The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Curr Opin Gastroenterol. 2019 Jul;35(4):321-329. doi: 10.1097/MOG.0000000000000537.
To describe the development of re-do pouch surgery, what it entails, its indications and role in the management of patients with inflammatory bowel disease.
Re-do pouch surgery has very good outcomes and excellent patient satisfaction when performed on carefully selected patients in specialized centers.
The ileal pouch anal anastomosis (IPAA) procedure, which was developed 40 years ago, is a mainstay in the reconstruction of patients who undergo a proctoclectomy for ulcerative colitis and familial adenomatous polyposis (FAP). It allows these patients to avoid a permanent ileostomy, with the majority having a very good quality of life and functional outcomes. Unfortunately, a small but not insignificant number of patients will develop technical complications that may severely affect their quality of life and function of the pouch. In the past, pouch excision with permanent diversion or Koch pouch were the only option available to these patients. Recent advances have resulted in the development of corrective surgical measures to restore pouch function. We will discuss strategies to evaluate and select the right patients for a re-do pouch surgery, how to surgically optimize them, and describe the proper technique of ileal pouch revision and reconstruction.
描述 redo pouch 手术的发展，其包含的内容，其在炎症性肠病患者管理中的适应证和作用。
redo pouch 手术在专门中心对精心挑选的患者进行时，具有非常好的结果和出色的患者满意度。
40 年前开发的回肠袋肛门吻合术（IPAA）是为溃疡性结肠炎和家族性腺瘤性息肉病（FAP）患者进行直肠结肠切除术重建的主要方法。它使这些患者能够避免永久性回肠造口术，大多数患者具有非常好的生活质量和功能结果。不幸的是，一小部分但并非微不足道的患者会出现严重影响其生活质量和 pouch 功能的技术并发症。过去，这些患者唯一的选择是 pouch 切除加永久性转流或 Koch pouch。最近的进展导致了开发纠正手术措施来恢复 pouch 功能。我们将讨论评估和选择 redo pouch 手术的合适患者的策略，如何对其进行手术优化，并描述 ileal pouch 修正和重建的适当技术。
