹泻不仅是克罗恩病和短肠综合征患者行有限半结肠切除术后的重要并发症。这可能源于回盲瓣本身的缺失，而非回肠或结肠段的缺失。我们的结果证明了尝试重建回盲瓣的合理性。
