家族性腺瘤性息肉病的外科治疗进展
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  • 英文篇名:Progress in surgical treatment of familial adenomatous polyposis
  • 作者:李凯钰 ; 刘刚
  • 英文作者:Kai-Yu Li;Gang Liu;Department of General Surgery, Tianjin Medical University General Hospital;
  • 关键词:家族性腺瘤性息肉病 ; 回肠贮袋肛管吻合术 ; 回肠直肠吻合术 ; 外科治疗 ; 腹腔镜技术
  • 英文关键词:Familial adenomatous polyposis;;Ileal pouchanal anastomosis;;Ileorectal anastomosis;;Surgical treatment;;Laparoscopic techniques
  • 中文刊名:XXHB
  • 英文刊名:World Chinese Journal of Digestology
  • 机构:天津医科大学总医院普通外科;
  • 出版日期:2019-02-28
  • 出版单位:世界华人消化杂志
  • 年:2019
  • 期:v.27;No.624
  • 语种:中文;
  • 页:XXHB201904007
  • 页数:8
  • CN:04
  • 分类号:49-56
摘要
家族性腺瘤性息肉病(familial adenomatous polyposis,FAP)是一种癌变倾向较高的常染色体显性遗传病.预防性外科干预的时机和手术方式的选择在以腺瘤的数量、大小和严重程度为主要决定因素的同时,应结合多方面情况综合考虑,在有效预防癌变的同时使患者易于接受.全结直肠切除、回肠贮袋肛管吻合术(ileal pouch anal anastomosis, IPAA)已经成为FAP患者的首选治疗方案.IPAA能够最大限度减少直肠黏膜残留、降低腺瘤复发癌变风险,而腹腔镜IPAA具有美观、恢复快、黏连少、妊娠率高等明显优势. FAP患者应由在专业的医疗中心工作的经验丰富的外科医生进行管理,以便在最佳的时机得到最合理的治疗,达到长期有效的治疗结果.
        Familial adenomatous polyposis(FAP) is an autosomal dominant genetic disease with a high tendency to develop colorectal cancer. The timing and choice of preventive surgical interventions should be based on the number, size and severity of adenomas, combined with a variety of considerations, in order to effectively prevent cancer and make patients easy to accept. Total proctocolectomy and ileal pouch-anal anastomosis(IPAA)procedure, which could minimize the residual rectal mucosa and reduce the risk of adenoma recurrence, has become the first choice for patients with FAP. Besides, laparoscopic IPAA has obvious advantages such as cosmetic appearance, quick recovery, little adhesion and high pregnancy rate. Patients with FAP should be managed by experienced surgeons working in specialized medical centers in order to get the most reasonable treatment at the best time and achieve longterm effective outcomes.
引文
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