直腸結腸切除、直腸結腸切除術

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/17 11:51:43」(JST)

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Proctocolectomy is the surgical removal of the rectum and all or part of the colon. It is a most widely accepted surgical method for ulcerative colitis and Familial adenomatous polyposis (FAP) .

A proctocolectomy is considered a cure for ulcerative colitis, as the disease only attacks the large intestine and the rectum, and the disease cannot flare-up again, but extra-intestinal symptoms will remain. It can also be performed for Crohn's disease that has damaged the entire large intestine and caused complications, but it does not cure or eliminate the disease.

References

http://www.webmd.com/ibd-crohns-disease/Proctocolectomy-and-ileostomy-for-inflammatory-bowel-disease

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1. 回腸嚢肛門吻合術を伴う肛門機能温存直腸結腸切除術：腹腔鏡によるアプローチ restorative proctocolectomy with ileal pouch anal anastomosis laparoscopic approach
2. 潰瘍性大腸炎の外科的マネージメント surgical management of ulcerative colitis
3. ストーマ造設術の外科的原則 surgical principles of ostomy construction
4. 小腸および大腸におけるクローン病の外科的マネージメント operative management of crohns disease of the small bowel and colon
5. 人工肛門造設または回腸瘻造設患者のマネージメント management of patients with a colostomy or ileostomy

English Journal

Risk and location of cancer in patients with preoperative colitis-associated dysplasia undergoing proctocolectomy.

Kiran RP, Ahmed Ali U, Nisar PJ, Khoury W, Gu J, Shen B, Remzi FH, Hammel JP, Lavery IC, Fazio VW, Goldblum JR.Author information Departments of *Colorectal Surgery †Gastroenterology; and ‡Anatomic Pathology, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH.AbstractOBJECTIVE: To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis.
Annals of surgery.Ann Surg.2014 Feb;259(2):302-9. doi: 10.1097/SLA.0b013e31828e7417.
OBJECTIVE: To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis.BACKGROUND: The ability to predict the presence and location of cancer in colitis patients with dysplasia is essential to facilitate recommendations rega
PMID 23579580

The association between autoimmunity and pouchitis.

Seril DN, Yao Q, Shen B.Author information Departments of *Gastroenterology/Hepatology, and †Rheumatic and Immunologic Disease, The Cleveland Clinic Foundation, Cleveland, Ohio.Abstract: Restorative proctocolectomy with ileal pouch-anal anastomosis is commonly used in the management of ulcerative colitis. Inflammation of the ileal pouch reservoir, or pouchitis, is a common complication of ileal pouch-anal anastomosis that is incompletely understood. Risk factors including nonsmoker status and primary sclerosing cholangitis have been linked with pouchitis development, but the etiopathogenesis of pouchitis remains poorly defined. Pouchitis is more commonly a complication of ileal pouch-anal anastomosis performed in patients with ulcerative colitis, and similar to ulcerative colitis, chronic pouchitis is associated with extraintestinal manifestations and other diseases of immune origin, suggesting overlap in the disease pathogenesis. It is becoming apparent that pouchitis encompasses clinically distinct subtypes based on the response or lack of response to antibiotic therapy. There is also emerging evidence of the role of autoimmunity in a subgroup of patients with pouchitis, including patients with concurrent primary sclerosing cholangitis, seropositivity for immunoglobulin G4, or infiltration of immunoglobulin G4-expressing plasma cells in the pouch mucosa. The identification of underlying autoimmunity may have important clinical implications in the diagnosis, subclassification, and management of pouchitis.
Inflammatory bowel diseases.Inflamm Bowel Dis.2014 Feb;20(2):378-88. doi: 10.1097/01.MIB.0000435761.82705.6a.
: Restorative proctocolectomy with ileal pouch-anal anastomosis is commonly used in the management of ulcerative colitis. Inflammation of the ileal pouch reservoir, or pouchitis, is a common complication of ileal pouch-anal anastomosis that is incompletely understood. Risk factors including nonsmoke
PMID 24374879

Chemoradiotherapy followed by restorative proctocolectomy with partial intersphincteric resection for advanced rectal cancer associated with ulcerative colitis: report of a case.

