Smedh K, Olaison G, Sjödahl R
Department of Surgery, University Hospital, Linköping, Sweden.
Dis Colon Rectum. 1990 Nov;33(11):987-90. doi: 10.1007/BF02139113.
To prevent coloileal reflux after ileocecal resection, an ileocolic nipple valve anastomosis was constructed in six patients with Crohn's disease. The patients were observed for more than 7 years and were compared with 21 Crohn patients in whom conventional end-to-end ileocolic anastomosis was performed during the same period. The outcome was more favorable in the group with nipple valve anastomosis, i.e., longer interval between surgery and symptomatic relapse, and tendency to less frequent recurrence and re-resection. An association was found between radiologically preserved nipple valve and remission, and two patients with intact valve at long-term follow-up remained symptom-free. The observations implied that protection of the terminal ileum from coloileal reflux after ileocecal resection for Crohn's disease may favorably influence the prognosis.
为预防回盲部切除术后的结肠回肠反流，对6例克罗恩病患者实施了回结肠乳头瓣吻合术。对这些患者进行了7年多的观察，并与同期接受传统端端回结肠吻合术的21例克罗恩病患者进行了比较。乳头瓣吻合术组的结果更优，即手术至症状复发的间隔时间更长，复发和再次切除的频率也较低。影像学检查显示保留乳头瓣与病情缓解之间存在关联，2例长期随访中瓣膜完整的患者无症状。这些观察结果表明，克罗恩病患者回盲部切除术后保护回肠末端免受结肠回肠反流的影响可能对预后产生有利影响。
