Miller-Ocuin Jennifer L, Ashburn Jean H
Division of Colorectal Surgery, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Department of Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina.
Clin Colon Rectal Surg. 2023 Mar 24;37(1):37-40. doi: 10.1055/s-0043-1762562. eCollection 2024 Jan.
Restorative proctocolectomy with ileal pouch-anal anastomosis remains the gold standard treatment for patients with ulcerative colitis who desire restoration of intestinal continuity. Despite a significant cancer risk reduction after surgical removal of the colon and rectum, dysplasia and cancers of the ileal pouch or anal transition zone still occur and are a risk even if an anal canal mucosectomy is performed. Surgical care and maintenance after ileoanal anastomosis must include consideration of malignant potential along with other commonly monitored variables such as bowel function and quality of life. Cancers and dysplasia of the ileal pouch are rare but sometimes difficult-to-manage sequelae of pouch surgery.
对于希望恢复肠道连续性的溃疡性结肠炎患者，回肠贮袋肛管吻合术的修复性直肠结肠切除术仍是金标准治疗方法。尽管手术切除结肠和直肠后癌症风险显著降低，但回肠贮袋或肛管过渡区的发育异常和癌症仍会发生，即使进行肛管黏膜切除术也存在风险。回肠肛管吻合术后的手术护理和维持必须包括考虑恶性潜能以及其他常见监测变量，如肠道功能和生活质量。回肠贮袋的癌症和发育异常很少见，但有时是贮袋手术难以处理的后遗症。
