Clinical features and management of afferent limb syndrome after ileal pouch-anal anastomosis for ulcerative colitis

被引：11

作者：

Okita, Yoshiki ^{[1
,2
]}

Araki, Toshimitsu ^{[1
,2
]}

Kawamura, Mikio ^{[1
,2
]}

Kondo, Satoru ^{[1
,2
]}

Inoue, Mikihiro ^{[1
,2
]}

Kobayashi, Minako ^{[1
,2
]}

Toiyama, Yuji ^{[1
,2
]}

Ohi, Masaki ^{[1
,2
]}

Tanaka, Koji ^{[1
,2
]}

Inoue, Yasuhiro ^{[1
,2
]}

Uchida, Keiichi ^{[1
,2
]}

Mohri, Yasuhiko ^{[1
,2
]}

Kusunoki, Masato ^{[1
,2
]}

机构：

[1] Mie Univ, Grad Sch Med, Inst Life Sci, Div Reparat Med,Dept Gastrointestinal Surg, 2-174 Edobashi, Tsu, Mie 5148507, Japan

[2] Mie Univ, Grad Sch Med, Inst Life Sci, Div Reparat Med,Dept Pediat Surg, 2-174 Edobashi, Tsu, Mie 5148507, Japan

来源：

SURGERY TODAY | 2016年 / 46卷 / 10期

关键词：

Afferent limb syndrome; Ileal pouch-anal anastomosis; Ulcerative colitis; Small bowel obstruction; Ileopexy; SMALL-BOWEL OBSTRUCTION; RESTORATIVE PROCTOCOLECTOMY; COMPLICATIONS; SURGERY;

D O I：

10.1007/s00595-016-1307-7

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Afferent limb syndrome (ALS) is a type of small bowel obstruction (SBO) caused by obstruction of the afferent intestinal limb after ileal pouch-anal anastomosis (IPAA). The aim of this study was to reveal the clinical features and management of ALS. Of 320 patients undergoing IPAA for ulcerative colitis, we analyzed data from patients presenting with SBO. Six of 19 patients with SBO were diagnosed with ALS. All patients with ALS presented with recurrent intermittent obstructive symptoms before admission, whereas 15 % of patients without ALS presented with these symptoms (P < 0.0005). Among the six patients with ALS, four patients required surgery, although they underwent transanal decompression for each episode of obstruction. The proportion of surgery was higher in the ALS group (P < 0.01). Acute angulation of the afferent limb was recognized in four cases and followed by fixation of the afferent limb. No further surgery was required in any patient following the last fixation. SBO after IPAA may be caused by acute angulation of the afferent limb of the ileal J-pouch. Most patients with ALS may eventually require fixation of the afferent limb due to acute angulation of the afferent limb.

引用

页码：1159 / 1165

页数：7

共 12 条

[1] Small-bowel obstruction after restorative proctocolectomy in patients with ulcerative colitis [J].