The ileoanal pouch procedure in the long-term perspective: a critical review.
The ileoanal pouch procedure in the long-term perspective: a critical review.
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DOI：
10.1007/s10151-005-0225-2
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发表时间：
2005-12-01
影响因子：
3.3
通讯作者：
Hulten, L
中科院分区：
文献类型：
--
作者：
Delaini, G G;Scaglia, M;Hulten, L
回肠贮袋肛门吻合术（IPAA）已成为溃疡性结肠炎和家族性腺瘤性息肉病的金标准手术。骨盆囊手术的临床结果往往是令人鼓舞的;当面对不同的手术选择时，大多数患者选择IPAA作为最佳手术。但是，即使IPAA是一个伟大的创新，它也绝不是所有患者的首选。对于年龄足够大的病人，参加一个负责任的讨论，各种手术的利弊必须仔细描述;外科手术的选择必须符合病人的愿望，并出现健全的基础上外科医生。必须考虑到大多数患者的年轻年龄，需要长时间的随访，以确定手术是否会对患者的性生活、性生活、生育能力和生活质量产生不利影响，如果是，影响程度如何。在肌肉或柱状袖中残留直肠粘膜的癌症转化风险是另一个可能影响最终决定的重要因素。本文批判性地回顾了我们的经验和文献。
An ileo-pouch anal anastomosis (IPAA) has become the gold standard procedure for ulcerative colitis and familial adenomatous polyposis. Clinical results on the pelvic pouch procedure have often been encouraging; when confronted with the different surgical options, the majority of patients select IPAA as the best operation. However, even if IPAA is a great innovation, it is by no means the first choice for all patients. For patients old enough to join in a responsible discussion, the pros and cons of the various operations must be carefully described; the choice of surgical procedure must meet the patient's wishes and appear soundly based to the surgeon. The young age of most patients has to be considered and a long follow-up time is required to establish whether and, if so, to what extent the operation may adversely impact the patient's continence, sex life, fertility, and quality of life. The risk of cancer transformation in the residual rectal mucosa in the muscular or columnar cuff is another important factor that may influence the eventual decision. This article critically reviews our experience and the literature.