Long-term outcomes of metachronous neoplasms in the ileal pouch and rectum after surgical treatment in patients with familial adenomatous polyposis
| Autor: | Takashi Kinoshita, Nozomi Okuno, Nobumasa Mizuno, Makoto Ishihara, Koji Komori, Vikram Bhatia, Tsutomu Tanaka, Kazuo Hara, Shinpei Matsumoto, Yasumasa Niwa, Yasushi Yatabe, Takamichi Kuwahara, Sachiyo Oonishi, Taihei Ooshiro, Yutaka Hirayama, Masahiro Tajika |
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| Rok vydání: | 2019 |
| Předmět: |
Original article
medicine.medical_specialty Adenoma Proctocolectomy business.industry medicine.medical_treatment Rectum Retrospective cohort study Anastomosis medicine.disease digestive system Gastroenterology digestive system diseases Familial adenomatous polyposis Chromoendoscopy stomatognathic diseases medicine.anatomical_structure Internal medicine medicine lcsh:Diseases of the digestive system. Gastroenterology Pharmacology (medical) lcsh:RC799-869 Pouch business |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 07, Iss 05, Pp E691-E698 (2019) |
| ISSN: | 2196-9736 2364-3722 |
| Popis: | Background and study aims Restorative proctocolectomy has become the most common surgical option for patients with familial adenomatous polyposis (FAP). However, adenomas and even carcinomas may develop in the ileal pouch over time. The aim of this study was to evaluate the long-term incidence and nature of ileal pouch or distal ileal adenomas and carcinomas in patients with FAP. Patients and methods This was a retrospective study of 47 FAP patients with Kock’s continent ileostomy (Kock) (n = 8), ileorectal anastomosis (IRA) (n = 13), and ileal pouch-anal anastomosis (IPAA) (n = 26). Patients were followed with a standardized protocol including chromoendoscopy and biopsies of visible polyps in the ileal pouch, distal ileum, and rectum every 6 to 12 months. Results Median follow-up was 21.0 years. Overall risk of adenoma development was significantly higher in IRA patients, with incidence rates of 85 % and 100 % at 5 and 10 years’ follow-up, respectively, compared to pouch patients (Kock + IPAA) (P Conclusions There is a significant incidence of adenoma(s) in the ileal pouch of FAP patients on long-term follow-up. Regular endoscopic surveillance is recommended, not only in IRA patients, but also in pouch patients after proctocolectomy. |
| Databáze: | OpenAIRE |
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