welcome to oneFAPvoice
- a positively charged Familial Adenomatous Polyposis community.- join today!
- login
Rectal and Pouch Recurrences After Surgical Treatment for Familial Adenomatous Polyposis
source: Journal of gastrointestinal surgery
year: 2008
authors: Campos F G, Imperiale A R, Seid V E, Perez R O, da Silva e Sousa A H Jr, Kiss D R, Habr-Gama A, Cecconello I
summary/abstract:BACKGROUND : Familial adenomatous polyposis (FAP) is a genetic disease characterized by multiple adenomatous colorectal polyps and different extracolonic manifestations (ECM). The present work is aimed to analyze the outcome after surgical treatment regarding complications and cancer recurrence.
METHODS : Charts from patients treated between 1977 and 2006 were retrospectively analyzed. Clinical and endoscopic data, results of treatment, pathological reports and information about recurrence were collected.
RESULTS : Eighty-eight patients (41 men [46.6%] and 47 women [53.4%]) were assisted. At diagnosis, associated colorectal cancer (CRC) was detected in 53 patients (60.2%), whose average age was higher than those without CRC (40.0 vs. 29.5 years). At colonoscopy, polyposis was classified as attenuated in 12 patients (14.3%). Surgical treatment consisted in total proctocolectomy with ileostomy (PCI, 15 [17.4%]), restorative proctocolectomy (RPC, 27 [31.4%]), total colectomy with ileal-rectum anastomosis (IRA, 42 [48.8%]), palliative segmental resection (1 [1.2%]) and internal bypass (1 [1.2%]). Two patients were not operated on due to religious reasons and advanced disease. Complications occurred in 25 patients (29.0%), more commonly after RPC (48.1%). There was no operative mortality. Local or distant metastases were detected in six (11.3%) patients with CRC treated to cure. During the follow-up of 36 IRA, cancer developed in the rectal cuff in six patients (16.6%), whose average age was higher than in patients without rectal recurrence (45.8 vs. 36.6 years). Five of them have had colonic cancer in the resected specimen. Among the 26 patients followed after RPC, cancer in the ileal pouch developed in 1 (3.8%).
CONCLUSIONS : (1) Within the present series, FAP patients presented a high incidence of associated CRC and diagnosis was generally established after the third decade of life; (2) operative complications occurred in about one third of the patients, being more frequent after the confection of an ileal reservoir; (3) rectal cancer after IRA was detected in 16.6% of patients and it was associated with greater age and previous colonic carcinoma; (4) both continuous and long-term surveillance of the rectal stump and ileal pouch are necessary during follow-up.
organization: University of São Paulo School of MedicineDOI: 10.1007/s11605-008-0606-8
read more full text source
expertly curated content related to this topic
-
Primary Chemoprevention of Familial Adenomatous Polyposis with SulindacBACKGROUND : Familial adenomatous polypo...
-
Prostanoids, Ornithine Decarboxylase, and Polyamines in Primary Chemoprevention of Familial Adenomatous PolyposisBACKGROUND & AIMS : Familial adenoma...
-
Woman with Ostomy Bag Refused Entry to Bathroom with Disability AccessThat’s the message English blogger Sam...
-
How to Defy a Hereditary Predisposition and Prevent Colon Cancerhttps://www.youtube.com/watch?v=IynYbT2i...
-
Female Fertility After Colorectal Surgery for Familial Adenomatous Polyposis: A Nationwide Cross-Sectional StudyBACKGROUND : Information on postoperativ...
-
Summertime and FAP – An Interview with Tracy WhittI was lucky enough to spend a little ti...
-
Familial Adenomatous Polyposis by Luke Pardyhttp://www.slideshare.net/asteinman/fami...