Becker J M, Raymond J L
Ann Surg. 1986 Oct;204(4):375-83. doi: 10.1097/00000658-198610000-00005.
Between August 1982 and November 1985, 100 patients underwent ileal "J" pouch-anal anastomosis (IPAA) at the University of Utah. All operations were performed in a standard fashion by a single surgeon. Seventy-eight patients were operated on for chronic ulcerative colitis and 22 for familial polyposis coli. Sixty of the patients were male and 40 were female with a mean age of 33.2 years and a range of 11-63 years. Mean +/- SEM operating time was 5.9 +/- 0.4 hours, blood loss was 666 +/- 49 ml, and total hospitalization was 10.1 +/- 0.3 days. No operative deaths occurred. The overall operative morbidity was 13% after IPAA. Clinical "pouchitis" was observed in 18 patients, all of whom were operated on for chronic ulcerative colitis. No patients had frank incontinence. Twenty per cent of patients experienced frequent nocturnal leakage in the early postoperative period with a significant improvement over the ensuing 6 months. Stool frequency at 1, 3, 6, 12, and 24 months was 7.5 +/- 0.2, 6.5 +/- 0.1, 6.2 +/- 0.3, 5.4 +/- 0.1, and 5.4 +/- 0.2, respectively. Stool frequency at 12 months correlated inversely with ileal pouch capacity and the diagnosis of familial polyposis. It is concluded that ileal pouch-anal anastomosis is a safe and effective operation for patients with chronic ulcerative colitis and familial polyposis coli.
1982年8月至1985年11月期间，100例患者在犹他大学接受了回肠“J”袋肛管吻合术（IPAA）。所有手术均由一名外科医生以标准方式进行。78例患者因慢性溃疡性结肠炎接受手术，22例因家族性结肠息肉病接受手术。患者中60例为男性，40例为女性，平均年龄33.2岁，年龄范围为11至63岁。平均手术时间±标准误为5.9±0.4小时，失血量为666±49毫升，总住院时间为10.1±0.3天。无手术死亡病例。IPAA术后总体手术发病率为13%。18例患者出现临床“袋炎”，所有这些患者均因慢性溃疡性结肠炎接受手术。无患者出现明显失禁。20%的患者在术后早期出现频繁夜间渗漏，在随后的6个月中有显著改善。术后1、3、6、12和24个月时的排便频率分别为7.5±0.2、6.5±0.1、6.2±0.3、5.4±0.1和5.4±0.2。12个月时的排便频率与回肠袋容量和家族性结肠息肉病的诊断呈负相关。结论是，回肠袋肛管吻合术对于慢性溃疡性结肠炎和家族性结肠息肉病患者是一种安全有效的手术。
