回肠贮袋肛管吻合术是直肠结肠切除术后恢复肠道连续性的首选方法。成功的回肠贮袋肛门吻合术需要回肠系膜充分到达骨盆。触及问题是术中造袋废弃的常见原因；然而，有关当代放弃率的数据很少，并且在修订环境中不存在。对单个转诊中心的连续回肠袋肛门吻合术进行了回顾性审查。初始或“初次”储袋和修正储袋手术均包括在内。总共进行了 447 次储袋肛门吻合术尝试，术中放弃率总体为 1.6%。造口袋废弃的原因是 3 次手术中肠系膜到达不足，2 次手术中硬纤维瘤，以及 2 次手术中剩余小肠不足。 12 名患者需要延长手术，包括 6 个 S 袋（1%）和 6 个 H 袋（1%）。一半（49%）的手术是回肠储袋肛门吻合术。总体而言，仅 0.4% 的初次造袋尝试和 1.0% 的翻修手术因触及问题而导致术中放弃。术前诊断为家族性腺瘤性息肉病与造口袋废弃有关 (P < .001)。即使在具有机构专业知识的大容量中心进行翻修治疗时，由于触及肠系膜，也可以实现极低的造袋废弃率。在修复环境中，腹内硬纤维瘤或短肠的可能性对造袋废弃率的影响与触及问题一样大。版权所有 © 2024。由 Elsevier Inc. 出版。

Ileal pouch anal anastomosis is the preferred method for restoration of intestinal continuity after proctocolectomy. Successful ileal pouch anal anastomosis requires adequate reach of the ileal mesentery to the pelvis. Reach issues are a common cause for intraoperative pouch abandonment; however, data regarding contemporary abandonment rates are rare and nonexistent in the revisional setting.A retrospective review was conducted of consecutive ileal pouch anal anastomosis surgery at a single referral center. Both initial or "primary" pouches and revisional pouch surgery were included.In total, 447 attempts at pouch anal anastomosis were made, with an 1.6% overall rate of intraoperative abandonment. Pouch abandonment was attributed to inadequate mesenteric reach during 3 surgeries, desmoid tumors in 2 surgeries, and insufficient remaining small bowel in 2 surgeries. Twelve patients required lengthening maneuvers including 6 S pouches (1%) and 6 H pouches (1%). One half (49%) of operations were revisional ileal pouch anal anastomosis surgery. Overall, reach issues led to intraoperative abandonment in only 0.4% of attempted primary pouches and 1.0% of revisional surgeries. A preoperative diagnosis of familial adenomatous polyposis was associated with pouch abandonment (P < .001).Extremely low pouch abandonment rates as a result of mesenteric reach can be achieved even in the revisional setting at a high-volume center with institutional expertise. In the revisional setting, intra-abdominal desmoids or the potential for short gut affects pouch abandonment rates as much as reach issues.Copyright © 2024. Published by Elsevier Inc.