Fonkalsrud E W, Ament M E
Ann Surg. 1978 Aug;188(2):245-8. doi: 10.1097/00000658-197808000-00019.
Five patients with chronic ulcerative colitis underwent endorectal excision of the rectal mucosa without removing the rectal muscle in combination with total colectomy and cutaneous ileostomy. This operative technique will cure the patient of the primary disease and obviates many of the usual unpleasant complications following total proctectomy, such as prolonged perineal drainage and sexual and bladder dysfunction. It has the further advantages of lower operative blood loss and earlier safe ambulation. On the basis of favorable clinical experience with these patients, we believe that the operation warrants further clinical trial in patients who have biopsy-proven ulcerative colitis without severe rectal ulcerations as well as in certain other nonmalignant conditions originating in the rectal mucosa.
五例慢性溃疡性结肠炎患者接受了保留直肠肌层的直肠黏膜经肛门切除术，并联合全结肠切除术及回肠造口术。该手术技术可治愈原发性疾病，避免了全直肠切除术后许多常见的不良并发症，如长期会阴引流以及性功能和膀胱功能障碍。它还具有术中失血少和早期安全下床活动的优点。基于对这些患者良好的临床经验，我们认为该手术值得在经活检证实为溃疡性结肠炎且无严重直肠溃疡的患者以及某些其他起源于直肠黏膜的非恶性疾病患者中进行进一步的临床试验。
