Kmiot W A, Keighley M R
General Hospital, Birmingham, UK.
Br J Surg. 1989 Sep;76(9):961-4. doi: 10.1002/bjs.1800760931.
A technique of totally stapled abdominal restorative proctocolectomy is reported in 20 consecutive patients using a 20 x 20 cm J pouch and a stapled ileoanal anastomosis. The stapled ileoanal anastomosis had to be abandoned in three patients because of attempted mucosectomy in one and megarectum in two. One patient receiving steroids had a covering ileostomy. The remaining 16 patients had a totally stapled procedure without a covering ileostomy. Three patients developed serious postoperative morbidity but they were the only patients receiving steroids at the time of the operation. Of the remaining 13 patients none developed serious complications, the median hospital stay was 14 days and the median operating time was 150 min. The operation may be a technical advance particularly in allowing pouch construction without ileostomy in fit patients who are not receiving steroids at the time of operation.
报道了一种全吻合器腹部直肠结肠切除重建术，对20例连续患者采用20×20cm的J形贮袋和吻合器回肠肛管吻合术。由于1例患者试图进行黏膜切除术，2例患者存在巨直肠，3例患者不得不放弃吻合器回肠肛管吻合术。1例接受类固醇治疗的患者行了覆盖性回肠造口术。其余16例患者进行了全吻合器手术，未行覆盖性回肠造口术。3例患者出现严重术后并发症，但他们是手术时仅有的接受类固醇治疗的患者。其余13例患者均未出现严重并发症，中位住院时间为14天，中位手术时间为150分钟。该手术可能是一项技术进步，特别是对于手术时未接受类固醇治疗的合适患者，可在不进行回肠造口术的情况下构建贮袋。
