CAJ | 학술논문

目的探讨应用双吻合器法改进传统的回肠贮袋肛管吻合术,术后长期的肛门功能情况.方法同顾性分析2002年1月-2011年3月完成的45例双吻合器法同肠贮袋肛管吻合术患者的临床资料,其中家族性息肉病患者16例和溃疡性结肠炎患者29例.应用Kirwan评分及Oresland贮袋特异性功能评分评估术后远期肛门功能.结果平均随访65个月(12 ～ 110个月)后,2例恶性家族性息肉病患者死亡,其余患者中2例出现不典型息肉增生,4例患者出现轻到中度的吻合口狭窄,1例患者出现严重的吻合口狭窄,需再次手术干预,16例患者出现贮袋炎的临床症状.本组45例患者中无肛门失禁发生,术后1年、2.5年、5年的中位Oresland贮袋特异性功能评分分别为6分、3分和2分.结论应用双吻合器法改进回肠贮袋肛管吻合术后大便控制能力满意,无肛门失禁发生.
목적 탐토응용쌍문합기법개진전통적회장저대항관문합술,술후장기적항문공능정황.방법 동고성분석2002년1월-2011년3월완성적45례쌍문합기법동장저대항관문합술환자적림상자료,기중가족성식육병환자16례화궤양성결장염환자29례.응용Kirwan평분급Oresland저대특이성공능평분평고술후원기항문공능.결과 평균수방65개월(12 ～ 110개월)후,2례악성가족성식육병환자사망,기여환자중2례출현불전형식육증생,4례환자출현경도중도적문합구협착,1례환자출현엄중적문합구협착,수재차수술간예,16례환자출현저대염적림상증상.본조45례환자중무항문실금발생,술후1년、2.5년、5년적중위Oresland저대특이성공능평분분별위6분、3분화2분.결론 응용쌍문합기법개진회장저대항관문합술후대편공제능력만의,무항문실금발생.
Objective To evaluate the long-term functional outcome after ileal pouch anal anastomosis with modified double-stapled technique.Methods From January 2002 to March 2011,forty-five patients underwent ileal pouch anal anastomosis with modified double-stapled technique.The clinical data of these patients were reviewed.The postoperative anal function was assessed by Kirwan classification and Oresland pouch-specific function score.Results During the median follow-up of 65 months,2 patients with malignant adenomatous polyps died,2 patients were diagnosed dysplasia by biopsy,4 patients developed mild to moderate anastomotic narrowing,1 patient developed persistent anastomotic stricture needing surgical intervention,16 patients developed at least 1 episode of pouchitis.There was no incontinence in these patients,and the median functional Oresland score was 6,3 and 2 after 1 year,2.5 years and 5 years respectively.Conclusion The functional results of ileal pouch anal anastomosis with modified double-stapled technique are promising,with no incontinence in our patients.