Long-term outcome of metachronous rectal cancer following ileorectal anastomosis for familial adenomatous polyposis.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Tomohiro YamaguchiYoshihiro Moriya

Abstract

Total colectomy with ileorectal anastomosis (IRA) for familial adenomatous polyposis (FAP) carries a potential risk of metachronous cancer in the residual rectum. This study evaluated the risk of cancer development in the residual rectum. Ninety-six patients who underwent initial surgery for prevention and cure of FAP were studied, and a clinicopathologic comparison was conducted between 59 patients who underwent IRA and 24 who underwent total proctocolectomy. The 5-year overall survival rates were 94% after IRA and 95% after total proctocolectomy with no significant difference. The incidence of dense-type rectal polyps (4/17, 24%) was significantly higher in patients who developed metachronous rectal cancer following IRA compared to that in patients who did not (1/39, 3%). Moreover, 60% of patients with dense-type colon polyps developed metachronous rectal cancer compared to 24% in patients without and 80% of those with dense type rectal polyps developed metachronous rectal cancer compared to 25% without. Endoscopic surveillance of the eight Tis or T1 patients was performed at intervals of 6 months to 1 year after IRA but was not performed in three T3 patients for more than 2 years. Effective IRA requires selection of patients...Continue Reading

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Citations

Jul 16, 2016·Japanese Journal of Clinical Oncology·Yasuhiro InoueKenichi Sugihara
May 17, 2013·Familial Cancer·Jennifer Liang, James M Church
Jun 9, 2012·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Masayasu HaraHiromitsu Takeyama
Nov 7, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Chukwuemeka C AneleAndrew Latchford

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