影响保留直肠结肠切除术术后储袋相关结局的因素。
Factors affecting pouch-related outcomes after restorative proctocolectomy.
作者信息
Noh Gyoung Tae, Han Jeonghee, Cho Min Soo, Hur Hyuk, Min Byung Soh, Lee Kang Young, Kim Nam Kyu
机构信息
Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
出版信息
PLoS One. 2017 Oct 19;12(10):e0186596. doi: 10.1371/journal.pone.0186596. eCollection 2017.
PURPOSES
Restorative proctocolectomy (RPC) with ileal pouch anal anastomosis (IPAA) is the procedure of choice for patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) despite morbidities that can lead to pouch failure. We aimed to identify factors associated with pouch-related morbidities.
METHODS
A retrospective analysis of patients who underwent RPC with IPAA was performed. To investigate the factors associated with pouch-related morbidities, patients' preoperative demographic and clinical factors, and intraoperative factors were included in the analysis.
RESULTS
A total of 49 patients with UC, FAP, and colorectal cancer were included. Twenty patients (40.8%) experienced leakage-related, functional, and/or pouchitis-related morbidities. Patients with American Society of Anesthesiologists (ASA) grade 2 or 3 had a higher risk of functional morbidity than those with grade 1. Intraoperative blood loss exceeding 300.0 mL was associated with an increased risk of pouchitis-related morbidity.
CONCLUSIONS
Our study demonstrated associations of higher ASA grade and increased intraoperative blood loss with poor functional outcomes and pouchitis, respectively.
目的
尽管存在可能导致贮袋功能衰竭的并发症，但回肠贮袋肛管吻合术（IPAA）的全直肠系膜切除术（RPC）仍是家族性腺瘤性息肉病（FAP）和溃疡性结肠炎（UC）患者的首选手术方式。我们旨在确定与贮袋相关并发症相关的因素。
方法
对接受RPC联合IPAA手术的患者进行回顾性分析。为了研究与贮袋相关并发症相关的因素，分析纳入了患者的术前人口统计学和临床因素以及术中因素。
结果
共纳入49例UC、FAP和结直肠癌患者。20例患者（40.8%）出现了与渗漏、功能和/或袋炎相关的并发症。美国麻醉医师协会（ASA）分级为2或3级的患者发生功能并发症的风险高于1级患者。术中失血超过300.0 mL与袋炎相关并发症的风险增加有关。
结论
我们的研究表明，较高的ASA分级和术中失血量增加分别与不良功能结局和袋炎相关。
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