Kock N G
Can J Surg. 1981 May;24(3):270-6.
Ileostomy in association with proctocolectomy in one or two stages is the accepted treatment for ulcerative colitis. There are many difficulties in managing the permanent ileostomy in spite of improvements in design and construction, in availability of stomal appliances and in better skin protection and adhesive materials. The collection and storage of excrement in a bag outside the body imposes severe difficulties. To eliminate these problems an alternative ileostomy method, the continent ileostomy, was devised and the clinical results achieved in 314 patients are reported. There was a 2.2% overall operative mortality but no operative deaths in the last consecutive series of 152 patients. The nonfatal complication rate has decreased from 24% to 7% and revision because of a malfunctioning outlet valve has decreased from 54% to 6%. At follow-up 94% of the patients were continent. Except for a slightly increased loss of bile salts and a potential risk of decreased vitamin B12 absorption no harmful effects of the reservoir procedure have been found after observation times up to 12 years.
回肠造口术联合一期或二期直肠结肠切除术是溃疡性结肠炎公认的治疗方法。尽管在造口设计与构建、造口器具的可用性以及更好的皮肤保护和粘合材料方面有所改进，但永久性回肠造口术的管理仍存在诸多困难。将排泄物收集并储存在体外的袋子中会带来严重问题。为消除这些问题，人们设计了一种替代性回肠造口术方法——可控性回肠造口术，并报告了314例患者的临床结果。总体手术死亡率为2.2%，但在最近连续的152例患者系列中无手术死亡病例。非致命并发症发生率从24%降至7%，因出口瓣膜功能障碍而进行的修复率从54%降至6%。随访时94%的患者具有可控性。在长达12年的观察期后，除了胆盐丢失略有增加以及维生素B12吸收可能降低的潜在风险外，未发现储袋手术有任何有害影响。
