Geoghegan J G, Carton E, O'Shea A M, Astbury K, Sheahan K, O'Donoghue D P, Hyland J M
Department of Surgery, St Vincent's Hospital, Dublin, Ireland.
Int J Colorectal Dis. 1998;13(5-6):256-9. doi: 10.1007/pl00013741.
Previous reports suggest that up to 70% of patients undergoing surgery for Crohn's disease of the large bowel do not have gastrointestinal continuity restored and require a permanent ileostomy. In this study the experience with patients requiring surgical treatment of large bowel Crohn's disease is reviewed with particular reference to the management of the rectum. The records of 19 elective and 25 urgent colonic resections performed for large bowel Crohn's disease in 44 patients (16 males, 28 females; mean age 41 years, range 17-76) between 1983 and 1995 were reviewed. Staged proctectomy was performed in 5 of 12 patients who had colectomy for acute colitis and in one patient who had had an elective colectomy. Permanent ileostomy was required in 72% of patients with acute Crohn's colitis and 84% of patients who had elective surgery for large bowel Crohn's. Over 70% of patients having surgical treatment of Crohn's disease of the large bowel required permanent ileostomy. No cases of cancer developed in patients with retained rectal stumps.
先前的报告表明，接受大肠克罗恩病手术的患者中，高达70%的患者肠道连续性未恢复，需要永久性回肠造口术。在本研究中，回顾了需要手术治疗大肠克罗恩病患者的经验，特别提及直肠的处理。回顾了1983年至1995年间44例患者（16例男性，28例女性；平均年龄41岁，范围17 - 76岁）因大肠克罗恩病进行的19例择期和25例急诊结肠切除术的记录。12例因急性结肠炎行结肠切除术的患者中有5例以及1例接受择期结肠切除术的患者接受了分期直肠切除术。急性克罗恩结肠炎患者中有72%以及因大肠克罗恩病接受择期手术的患者中有84%需要永久性回肠造口术。超过70%接受大肠克罗恩病手术治疗的患者需要永久性回肠造口术。保留直肠残端的患者未发生癌症病例。
