家族性腺瘤息肉病预防性手术后的腺癌

• 作 者: 龚媛倩
• 机 构: 四川大学华西临床医学院,
• 出 处: 中国普外基础与临床杂志
• 发表日期: 2014年01期
• 关键词: 直肠吻合术 回肠造口术 直肠切除 结直肠切除术 息肉病 全结肠切除 结直肠癌 性腺瘤 结肠息肉病 腺癌

家族性腺瘤样息肉病(FAP)的发病率为1/7 000~12 000,未经手术治疗的FAP患者都不可避免地会发展成结直肠癌,因为他们携带了腺瘤性结肠息肉病基因,因此提出了对FAP患者可实施预防性结直肠切除术。其术式主要有结肠切除、回肠-直肠吻合术,结直肠切除、回肠储袋肛管吻合术,结直肠切除、回肠造口术以及结直肠切除、控制性回肠造口术4种。全结肠切除、回肠-直肠吻合术后患者的功能远胜于回肠储袋肛管吻合术者,但发生直肠癌的风险增加了30%。Smith JC等人回顾了

The incidence of familial adenomatous polyposis (FAP) is 1/7 000 to 12 000. Non-surgical FAP patients inevitably develop into colorectal cancer because they carry the adenomatous polyposis coli gene , Proposing a prophylactic colorectal resection for FAP patients. The main surgical methods are colon resection, ileum - rectal anastomosis, colorectal resection, ileal pocket anal anastomosis, colorectal resection, ileostomy and colorectal resection, controlled ileostomy 4. Patients who underwent total colon resection and ileostomy-rectal anastomosis performed far more well than those who underwent ileostomy and anastomosis, but the risk of rectal cancer increased by 30%. Smith JC et al review