Mignon M, Stettler C, Phillips S F
Service d'Hépato-Gastroentérologie, Hôpital Bichat-Claude Bernard, Paris, France.
Dis Colon Rectum. 1995 Jan;38(1):100-3. doi: 10.1007/BF02053868.
Pouchitis is an increasing drawback to patients who undergo ileal pouch-anal anastomosis for ulcerative colitis; complication overshadows the overall good functional results of this sphincter-saving operation. There is a need for cooperative, multicenter, and longitudinal studies of patients undergoing ileal pouch-anal anastomosis, to unravel the etiology and pathophysiology of pouchitis. Because of the absence of a mucosal inflammation before pouch construction, patients operated on for familial adenomatous polyposis are the perfect control group. Thus, it may be possible to elucidate and define the sequence that leads to pouchitis, including overgrowth of a colonic type flora, transformation of the histology to an epithelium with colonic features, an altered biochemical milieu in the lumen (volatile fatty acids, secondary bile acids), and changes in mucosal defense mechanisms.
对于因溃疡性结肠炎接受回肠储袋肛管吻合术的患者而言，袋炎是一个日益突出的问题；该并发症掩盖了这种保留括约肌手术总体良好的功能效果。需要对接受回肠储袋肛管吻合术的患者进行合作性、多中心和纵向研究，以阐明袋炎的病因和病理生理学。由于在构建储袋之前不存在黏膜炎症，因此因家族性腺瘤性息肉病接受手术的患者是理想的对照组。因此，有可能阐明并确定导致袋炎的一系列过程，包括结肠型菌群过度生长、组织学转变为具有结肠特征的上皮、肠腔内生化环境改变（挥发性脂肪酸、次级胆汁酸）以及黏膜防御机制的变化。
