Luukkonen P, Järvinen H, Tanskanen M, Kahri A
Second Department of Surgery, University Central Hospital, Helsinki, Finland.
Gut. 1994 Feb;35(2):243-6. doi: 10.1136/gut.35.2.243.
The incidence and characteristics of reservoir inflammation after restorative proctocolectomy for ulcerative colitis were studied in a series of 179 patients. The median follow up time was 27 months (range 6-80). Pouchitis occurred in 36 patients (20%) and nine of these (5%) developed a chronic, persisting pouchitis. There were no pouch failures as a result of pouchitis and no significant adverse effect on longterm functional outcome. The overall cumulative risk to develop pouchitis four years after surgery was 23%. The risk of pouchitis is unpredictable on clinical grounds except that there were significantly less patients with left sided colitis in the group who subsequently developed pouchitis. Morphological and histochemical studies showed a greater degree of colonic metaplasia in the pouch mucosa in patients with pouchitis and patients with a chronic pouchitis had the highest degree of changes. The results support the view that pouchitis is a novel manifestation of inflammatory bowel disease in ileal mucosa that has changed slowly to a colon like mucosa.
在179例患者中研究了溃疡性结肠炎行保留直肠结肠切除术术后储袋炎的发生率及特征。中位随访时间为27个月（范围6 - 80个月）。36例患者（20%）发生了储袋炎，其中9例（5%）发展为慢性持续性储袋炎。没有因储袋炎导致储袋失败，对长期功能结局也没有显著不良影响。术后四年发生储袋炎的总体累积风险为23%。除了随后发生储袋炎的组中左侧结肠炎患者明显较少外，储袋炎的风险在临床上无法预测。形态学和组织化学研究表明，患储袋炎患者的储袋黏膜中结肠化生程度更高，慢性储袋炎患者的变化程度最高。这些结果支持这样一种观点，即储袋炎是炎症性肠病在回肠黏膜中的一种新表现，回肠黏膜已缓慢转变为类似结肠的黏膜。
