Studies Onpathophysiology After Total Colectomy, Mucosal Proctectomy and Ileoanal Anastoniosis.

研究全结肠切除术、直肠粘膜切除术和回肠肛门吻合术后的病理生理学。

• 批准号: 63480315
• 负责人: UTSUNOMIYA Joji
• 金额: $ 4.42万
• 依托单位: Hyogo Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1988
• 资助国家: 日本
• 起止时间: 1988 至 1990
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-63480315/
• 关键词: total colectomy; ileoanal anastomosis; ulcerative colitis; adenomotous polyposis coli; anal function; metabolic changes; pouchitis; colonalization; 大腸他臓器相関; 回腸嚢炎; 大腸化; 胆汁酸

Studies on pathophysiology after total colectomy, mucosal proctectomy and ileoanal anastomosis J. Utsunomiya, M. D., T. Yamamura, M. D., M. Kusuoniki, M. D., T. Kuroki, M. D., H. Natori, M. D., Y. Sakanoue, M. D., and K. Kusuhara, M. D. (Second Dept. of Surgery, Hyogo College of Medicine)Aims of the study are to understand physiological background of bowel function and to clarify metabolic alternation in the patient after ileoanal anastomosis (IAA) in order to establish the practical procedure, which can provide the quality of life acceptable to the patients. The J-pouch anal anastomosis that had been developed by Utsunomiya J. in Tokyo through his experiences on 49 cases including 11 ulcerative colitis (UC) and 38 adenomatous polyposis coli (APC) since 1979 were further improved after 1983 in Hyogo to accumulate a new series of 94 patients (56 UC, 36 APC and 2 others). The patients with the muscular cuff that were preserved on the subperitoneal lower rectal portion (the medium cuff) w … More ere found to show a superior clinical functional result as well as better preserved resting and squeeze anal pressure comparing with those with the "minimum" rectal cuff in which the cuff was excised above the levator. For succeeding in such an extensive mucosectomy, the procedure which was devised by us included the "forceps coagulating technique" at the prone jackknife position. Hemodynamic study revealed no significant demerit during changing position of the patient. The original J-pouch with bilateral blood supplies was found to have a 24% increase in circulating blood volume in the pouch apex comparing with the short J-pouch that was created by dividing the ileocolic artery. The criteria for psychological, clinical as well as physiological aspects have been developed for objective comparative study on the late result. The metabolic states of water, electrolytes and bile acids in the patients with IAA were found to be situated in between those of the patients with terminal ileostomy and of the individual with a natural anal excretion. Less

全结肠切除、直肠粘膜切除和回肛门吻合术后病理生理学的研究J.宇都宫，M. D、T. Yamamura，M. D、M. Kusuoniki，M. D、T. Kuroki，M. D、H.名取湾D、Y. Sakanoue，M. D、和K. Kusuhara，M. D.（第二部）本研究的目的是了解回肠肛门吻合术（IAA）后患者肠功能的生理背景和阐明代谢变化，以建立可为患者提供可接受的生活质量的实用程序。宇都宫J.自1979年以来在东京根据他对49例包括11例溃疡性结肠炎（UC）和38例腺瘤性结肠息肉病（APC）的经验发展了J型袋肛门吻合术，1983年后在兵库进一步改进，积累了94例新的系列病例（56例UC，36例APC和2例其他）。保留腹膜下直肠下段肌袖（中袖）的患者， ...更多信息 结果发现，与在提肌上方切除“最小”直肠袖带的患者相比，“最小”直肠袖带的患者显示出上级临床功能结果以及更好地保持静息和挤压肛门压力。为了成功地进行如此广泛的粘膜切除术，我们设计的手术包括俯卧折刀位的“钳钳技术”。血流动力学研究显示，在改变患者体位时无明显不良反应。与通过分割回结肠动脉创建的短J形袋相比，发现具有双侧血液供应的原始J形袋在袋顶端的循环血量增加了24%。制定了心理、临床和生理方面的标准，以便对晚期结果进行客观的比较研究。IAA患者的水、电解质和胆汁酸的代谢状态位于末端回肠造口术患者和自然肛门排泄的个体之间。少

项目成果

J. Utsunomiya: "A method for clinical functional assessment after ileoanal anastomosis ーThe continence disturbance grade-" Jap J Gastroent Surg. 23. 2168-2173 (1990)

J. Utsunomiya：“回肠肛门吻合术后临床功能评估的方法 - 失禁障碍等级 -” Jap J Gastroent Surg. 23. 2168-2173 (1990)

J.Utsunomiya,T.Yamamura,: "Radikale Chirurgie bei schwerer Colitis ulcerosa" Chirurg. 60. 565-572 (1989)

J.Utsunomiya，T.Yamamura，：“Radikale Chirurgie bei schwerer 溃疡性结肠炎”Chirurg。

M.Kusunoki,Y.Sakanove,Y.Shoji,K.Kosuhara,T.Yamamura,J.Utsunomiya: "Conversion of maltunctioning Jーpouch to kock'spouch" Acta.Chir.Scand. 156. 179-181 (1990)

M.Kusunoki、Y.Sakanove、Y.Shoji、K.Kosuhara、T.Yamamura、J.Utsunomiya：“将 Maltunctioning Jpouch 转换为 kockspouch” Acta.Chir.Scand 156. 179-181 (1990)

Y.Sakanove,M.Kusunoki,T.Yamamura,J.Utsunomiya: "Crohn's disease in ileal Jーpouch" Dis&Rect. 33(6). 541 (1990)

Y. Sakanove、M. Kusunoki、T. Yamamura、J. Utsunomiya：“回肠 J 袋中的克罗恩病”Dis&Rect 33(6) 541 (1990)。

T.Hatada,M.Kusunoki,T.Sakiyama,Y.Sakanove,T.Yamamura,R.Okutani,K.Kono,H.Ishida,J.Utsunomiya: "He odynamics in the prone jackknite position during surgery." Am.J.Surg. (1991)

T.Hatada、M.Kusunoki、T.Sakiyama、Y.Sakanove、T.Yamamura、R.Okutani、K.Kono、H.Ishida、J.Utsunomiya：“手术期间俯卧针织位置的流体力学。”