Nicholls R J, Pezim M E
Br J Surg. 1985 Jun;72(6):470-4. doi: 10.1002/bjs.1800720622.
One hundred and four patients were treated by restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial polyposis. Three different designs of reservoir were used (triple loop 68, double loop 13, quadruple loop 23). There were no postoperative deaths but six (5.8 per cent) had the reservoir removed. Rates for pelvic sepsis were 25, 15 and 13 per cent, and for intestinal obstruction requiring laparotomy 14.7,0 and 8.6 per cent. Function was assessed in 88 patients (58, 12 and 18) after mean intervals from closure of the ileostomy of 23.7, 12.7 and 4.5 months. Frequency of defaecation per 24 h was 3.7 +/- 1.6, 5.5 +/- 1.6 and 4.1 +/- 1.3, being significantly greater for double loop reservoirs; night evacuation was more prevalent in the same group (26, 58 and 22 per cent). Significantly fewer patients with triple than with double loop reservoirs required antidiarrhoeal medication (19 and 58 per cent). Normal continence occurred in 67, 75 and 89 per cent of patients in the three groups. All patients with double or quadruple loop reservoirs defaecated spontaneously while only 41 per cent with triple loop reservoirs did so. Mean intra-operative reservoir volumes were 177 +/- 64, 172 +/- 58 and 325 +/- 37 ml and volumes after closure of the ileostomy were 416 +/- 176, 197 +/- 69 and 322 +/- 33 ml respectively. Double loop reservoirs were significantly smaller than the other two designs after ileostomy closure. There was an inverse relationship between reservoir volumes and frequency. A quadruple loop reservoir directly connected to the anal sphincter preserved spontaneous evacuation and resulted in function similar to that obtained with the triple loop reservoir.
104例溃疡性结肠炎和家族性息肉病患者接受了保留回肠储袋的直肠结肠切除修复术。使用了三种不同设计的储袋（三袢68例、双袢13例、四袢23例）。术后无死亡病例，但有6例（5.8%）切除了储袋。盆腔脓毒症发生率分别为25%、15%和13%，需要剖腹手术的肠梗阻发生率分别为14.7%、0和8.6%。在回肠造口关闭后平均间隔23.7个月、12.7个月和4.5个月，分别对88例患者（58例、12例和18例）的功能进行了评估。每24小时排便次数分别为3.7±1.6次、5.5±1.6次和4.1±1.3次，双袢储袋的排便次数明显更多；夜间排便在同一组中更为普遍（分别为26%、58%和22%）。使用止泻药的三袢储袋患者明显少于双袢储袋患者（分别为19%和58%）。三组患者中分别有67%、75%和89%的患者控便功能正常。所有双袢或四袢储袋患者均能自主排便，而三袢储袋患者只有41%能自主排便。术中储袋平均容量分别为177±64ml、172±58ml和325±37ml，回肠造口关闭后的容量分别为416±176ml、197±69ml和322±33ml。回肠造口关闭后，双袢储袋明显小于其他两种设计。储袋容量与排便次数呈负相关。直接与肛门括约肌相连的四袢储袋保留了自主排便功能，其功能与三袢储袋相似。
