King D W, Lubowski D Z, Cook T A
Colorectal Unit, St. George Hospital, Sydney, New South Wales, Australia.
Br J Surg. 1989 Sep;76(9):970-2. doi: 10.1002/bjs.1800760933.
In an attempt to improve continence after restorative proctocolectomy, ileal reservoir-anal anastomosis at the level of the anorectal junction has been advocated. This procedure preserves the entire mucosa of the anal canal. The histological appearances of the anal mucosa have been examined in 16 consecutive patients undergoing restorative proctocolectomy for ulcerative colitis. In 14 patients there was chronic inflammation characteristic of ulcerative colitis. Four patients had moderate dysplasia and in one of these patients an unsuspected adenocarcinoma of the anal canal extending down to the level of the dentate line was present. We believe that the anal mucosa should always be removed down to the level of the dentate line in restorative proctocolectomy for ulcerative colitis.
为了改善保留肛门直肠切除术术后的控便能力，有人主张在肛管直肠交界处进行回肠贮袋肛管吻合术。该手术保留了肛管的全部黏膜。对16例因溃疡性结肠炎接受保留肛门直肠切除术的连续患者的肛门黏膜组织学表现进行了检查。14例患者有溃疡性结肠炎的慢性炎症特征。4例有中度发育异常，其中1例患者存在未被怀疑的肛管腺癌，癌肿向下延伸至齿状线水平。我们认为，对于溃疡性结肠炎行保留肛门直肠切除术时，应始终将肛门黏膜切除至齿状线水平。
