Emblem R, Larsen S, Torvet S H, Bergan A
Institute for Surgical Research, National Hospital, Oslo, Norway.
Scand J Gastroenterol. 1988 May;23(4):493-500. doi: 10.3109/00365528809093900.
Fifty-four patients with ulcerative colitis were operated on during a 3-year period; 35 had conventional proctectomy and Brooke ileostomy, and 19 had mucosal proctectomy, performed from the abdominal side, leaving 1-2 cm of the distal anal mucosa, and a straight ileoanal anastomosis (IAA) without diverting ileostomy. There were no operative deaths. In the ileostomy group 19 (54%) of the patients had a total of 38 reoperations: 10 laparotomies and 28 revisions of a perineal sinus. Three (16%) of the IAA patients had a total of five reoperations: four laparotomies and one closure of a loop ileostomy. All IAA patients had perfect continence day and night and a median stool frequency of 7.5/24 h 1 year after the operation. Ileostomy patients had significantly longer time out of work, and more urinary, sexual, and social dysfunctions than the IAA patients. After 2-3 years' follow-up study, all differences in results are greatly in favour of the ileoanal procedure.
在3年期间，对54例溃疡性结肠炎患者实施了手术；35例行传统直肠切除术及布鲁克回肠造口术，19例行经腹黏膜直肠切除术，保留肛门远端黏膜1 - 2厘米，并进行无转流性回肠造口的直端端回肠肛管吻合术（IAA）。无手术死亡病例。在回肠造口术组中，19例（54%）患者共进行了38次再次手术：10次剖腹手术和28次会阴窦修复术。IAA组中有3例（16%）患者共进行了5次再次手术：4次剖腹手术和1次袢式回肠造口关闭术。所有IAA患者术后1年日夜控便良好，大便频率中位数为7.5次/24小时。回肠造口术患者的误工时间明显长于IAA患者，且泌尿、性功能及社交功能障碍也更多。经过2 - 3年的随访研究，结果上的所有差异都非常有利于回肠肛管手术。
