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Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis:A narrative review

World Journal of Gastrointestinal Surgery 2016年第8期8卷 556-563页

作者： Luigi Sofo Paola Caprino franco sacchetti Maurizio Bossola Division of General Surgery Catholic University of the Sacred Heart Division of Gastroenterology Catholic University of the Sacred Heart

Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative ***,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March *** large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial *** available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected *** 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely *** long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by ***-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.

关键词： ulcerative colitis total proctocolectomy ileal pouch anal anastomosis surgery laparoscopic

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