NDLI: Comparison of proctocolectomy and ileal pouch-anal anastomosis to colectomy and ileorectal anastomosis in familial adenomatous polyposis

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Comparison of proctocolectomy and ileal pouch-anal anastomosis to colectomy and ileorectal anastomosis in familial adenomatous polyposis

Content Provider	Springer Nature Link
Author	Koskenvuo, L. Mustonen, H. Renkonen Sinisalo, L. Järvinen, H. J. Lepistö, A.
Copyright Year	2014
Abstract	Prophylactic surgical options for familial adenomatous polyposis (FAP) are either colectomy and ileorectal anastomosis (IRA) or proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this study was to analyse the short-term and long-term outcomes of these two operative techniques. All patients with FAP in Finland have been prospectively recorded in a database since 1963 were retrospectively reviewed in this analysis. Altogether 140 (61 %) colectomies with IRA and 88 (39 %) proctocolectomies with IPAA have been performed. Complications occurred in 28 (21 %) patients after IRA and in 26 (30 %) patients after IPAA. There were 15 (11 %) severe complications for IRA and 5 (6 %) for IPAA. Twenty-one (15 %) patients of the IRA group ended up in conventional ileostomy whereas 3 (3.4 %) patients of the IPAA group had their ileal reservoir converted to an ileostomy (p = 0.01). Cumulative survival for IRA was lower than for the IPAA (p = 0.03), but if accounting only for operations made after the IPAA era had commenced, there was no significant difference. IPAA was associated with improved long-term survival without an increase in postoperative complications. The risk of death after colectomy and IRA seemed to be predominantly related to the remaining risk of rectal cancer. Therefore, we favour proctocolectomy with IPAA as the prophylactic surgical procedure for FAP with intermediate or severe polyposis.
Starting Page	221
Ending Page	227
Page Count	7
File Format	PDF
ISSN	13899600
Journal	Familial Cancer
Volume Number	14
Issue Number	2
e-ISSN	15737292
Language	English
Publisher	Springer Netherlands
Publisher Date	2014-12-11
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Familial adenomatous polyposis FAP Ileorectal anastomosis Ileal pouch-anal anastomosis Profylactic colectomy Cancer Research Human Genetics Epidemiology Biomedicine general
Content Type	Text
Resource Type	Article
Subject	Genetics Cancer Research Genetics (clinical) Oncology

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