Subsequent Adenomas of Ileal Pouch and Anorectal Segment after Prophylactic Surgery for Familial Adenomatous Polyposis.

摘要: Familial adenomatous polyposis (FAP) is an autosomally dominant disease characterized by the early development of colorectal adenomas and carcinoma in untreated patients. Patients with FAP may develop rectal cancer at their initial presentation (primary) or after prophylactic surgery (secondary). Controversies exist regarding which surgical procedure represents best first-line treatment. The options for are ileorectal anastomosis (IRA) a restorative proctocolectomy (RPC) either handsewn stapled ileal pouch-anal (IPAA), without mucosectomy. purpose these surgeries to stop progression adenoma-cancer sequence eradicating colon, prone organ. Unfortunately, procedures, excise entire colon rectum while maintaining transanal fecal continence, do not guarantee that patients still won't adenomas. Based on available literature, we therefore reviewed reported incidences pouch-related occurred post FAP. review consists collection case, descriptive, prospective retrospective reports. OBJECTIVES To provide data natural history subsequent (by type) METHODS A was conducted existing reports undergoing (1975 - August, 2013). In each were clearly diagnosed one following: pouch mucosa (above anastomosis), within anorectal segment (ARS) below anastomosis, afferent loop. RESULTS total 515 (36%) have been reported. Two hundred eleven (211) had mucosa, 295 them ARS 9 dysplasia endoscopically polypectomized treated coagulation modality using Nd:Yag laser argon plasma (as indicated). dysplastic excised (pouchectomy). CONCLUSION IRA RPC IPAA, formation pouch-body ARS/anastomosis loop apparent. Because risks adenoma recurrence, life time endoscopic pouch-surveillance warranted.