Utsunomiya J, Iwama T, Imajo M, Matsuo S, Sawai S, Yaegashi K, Hirayama R
Dis Colon Rectum. 1980 Oct;23(7):459-66. doi: 10.1007/BF02987076.
A safe and practical procedure for total colectomy and mucosal proctectomy with ileoanal anastomosis has been developed and performed by us on 11 patients with adenomatosis coli and two patients with ulcerative colitis. The major features of the operative procedure are 1) total removal of the rectal mucosa to just above the dentate line; 2) preservation of anorectal function by a long rectal cuff procedure achieved by rectal mucosal excision from a level just below the sacral promontory, using a rectal internal stent and gauze packing techniques for rectal mucosal stripping, with, in some patients, an ileal reservoir added; and 3) prevention of pelvic sepsis by intraoperative rectal irrigation, rectal cuff drainage, and a temporary defunctioning loop ileostomy. Of six patients with at least three months of follow-up after reconstruction, each has returned to normal life, averaging two to seven semiformed stools each day. A side-to-end ileoanal anastomosis with a low-lying, loop-type ileal reservoir provided the best functional results.
我们已开发并对11例结肠腺瘤病患者和2例溃疡性结肠炎患者实施了一种安全实用的全结肠切除及黏膜直肠切除回肠肛管吻合术。该手术的主要特点包括：1）将直肠黏膜完全切除至齿状线以上；2）通过从骶岬下方水平进行直肠黏膜切除、使用直肠内支架和纱布填塞技术进行直肠黏膜剥离的长直肠袖状手术（部分患者加做回肠储袋）来保留肛门直肠功能；3）通过术中直肠冲洗、直肠袖状引流和临时性失功性回肠造口预防盆腔感染。在重建术后至少随访3个月的6例患者中，每例均已恢复正常生活，平均每天排便2至7次，呈半成形便。低位袢式回肠储袋的端侧回肠肛管吻合术功能效果最佳。
