Kobayashi Yasuo, Iiai Tsuneo, Yagi Minoru, Okamoto Haruhiko, Tani Tatsuo, Hatakeyama Katsuyoshi
Department of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Int Surg. 2011 Jul-Sep;96(3):201-6. doi: 10.9738/1387.1.
An ileal pouch is usually reconstructed as an alternative to a neorectum after a total proctocolectomy for ulcerative colitis (UC). However, the real defecatory function of an ileal pouch is uncertain. This study was designed to analyze the functional and clinical outcomes after a proctocolectomy and ileal pouch-anal anastomosis (IPAA) for UC using fecoflowmetry (FFM). Sixteen patients who underwent IPAA for UC between 1990 and 2005 were studied. They were evaluated by FFM, together with Kelly's clinical score (KCS), and anorectal manometric assessments were also performed. FFM showed that the fecoflow pattern (FFP) of 14 patients (87%) was the block type and of 2 patients (13%) was the segmental type. The clinical score and tolerance volume showed no improvement 1 year or more after IPAA. However, the value of the maximum fecal stream flow rate (Fmax) improved with time. FFM shows that the defecatory function improved after IPAA, and it may therefore contribute to a good long-term outcome after the surgery.
对于溃疡性结肠炎（UC）患者，在全直肠结肠切除术后，回肠贮袋通常被重建作为新直肠的替代方案。然而，回肠贮袋的实际排便功能尚不确定。本研究旨在使用粪便流量测定法（FFM）分析UC患者行直肠结肠切除及回肠贮袋肛管吻合术（IPAA）后的功能和临床结局。研究对象为1990年至2005年间接受IPAA治疗UC的16例患者。对他们进行了FFM评估，同时采用凯利临床评分（KCS），并进行了肛肠测压评估。FFM显示，14例患者（87%）的粪便流型（FFP）为阻滞型，2例患者（13%）为节段型。IPAA术后1年或更长时间，临床评分和耐受容量均无改善。然而，最大粪便流速（Fmax）值随时间有所改善。FFM表明IPAA术后排便功能有所改善，因此可能有助于手术获得良好的长期结局。
