Hallgren T, Fasth S, Nordgren S, Oresland T, Hultén L
Dept. of Surgery II, Sahlgren's Hospital, University of Gothenburg, Sweden.
Scand J Gastroenterol. 1990 Nov;25(11):1161-8. doi: 10.3109/00365529008998549.
Thirty patients were operated on with restorative proctocolectomy with an end-to-end ileal pouch-anal anastomosis constructed by double stapling (STP). Pouches were randomized to either J type or K type (folded by the principles used for the Kock continent ileostomy). Manovolumetric and functional results were compared. Patients were followed up for at least 6 months. K pouches acquired a significantly larger volume than the J-configurated pouches, and at 6 months the mean +/- SD volumes amounted to 361 +/- 59.8 ml versus 283 +/- 43.0 ml (p less than 0.01) with a concomitant reduction in 24-h frequency (4.4 +/- 1.5 versus 5.8 +/- 1.9; p less than 0.05). The initial postoperative mean reduction of resting anal pressure amounted to 33%. which was similar to that observed in a group of matched historical controls operated on with endoanal mucosectomy and hand-sutured pouch-anal anastomosis. Compared with these controls STP patients showed a superior overall functional result, most marked in the early postoperative period.
30例患者接受了保留性直肠结肠切除术，并采用双吻合器技术（STP）构建了端端回肠贮袋肛管吻合术。贮袋随机分为J型或K型（按照用于Kock可控回肠造口术的原则折叠）。比较了测压和功能结果。对患者进行了至少6个月的随访。K型贮袋的容量明显大于J型贮袋，6个月时，平均±标准差容量分别为361±59.8 ml和283±43.0 ml（p<0.01），同时24小时排便次数减少（4.4±1.5对5.8±1.9；p<0.05）。术后初期静息肛管压力平均降低33%，这与一组采用经肛门黏膜切除术和手工缝合贮袋肛管吻合术的匹配历史对照患者观察到的情况相似。与这些对照相比，STP患者总体功能结果更佳，在术后早期最为明显。
