Serrero Mélanie, Santoni Aurélia, Grimaud Jean-Charles, Desjeux Ariadne, Gonzalez Jean-Michel, Barthet Marc
Hôpital Nord, Marseille, France.
Endosc Int Open. 2020 Apr;8(4):E544-E547. doi: 10.1055/a-0996-7975. Epub 2020 Mar 23.
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the reference surgical treatment for patients with ulcerative colitis (UC) refractory to medical treatment. One of the complications is leaving a strip of rectal mucosa which can be a cause of persistent inflammation or cuffitis. The objective of our study is to present an endoscopic approach for the treatment of cuffitis. This retrospective study included three patients who suffered from cuffitis after a proctocolectomy with IPAA for UC refractory to medical treatment. An endoscopic resection of the cuffitis was performed by the same operator. Two different techniques were used: hybrid endoscopic submucosal dissection (ESD) for one patient and mucosectomy with cap and resection for the two others. The endoscopic treatment was performed successfully in all three patients. The only complication observed was rectal bleeding which did not require endoscopic revision. The three patients are now asymptomatic. Endoscopic treatment of cuffitis appears to be an interesting approach with few complications in the short term and good clinical efficacy.
回肠贮袋肛管吻合术（IPAA）的全直肠系膜切除术是药物治疗无效的溃疡性结肠炎（UC）患者的标准手术治疗方法。并发症之一是残留一条直肠黏膜带，这可能是持续性炎症或袖口炎的原因。我们研究的目的是提出一种治疗袖口炎的内镜方法。 这项回顾性研究纳入了3例因药物治疗无效的UC接受IPAA全直肠系膜切除术后发生袖口炎的患者。由同一名操作者进行袖口炎的内镜切除。使用了两种不同的技术：1例患者采用内镜下黏膜下剥离术（ESD），另外2例采用带帽切除术。 所有3例患者均成功进行了内镜治疗。观察到的唯一并发症是直肠出血，无需内镜下修正。这3例患者目前均无症状。 内镜治疗袖口炎似乎是一种有趣的方法，短期内并发症少，临床疗效良好。
