Khazraei Hajar, Bananzadeh Alimohammad, Hosseini Seyed Vahid
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Adv Biomed Res. 2018 Jan 30;7:11. doi: 10.4103/abr.abr_175_16. eCollection 2018.
Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the final treatment is colectomy. The aim of this study was to investigate the outcomes of proctocolectomy in patients that used a high dose of prednisolone.
Seventy-five patients presenting for surgical management of histopathologically proven UC. All patients were offered total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). Patients were divided into two groups: low dose of steroids (Group A) and high dose of steroid (Group B) consumers. Data from these patients after 2 years were reviewed and analyzed.
From total patients, 34 of them were male and 34 ones were female and seven patients underwent laparatomy. Overall incontinence rate was 8.8%; dysplasia was 22%, pouchitis was 18.9% while mortality was nil. The length of hospital stay was 6.76 days in Group A and 9.21 days in Group B ( = 0.399). Leakage was observed in nine of the patients after surgery ( = 0.589). Fecal incontinence between two groups was not statistically different ( = 0.063).
Laparoscopic TPC-IPAA is feasible in patients needing surgical management of UC. Preoperative treatment with high-dose corticosteroids is associated with an increased risk of complications and reoperations.
溃疡性结肠炎（UC）是一种特发性炎症性疾病。目前，最终的治疗方法是结肠切除术。本研究的目的是调查使用高剂量泼尼松龙的患者行直肠结肠切除术的结果。
75例经组织病理学证实为UC并接受手术治疗的患者。所有患者均接受全直肠结肠切除术（TPC）加回肠袋肛管吻合术（IPAA）。患者分为两组：低剂量类固醇使用者（A组）和高剂量类固醇使用者（B组）。对这些患者2年后的数据进行回顾和分析。
在所有患者中，34例为男性，34例为女性，7例患者接受了开腹手术。总体失禁率为8.8%；发育异常为22%，袋炎为18.9%，死亡率为零。A组住院时间为6.76天，B组为9.21天（P = 0.399）。术后9例患者出现渗漏（P = 0.589）。两组间大便失禁无统计学差异（P = 0.063）。
腹腔镜TPC-IPAA对需要手术治疗的UC患者是可行的。术前使用高剂量皮质类固醇与并发症和再次手术风险增加相关。
