Scotte M, Del Gallo G, Steinmetz L, Manouvrier J L, Wiktor F, Leblanc I, Meunier Y, Michot F, Teniere P
Service de Chirurgie Generale et Digestive and Groupe de Recherche sur l'Appareil Digestif, Rouen, France.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2123-6.
BACKGROUND/AIMS: Proctocolectomy with ileoanal anastomosis (IAA) has proved to be the most suitable surgical treatment for ulcerative colitis. The aim of this study was to compare the results of IAA according to the evolution of surgical procedures and particularly to compare the results of stapled versus hand-sewn anastomosis.
From 1984 to 1996, 37 men and 31 women were operated on in our centre for ulcerative colitis. The anastomosis between the J pouch and the dentate line was handsewn in 35 patients (group 1) and stapled in 33 patients (group 2).
The mean operative time was significantly shorter in group 2 as compared with group 1 (265+/-59 vs. 323+/-53, p<0.01, respectively), whereas morbidity and functional results were comparable in both groups. In 10 patients with stapled IAA, a diverting ileostomy was not performed and the morbidity in this group did not increase.
These results suggest that stapled IAA anastomosis is a safe procedure. The stapling technique of IAA simplifies total excision of the rectum and could mean that a diverting ileostomy is not necessary.
背景/目的：回肠肛管吻合术（IAA）直肠结肠切除术已被证明是治疗溃疡性结肠炎最合适的手术方式。本研究的目的是根据手术方法的演变比较IAA的结果，特别是比较吻合器吻合与手工缝合吻合的结果。
1984年至1996年，我院中心为37例男性和31例女性进行了溃疡性结肠炎手术。35例患者（第1组）的J形贮袋与齿状线之间的吻合采用手工缝合，33例患者（第2组）采用吻合器吻合。
与第1组相比，第2组的平均手术时间明显缩短（分别为265±59和323±53，p<0.01），而两组的发病率和功能结果相当。在10例行吻合器IAA的患者中，未进行转流性回肠造口术，该组的发病率未增加。
这些结果表明吻合器IAA吻合术是一种安全的手术方法。IAA的吻合器技术简化了直肠的完全切除，可能意味着无需进行转流性回肠造口术。
