Funovics J, Kovats E, Rauhs R
Langenbecks Arch Chir. 1982;356(1):61-4. doi: 10.1007/BF01270603.
Eighteen cases of operated ulcerative colitis are described. In 15 cases ileorectal anastomosis was performed. In one case, the rectum had to be excised because of a massive rectal haemorrhage; in another case, the anastomosis had to be separated Hartmann's operation) because of a dehiscence of the anastomosis. A re-examination of 13 patients shows full continence in 12 cases; one patient was incontinent with regard to flatus. The Karnofsky Index shows 100 in 10 patients, and 90 in 3 patients. The sigmoidoscopy reveals normal rectal mucosa in 6 patients, a moderate colitis in 5 patients and a severe colitis in 2 patients. There are only two indications for rectal excision in our opinion: uncontrollable rectal haemorrhage and carcinoma (dysplasia).
本文描述了18例溃疡性结肠炎手术病例。其中15例行回肠直肠吻合术。1例因直肠大出血不得不切除直肠;另1例因吻合口裂开不得不再次行Hartmann手术。对13例患者进行复查,结果显示12例患者排便完全正常,1例患者排气失禁。卡氏评分显示,10例患者为100分,3例患者为90分。乙状结肠镜检查显示,6例患者直肠黏膜正常,5例患者为中度结肠炎,2例患者为重度结肠炎。我们认为,直肠切除仅适用于两种情况:无法控制的直肠出血和癌变(发育异常)。