Yuen Andrew, Brar Mantaj S, de Buck van Overstraeten Anthony
Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Clin Colon Rectal Surg. 2022 Feb 28;35(2):135-140. doi: 10.1055/s-0041-1742114. eCollection 2022 Mar.
Surgical management of inflammatory bowel disease has advanced significantly over the years. One particular focus of its evolution has been to minimize invasiveness. Transanal surgery has given the contemporary surgeon an alternate approach to access the low rectum situated in the confines of the deep pelvis. In benign disease, combining transanal surgery with laparoscopy has allowed for the development of novel techniques to create ileal pouch-anal anastomoses, perform intersphincteric Crohn's proctectomies, manage complications from pelvic surgery, and facilitate redo pelvic surgery. We aim to review the indications for transanal surgery in benign disease, describe an approach to transanal pouch surgery in detail, and discuss the potential benefits, pitfalls, and contentious issues surrounding this approach.
多年来，炎症性肠病的外科治疗取得了显著进展。其发展的一个特别重点是尽量减少侵袭性。经肛门手术为当代外科医生提供了一种进入位于骨盆深处的低位直肠的替代方法。在良性疾病中，将经肛门手术与腹腔镜手术相结合，使得开发新的技术来创建回肠贮袋肛管吻合术、进行括约肌间克罗恩病直肠切除术、处理盆腔手术并发症以及促进盆腔再次手术成为可能。我们旨在回顾经肛门手术在良性疾病中的适应证，详细描述经肛门贮袋手术的方法，并讨论围绕该方法的潜在益处、陷阱和有争议的问题。
