UC手术治疗PPT课件.pptx

腹腔镜微创技术助力UC手术治疗,金华市中心医院结直肠肛门外科,.,1,Ulcerativecolitis,UC,内科治疗,外科治疗,UC,MDT,.,2,surgery,FIGURE1.CumulativeriskofsurgeryrelatedtoIBDamongpatientswithUCstratifiedbyageatdiagnosisasyoungadults(1840yr),middle-ageadults(4164yr),andelderly($65yr).,FIGURE2.CumulativeriskofsurgeryrelatedtoIBDamongpatientswithCDstratifiedbyageatdiagnosisasyoungadults(1840yr),middle-ageadults(4164yr),andelderly($65yr).,1NguyenGC,BernsteinCN,BenchimolEI.RiskofSurgeryandMortalityinElderly-onsetInflammatoryBowelDisease:APopulation-basedCohortStudyJ.InflammBowelDis.2017,23(2):218-223.,.,3,RestorativeproctolectomyIPAAVSIRA(ilealpouch-analanastomosis)(totalcolectomywithileorectalanastomosis),MTV(maximumtoleratedvolume)120ML;RC(rectalcompliance)1.5mlair/mmhg,1TonelliF,DiMartinoC,GiudiciF.CouldTotalColectomywithIleorectalAnastomosisBeanAlternativetoTotalProctocolectomywithIlealPouch-AnalAnastomosisinSelectedUlcerativeColitisPatients?J.GastroenterolResPract.2016,2016:5832743.,.,4,laparoscopicVSopen,.,5,1MagroF,GionchettiP,EliakimR,etal.ThirdEuropeanEvidence-BasedConsensusonDiagnosisandManagementofUlcerativeColitis.Part1:Definitions,diagnosis,extra-intestinalmanifestations,pregnancy,cancersurveillance,surgery,andileo-analpouchdisordersJ.JCrohnsColitis.2017.,.,6,腹腔镜微创IPAA手术就其操作设备而言包括传统腹腔镜、机器人腔镜方式1；就其辅助切口而言包括多孔、单孔及自然腔道2-5。微创手术较传统开放手术具有显著的微创优势6,7，有助于提升患者的手术耐受8，一定程度上可能会对UC手术的适应症产生影响。1Mark-ChristensenA,PachlerFR,NoragerCB,etal.Short-termOutcomeofRobot-assistedandOpenIPAA:AnObservationalSingle-centerStudyJ.DisColonRectum.2016,59(3):201-207.2RencuzogullariA,StocchiL,CostedioM,etal.Characteristicsoflearningcurveinminimallyinvasiveilealpouch-analanastomosisinasingleinstitutionJ.SurgEndosc.2017,31(3):1083-1092.3LeoCA,SamaranayakeS,Perry-WoodfordZL,etal.Initialexperienceofrestorativeproctocolectomyforulcerativecolitisbytransanaltotalmesorectalrectalexcisionandsingle-incisionabdominallaparoscopicsurgeryJ.ColorectalDis.2016,18(12):1162-1166.4BaekSJ,DozoisEJ,MathisKL,etal.Safety,feasibility,andshort-termoutcomesin588patientsundergoingminimallyinvasiveilealpouch-analanastomosis:asingle-institutionexperienceJ.TechColoproctol.2016,20(6):369-374.5deBuckVOA,WolthuisAM,DHooreA.Transanalcompletionproctectomyaftertotalcolectomyandilealpouch-analanastomosisforulcerativecolitis:amodifiedsinglestapledtechniqueJ.ColorectalDis.2016,18(4):O141-O144.6JaniK,ShahA.Laparoscopictotalproctocolectomywithilealpouch-analanastomosisforulcerativecolitisJ.JMinimAccessSurg.2015,11(3):177-183.7ColomboF,SahamiS,deBuckVOA,etal.RestorativeProctocolectomyinElderlyIBDPatients:AMulticentreComparativeStudyonSafetyandEfficacyJ.JCrohnsColitis.2016.8OkitaY,ArakiT,HiroJ,etal.SystemicAcute-phaseResponseinLaparoscopicandOpenIlealPouchAnalAnastomosisinPatientsWithUlcerativeColitis:ACase-matchedComparativeSt