Gelernt I M, Bauer J J, Kreel I
Ann Surg. 1977 Feb;185(2):179-84. doi: 10.1097/00000658-197702000-00008.
Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patients are completely continent to feces; only one of these three requires the occasional use of a stomal appliance. There were no mortalities. Complications included suture line dehiscences, small intestinal obstruction or prolonged paralytic ileus, and hemorrhage from the reservoir. All complications were successfully treated and removal of the ileal reservoir was not required in any patient. These complications and steps which may be taken to avoid them are discussed. In addition, indications and contraindications for surgery are enumerated. It is well documented that both the colonic polyposes and long standing chronic ulcerative colitis are premalignant diseases. The availability of a continent, reservoir ileostomy as an alternative to the standard, incontinent, stoma has significantly reduced patient resistance to colectomy, and permitted earlier surgery.
1972年至1975年间，对54例患者实施了贮袋和回肠造口术。原发性结肠病变包括47例慢性溃疡性结肠炎、1例克罗恩结肠炎、5例家族性息肉病和1例加德纳综合征。随访完整，时间从6个月到3年不等。除3例患者外，所有患者均能完全控制粪便；这3例中只有1例偶尔需要使用造口器具。无死亡病例。并发症包括缝线裂开、小肠梗阻或麻痹性肠梗阻延长以及贮袋出血。所有并发症均得到成功治疗，无需对任何患者切除回肠贮袋。文中讨论了这些并发症以及为避免并发症可采取的措施。此外，还列举了手术的适应证和禁忌证。有充分文献记载，结肠息肉病和长期慢性溃疡性结肠炎均为癌前疾病。可控性贮袋回肠造口术作为标准的不可控造口的替代方法，显著降低了患者对结肠切除术的抵触情绪，并使手术能够更早进行。
