无袖J袋肛管吻合术治疗溃疡性结肠炎

Cuff-less J Pouch Anal Stapling Anastomosis for Ulcerative Colitis.

作者信息

Kawahara Hidejiro, Akiba Tadashi, Yanaga Katsuhiko

机构信息

Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan

Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.

出版信息

Anticancer Res. 2017 Oct;37(10):5743-5745. doi: 10.21873/anticanres.12013.

DOI:10.21873/anticanres.12013

PMID:28982895

Abstract

BACKGROUND/AIM: For ulcerative colitis, J pouch anal anastomosis with preserved rectal cuff had been popularized with its acceptable defecation function. However, some complications associated with rectal cuff after surgery have been reported. We are performing a novel procedure, laparoscopic cuff-less J pouch anal stapling anastomosis.

PATIENTS AND METHODS

From January 2014 to December 2016, ten patients with ulcerative colitis, including three with concomitant cancer underwent this procedure. J pouch anal anastomosis was performed at the dentate line in all patients by our original procedure. In a manometric examination of all patients more than one year after the operation, maximum resting pressure was 68.0 (52-84) mmHg, maximum squeeze pressure was 101.7 (87-121) mmHg, length of high-pressure zone was 32.3 (30-35), and none had observed rectoanal reflex. Good defecation was confirmed by defecography.

CONCLUSION

Cuff-less J pouch anal stapling anastomosis seems to be a useful procedure for patients with ulcerative colitis.

摘要

背景/目的：对于溃疡性结肠炎，保留直肠袖带的J形贮袋肛管吻合术因其可接受的排便功能而得到推广。然而，术后一些与直肠袖带相关的并发症已有报道。我们正在开展一种新的手术，即腹腔镜无袖带J形贮袋肛管吻合术。

患者与方法

2014年1月至2016年12月，10例溃疡性结肠炎患者接受了该手术，其中3例合并癌症。所有患者均通过我们的原始手术在齿状线处进行J形贮袋肛管吻合术。在对所有患者术后一年以上进行的测压检查中，最大静息压力为68.0（52 - 84）mmHg，最大挤压压力为101.7（87 - 121）mmHg，高压区长度为32.3（30 - 35），且均未观察到直肠肛门反射。排粪造影证实排便良好。