Inoue Y, Araki T, Okugawa Y, Kawamoto A, Hiro J, Toiyama Y, Tanaka K, Uchida K, Mohri Y, Kusunoki M.Author information Division of Reparative Medicine, Department of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan, yasinoue@clin.medic.mie-u.ac.jp.AbstractThe role of restorative proctocolectomy with ileal J-pouch anal anastomosis (IPAA) is uncertain for patients with ulcerative colitis (UC), when advanced lower rectal cancer is diagnosed. We report what to our knowledge is the first documented case of successful preoperative chemoradiotherapy followed by IPAA with partial intersphincteric resection of advanced rectal cancer associated with UC. A 59-year-old woman with a 24-year history of extensive UC was found to have advanced rectal cancer located 2 cm from the anal verge. She underwent preoperative conventional chemoradiotherapy followed by restorative proctocolectomy with total mesorectal excision. The procedure included intersphincteric resection of one quadrant and construction of an IPAA with diverting ileostomy. The postoperative course was uneventful, and the ileostomy was closed 6 months after the initial surgery. The patient was doing well with good pouch function and no evidence of recurrent disease 1 year after her initial surgery.
Surgery today.Surg Today.2014 Feb;44(2):387-90. doi: 10.1007/s00595-013-0558-9. Epub 2013 Mar 24.
The role of restorative proctocolectomy with ileal J-pouch anal anastomosis (IPAA) is uncertain for patients with ulcerative colitis (UC), when advanced lower rectal cancer is diagnosed. We report what to our knowledge is the first documented case of successful preoperative chemoradiotherapy followe
PMID 23525639

Japanese Journal

分割的全結腸直腸切除術を施行し得た超高齢者潰瘍性大腸炎の1例

生澤史江,舟山裕士,高橋賢一,羽根田祥,小島康弘
日本大腸肛門病学会雑誌 68(5), 306-311, 2015
症例は88歳，男性．血便を主訴に近医を受診し，潰瘍性大腸炎の疑いで入院となった．ステロイド治療を開始したが，改善せず，精査加療目的に当院へ転院となった．転院後，左側大腸炎，中等症の潰瘍性大腸炎の診断にて，ステロイドパルス療法を施行したが，治療抵抗性で，画像診断で口側進展が認められたことから，前医入院から20日後に手術となった．初回手術は用手補助腹腔鏡下に大腸亜全摘を施行し，術後第28病日に退院とな …
NAID 130005068286

潰瘍性大腸炎に対する用手補助腹腔鏡下大腸全摘術の短期成績

ITABASHI Michio,NAKAO Sayumi,BAMBA Yoshiko,HASHIMOTO Takuzo,HIROSAWA Tomoichiro,OGAWA Shimpei,KAMEOKA Shingo,板橋道朗,中尾紗由美,番場嘉子,橋本拓造,廣澤知一郎,小川真平,亀岡信悟
東京女子医科大学雑誌 84(臨時増刊3(医学部外科学(第2)講座亀岡信悟教授退任記念特別)), E331-E337, 2014-11-30
NAID 120005527217

大腸全摘術を施行した潰瘍性大腸炎症例における骨粗鬆症の危険因子

BAMBA Yoshiko,ITABASHI Michio,NAKAO Sayumi,HATTA Kazuha,IHARA Takeshi,UBUKATA Mamiko,KAJI Sanae,HASHIMOTO Takuzo,HIROSAWA Tomoichiro,OGAWA Shimpei,SESHIMO Akiyoshi,KAMEOKA Shingo,番場嘉子,板橋道朗,中尾紗由美,八田一葉,井原健,産形麻美子,加治早苗,橋本拓造,廣澤知一郎,小川真平,瀬下明良,亀岡信悟
東京女子医科大学雑誌 84(臨時増刊3(医学部外科学(第2)講座亀岡信悟教授退任記念特別)), E360-E364, 2014-11-30
NAID 120005527212