储袋炎性疾病与功能障碍的诊疗进展
Progress in diagnosis and treatment of inflammatory disorders and dysfunctions related to ileal pouch
全结直肠切除(TPC)+回肠储袋肛管吻合术(IPAA)已成为外科治疗难治性溃疡性结肠炎(UC)、UC合并癌变以及家族性腺瘤性息肉病的标准术式。IPAA术后除了常见手术并发症外,还可能出现一系列与储袋相关的炎性疾病和功能异常,如储袋炎、储袋克罗恩病(CD)和直肠残端封套炎等,从而影响患者的手术恢复和生活质量,其中储袋炎是UC患者IPAA术后最常见的远期并发症,其累计发病率可达50%。随着我国IPAA手术的不断成熟和推广应用,越来越多的患者将会面临着储袋炎性疾病及功能障碍的困扰,而不同类型的储袋炎性疾病及功能障碍的诊断和治疗手段也不尽相同。本文就目前储袋炎性疾病及功能障碍的诊断和治疗进展进行汇总及论述。
更多Total proctocolectomy (TPC) and ileal pouch-anal anastomosis (IPAA) has become a standard surgical treatment for patients with refractory ulcerative colitis (UC) , UC complicated by neoplasia, and familial adenomatous polyposis. However, besides common surgery-related complications, a series of inflammatory disorders and dysfunctions related to pouch may also develop after IPAA, such as pouchitis, Crohn′s disease (CD) of the pouch, and cuffitis of the rectum stub, affecting postoperative recovery and the quality of life. Pouchitis is the most frequent long-term complication in patients with UC after IPAA, with a cumulative prevalence up to 50%. With the maturity and continuous application of IPAA, more and more patients will suffer the inflammatory disorders and dysfunctions related to pouch. There are different diagnosis and treatment methods for different types of the inflammatory disorders and dysfunctions related to pouch. This article summarizes and discusses the research progress in diagnosis and treatment of the inflammatory disorders and dysfunctions related to pouch.
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