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次全大肠切除术治疗家族性腺瘤性息肉病21例疗效随访
于恩达,徐晓东,孟荣贵,YUEn-da,XUXiao-dong,MENGRong-gui
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摘要:
目的:评价次全大肠切除术治疗家族性腺瘤性息肉病(FAP)的近、远期疗效.方法:回顾性分析我科1985~2000年21例FAP患者行次全大肠切除术后残留结肠或(和)直肠的结肠镜随访结果.结果:所有患者残留结肠、直肠内都有不同程度的腺瘤复发,发生率100%;残留直肠内腺瘤生长较近端的残留结肠密集;1例术后4年直肠腺瘤癌变,累积直肠癌的发生率4.8%.结论:采用保留直肠的手术方式操作简单,术后并发症少,但有残留直肠息肉癌变的危险.
关键词:  腺瘤息肉病,结肠、次全大肠切除术、治疗结果
DOI:10.3724/SP.J.1008.2006.00367
基金项目:
Outcomes of subtotal proctocolectomy for familial adenomatous polyposis: a follow-up study of 21 clinical cases
于恩达,徐晓东,孟荣贵,YU En-da,XU Xiao-dong,MENG Rong-gui
()
Abstract:
Objective:To evaluate the short- and long-term outcomes of subtotal proctocolectomy for familial adenomatous polyposis (FAP). Methods: Twenty-one FAP patients who had undergone subtotal proctocolectomy during 1985-2000 in our department were followed up colonoscopically to observe whether there was any recurrence of polyps in postoperatively residual colon or/and rectum. Results: Adenomatous recurrence with variant degrees was detected in the residual colon or/and rectum in all 21 patients, the recurrence rate being 100%. Polypous growth was denser in the residual rectum than in the proximal residual colon. The adenomatous polyp in one patient cancerized 4 years after the initial operation. The cumulative occurrence of colorectal cancer was 4.8 %. Conclusion: Subtotal proctocolectomy is a simple procedure for FAP with fewer complications, but there is a risk of polyps cancerization in the residual colon or/and rectum.
Key words:  adenomatous polyposis coil  subtotal proctocolectomy  treatment outcome