炎症性肠道疾病的直肠切除术后的恢复性囊手术:过去的经验和未来的方向
David Cohen1, Caitlin Silvestri1, David M Schwartzberg2
1Department of Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, NY, USA.
Translational gastroenterology and hepatology
|August 21, 2023
概括
恢复性直肠切除术与阴道囊-门解剖 (IPAA) 彻底改变了炎症性肠病 (IBD) 的手术. 再手术口袋手术现在为口袋并发症提供了解决方案,改善了没有永久性口腔切除的生活质量.
科学领域:
- 胃肠病学和外科创新的创新
- 炎症性肠病 (IBD) 管理管理
背景情况:
- 从历史上看,带末端结肠静脉切除术是性结肠炎 (UC) 和克罗恩病 (CD) 的标准.
- 在20世纪70年代末引入囊-门解剖 (IPAA),为IBD患者提供了无门的替代方案.
- 手术技术的进步,包括合器和最少的侵入性方法,已经改进了盆腔袋手术.
研究的目的:
- 审查UC和CD患者的直肠炎外科治疗的发展情况.
- 突出重复手术囊手术的出现和重要性,以管理囊并发症.
- 评估经过重复手术的患者的结局和生活质量.
主要方法:
- 对IBD相关的乳头结肠炎的历史手术方法的审查.
- 分析囊-门解剖 (IPAA) 程序的发展和完善.
- 检查重复手术囊手术在解决囊衰竭方面的作用和成功.
主要成果:
- 通过避免永久性口腔切除,IPAA显著改善了生活质量.
- 最少侵入性技术,虽然推进了手术,但与增加袋子并发症有关.
- 重复手术口袋手术有效地解决了机械并发症,并恢复了许多患者的生活质量.
结论:
- 重复手术口袋手术是患有口袋衰竭的患者的可行选择,可以替代永久性口腔.
- 仔细选择患者至关重要,区分克罗恩病的囊袋和可纠正的机械问题.
- 成功的再手术囊外科手术导致IBD患者的可接受生活质量.
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