Adenocarcinoma After Ileoanal Anastomosis for Familial Adenomatous Polyposis: Review of Risk Factors and Current Surveillance Apropos of A Case

Campos, Fábio Guilherme; Habr‐Gama, Angelita; Kiss, Desidério Roberto; Silva, Edésio Vieira da; Rawet, Viviane; Imperiale, Antônio Rocco; Perez, Rodrigo Oliva; Silva, José Hyppólito da; Sousa, Afonso Henrique Silva e; Gama-Rodrigues, Joaquim

doi:10.1016/j.gassur.2004.10.017

Cited by 35 publications

(24 citation statements)

References 44 publications

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“…In our study only, one patient was older than 50 years and there are no recurrences within the follow-up time period. However, recently, Campos in 2005 reported that the cumulative risk of developing polyps and carcinoma at the pouch and at the anastomotic site increased with time, recommending a careful and longterm surveillance of patients with FAP [44]. In more recent reports, cumulative rectal cancer risk after TC/IRA in 16.6% and it was associated with greater age and previous colonic carcinoma [45].…”

Section: Cancer Recurrencementioning

confidence: 99%

Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis

et al. 2010

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Section: Cancer Recurrencementioning

confidence: 99%

Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis

et al. 2010

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“…It is then possible that the cancer evolved from an excluded segment of rectal mucosa Such mechanism of extraluminal tumor growth has been reported in patients with Familial Adenomatous Polyposis (FAP) who undergo restorative proctocolectomy and ileal pouch anal anastomosis (IPAA) with mucosectomy and hand-sewn anastomosis. Multiple reports have documented the occurrence of adenocarcinoma in residual or excluded rectal mucosa following such procedures [1,2]. Residual islets of rectal mucosa after mucosectomy have also been found in the rectal cuff or at the anastomotic line of specimen in pouches that were later excised for other complications such as severe pouchitis, obstruction, etc.…”

Section: Discussionmentioning

confidence: 99%

Primary Rectal Cancer from Outside the Rectum

Cherenfant¹,

Ruggiero²

2014

J Gastrointest Dig Syst

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Rectal cancer typically arises from the epithelial cells lining the lumen of the rectum. Extra-luminal primary rectal cancers are rare and differ histologically from retrorectal and sacral tumors. The current report presents the case of a 44 year-old male who developed adenocarcinoma outside of the lumen of the rectum 38 years after he underwent a pull-through procedure for Hirschsprung's disease. We hypothesize that the tumor emerged from an excluded, entrapped segment of rectal mucosa at the time of the patient's childhood procedure.

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“…No obstante, tiene una tasa global de complicaciones del 24%, entre las que se describen la obstrucción de intestino delgado, la sepsis pélvica, la disfunción sexual masculina y femenina, el fallo del reservorio y la reservoritis (21-29) y no es desdeñable el riesgo de desarrollar pólipos neoplásicos y cáncer en el reservorio o en islotes de mucosa rectal retenidos, de los que hay ya numerosos casos descritos (9,(30)(31)(32)(33)(34)(35)(36)(37)(38).…”

Section: Discussionunclassified

Seguimiento posquirúrgico de los pacientes con poliposis adenomatosa familiar: resultados en una población del sur de España

Fernández

Moreno

Benavides

et al. 2007

Rev. esp. enferm. dig.

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INTRODUCCIÓNLa poliposis adenomatosa familiar (PAF) es una enfermedad hereditaria de carácter autosómico dominante, causada por una mutación en la línea germinal del gen APC (gen de la poliposis cólica), situado en el cromosoma 5q21 (1). Clásicamente la PAF se ha caracterizado por la presencia de más de 100 pólipos en el colon y recto, que de forma natural evolucionan indefectiblemente a carcinoma alrededor de la cuarta década de la vida.Para prevenir el desarrollo del cáncer sería necesario extirpar la mucosa del colon y recto en su totalidad. No existe actualmente un proceder único para lograr ese ob- RESUMENObjetivo: analizar la evolución de la mucosa rectal y del reservorio así como idoneidad de los intervalos de seguimiento y del tratamiento realizado para evitar la aparición del cáncer, en una serie de pacientes con poliposis adenomatosa familiar (PAF), intervenidos.Método: estudio prospectivo de 28 pacientes con PAF intervenidos mediante anastomosis íleo-rectal (20 pacientes) y anastomosis íleo-anal con reservorio (8 pacientes). A todos se les había realizado un control endoscópico dos veces al año y análisis del número y características macroscópicas e histológicas de los póli-pos antes y después de la cirugía así como del tratamiento realizado, de sus complicaciones y de la adecuación del intervalo de seguimiento. El seguimiento medio fue de 6,47 años (DE = 4,59; rango = 0,72-16,75 años).Resultados: ninguno de los 26 pacientes que cumplimentaron correctamente el protocolo de seguimiento desarrolló cáncer. Sólo dos pacientes lo desarrollaron al 1,75 y los 3 años, respectivamente del abandono del protocolo. Los pacientes que desarrollaron adenomas durante el seguimiento fueron tratados con éxito mediante polipectomía endoscópica, salvo en dos casos que se indicó cirugía.Conclusiones: en nuestra serie, el incumplimiento de las revisiones ha sido el factor que ha condicionado la aparición de cáncer.Palabras clave: Poliposis adenomatosa familiar. Anastomosis íleo-rectal. Anastomosis íleo-anal con reservorio ileal. Adenomas de colon. Seguimiento posquirúrgico. ABSTRACTObjective: the study was to assess changes in the rectal mucosa and pouch in a series of patients with familial adenomatous polyposis (FAP) who underwent either subtotal colectomy and ileorectal anastomosis (IRA) or proctocolectomy and ileal pouchanal anastomosis (IPAA), and to evaluate the suitability of the follow-up interval and postoperative treatment employed to prevent the development of cancer.Method: this study involved 28 patients with FAP who underwent IRA (n=20) or IPAA (n=8), and were followed endoscopically over a mean period of 7.47 years. The number and both macroscopic and histological features of polyps before and after surgery, the treatment, and complications were all analyzed. The suitability of the follow-up interval was assessed.Results: none of the 26 patients who complied with follow-up developed rectal cancer. Two patients developed rectal cancer at 21 and 36 months after withdrawing from the protocol. Except in two cas...

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Adenocarcinoma After Ileoanal Anastomosis for Familial Adenomatous Polyposis: Review of Risk Factors and Current Surveillance Apropos of A Case

Cited by 35 publications

References 44 publications

Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis

Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis

Primary Rectal Cancer from Outside the Rectum

Seguimiento posquirúrgico de los pacientes con poliposis adenomatosa familiar: resultados en una población del sur de España

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