臨床外科65巻11号

2010年10月発行

特集 外科医のための大腸癌の診断と治療 5．大腸癌の外科治療 ■開腹手術

J-pouch，Coloplasty

著者： 松岡弘芳¹ 正木忠彦¹ 植木ひさよ¹ 小林敬明¹ 佐藤和典¹ 杉山政則¹ 跡見裕¹

所属機関： ¹杏林大学医学部消化器一般外科

ページ範囲：P.292 - P.295

■吻合部が肛門縁4cm以内では，J-pouchまたはcoloplastyによるパウチオペレーションを行う．

■J-pouchは長さ5cmほどの小さめのパウチにする．

■Coloplastyでは，新直腸内腔確保のためGambee縫合にて形成を行う．

参考文献

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2）McDonald PJ, Heald RJ：A survey of postoperative function after rectal anastomosis with circular stapling devices. Br J Surg 70：727-729, 1983

3）Pedersen IK, Christiansen J, Hint K, et al：Anorectal function after low anterior resection for carcinoma. Ann Surg 204：133-135, 1986

4）Lewis WG, Martin IG, Williamson ME, et al：Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma? Dis Colon Rectum 38：259-263, 1995

5）Yamana T, Oya M, Komatsu J, et al：Preoperative anal sphincter high pressure zone, maximum tolerable volume, and anal mucosal electrosensitivity predict early postoperative defecatory function after low anterior resection for rectal cancer. Dis Colon Rectum 42：1145-1151, 1999

6）Lazorthes F, Fages P, Chiotasso P, et al：Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum. Br J Surg 73：136-138, 1986

7）Z'graggen K, Maurer CA, Birrer S, et al：A new surgical concept for rectal replacement after low anterior resection：the transverse coloplasty pouch. Ann Surg 234：780-785, 2001

8）Fazio VW, Mantyh CR, Hull TL：Colonic“coloplasty”：novel technique to enhance low colorectal or coloanal anastomosis. Dis Colon Rectum 43：1448-1450, 2000

9）Ho YH, Brown S, Heah SM, et al：Comparison of J-pouch and coloplasty pouch for low rectal cancers：a randomized, controlled trial investigating functional results and comparative anastomotic leak rates. Ann Surg 236：49-55, 2002

10）Liao C, Gao F, Cao Y, et al：Meta-analysis of the colon J-pouch vs transverse coloplasty pouch after anterior resection for rectal cancer. Colorectal Dis 12：624-631, 2010

11）Ulrich AB, Seiler CM, Z'graggen K, et al：Early results from a randomized clinical trial of colon J pouch versus transverse coloplasty pouch after low anterior resection for rectal cancer. Br J Surg 95：1257-1263, 2008

12）Fürst A, Suttner S, Agha A, et al：Colonic J-pouch vs. coloplasty following resection of distal rectal cancer：early results of a prospective, randomized, pilot study. Dis Colon Rectum 46：1161-1166, 2003

13）Pimentel JM, Duarte A, Gregório C, et al：Transverse coloplasty pouch and colonic J-pouch for rectal cancer-a comparative study. Colorectal Dis 5：465-470, 2003

14）Matsuoka H, Masaki T, Kobayashi T, et al：Comparison of functional and clinical outcomes：colonic J-pouch vs. coloplasty in patients with low rectal cancer. Hepatogastroenterology 57：70-72, 2010

15）Heriot AG, Tekkis PP, Constantinides V, et al：Meta-analysis of colonic reservoirs versus straight coloanal anastomosis after anterior resection. Br J Surg 93：19-32, 2006

16）Joo JS, Latulippe JF, Alabaz O, et al：Long-term functional evaluation of straight coloanal anastomosis and colonic J-pouch：is the functional superiority of colonic J-pouch sustained? Dis Colon Rectum 41：740-746, 1998

17）Hida J, Yoshifuji T, Tokoro T, et al：Comparison of long-term functional results of colonic J-pouch and straight anastomosis after low anterior resection for rectal cancer：a five-year follow-up. Dis Colon Rectum 47：1578-1585, 2004