Carcinoma of the rectal pouch following restorative proctocolectomy

Puthu, Devanand; Rajan, N.; Rao, Ravikala; Rao, Lakshmi; Venugopal, P

doi:10.1007/bf02051019

Cited by 133 publications

(63 citation statements)

References 16 publications

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“…One proved to be a squamous carcinoma of the anus, and the other was felt to arise from retained anal crypt mucosa, is Three subsequent cases of adenocarcinoma in the pelvic pouch have been reported as well, all apparently arising from retained rectal mucosa. [19][20][21] Treatment of pelvic reservoir cancers has not been well defined, because of the relative rarity of its occurrence. All reported patients with pelvic pouch cancer eventually underwent abdominoperineal resection, with excision of the pelvic pouch and formation of an end ileostomy.…”

Section: Discussionmentioning

confidence: 99%

Development of invasive adenocarcinoma in a long-standing kock continent ileostomy

Cox¹,

Butts²,

Roberts³

et al. 1997

Diseases of the Colon &Amp; Rectum

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The first case of adenocarcinoma developing in a continent ileostomy is reported. A healthy, 39-year-old man with a continent ileostomy for 17 years developed subacute obstructive symptoms and was found on endoscopy to have a large adenocarcinoma involving the intussusception valve. At operation, he was found to have a large tumor originating in the valve, extending through the reservoir, and involving the afferent ileal limb. A number of metastatic lymph nodes were identified in the mesentery of the small bowel. He underwent excision of the pouch and formation of an end ileostomy. He is currently undergoing adjuvant chemotherapy. Biochemical and morphologic changes in the ileal pouch, both in the pelvis and the continent ileostomy, are discussed. The implications of this apparent de novo cancer arising in an ileal pouch are discussed.

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Section: Discussionmentioning

confidence: 99%

Development of invasive adenocarcinoma in a long-standing kock continent ileostomy

Cox¹,

Butts²,

Roberts³

et al. 1997

Diseases of the Colon &Amp; Rectum

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show abstract

Section: Discussionmentioning

confidence: 99%

“…Seven of these pouches were performed for UC [1, 2, 3, 4, 5, 6, 7]and 3 for FAP [8, 9, 10]. The resultant cancer was histologically categorized as adenocarcinoma in 9 patients [1, 2, 3, 4, 6, 7, 8, 9, 10]and lymphoma in 1 [5]. The surgical technique in 8 cases was rectal mucosectomy with endorectal IPAA [1, 2, 3, 4, 5, 7, 8, 9]and non-mucosectomy stapled IPAA in 2 cases [6, 10].…”

Section: Discussionmentioning

confidence: 99%

Carcinoma of Pelvic Pouch following Restorative Proctocolectomy: Report of a Case and Review of the Literature

Negi¹,

Chaudhary²,

Gondal

2003

Dig Surg

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One of the possible long-term complications following an ileoanal pouch procedure is the development of malignancy in the mucosa of the rectal stump. Only 10 such cases have been reported so far. We report the case of a 23-year-old male who had ulcerative colitis with high-grade dysplasia and underwent an ileoanal pouch procedure. He was found to have a malignancy in the rectal stump 5 years after surgery. The malignancy presented with symptoms of refractory pouchitis. Pouch excision was performed. The risk of developing malignancy in the rectal mucosa after an ileoanal pouch procedure mandates regular follow-up in these patients, with a high index of suspicion especially in patients with delayed onset pouchitis.

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“…In at least one patient, a long rectal mucosectomy had been performed ( l 3), and in at least another one, severe dysplasia of the rec-260 tum was present at the time the muco~al proctectomy was performed ( 14 ). In the third report, neither the extent of the mucoscctomy nor the presence or absence of dyspl;1sia at the time of operation are mentioned ( 15 ).…”

Section: !Leal Pouch-anal Anastomosis With Complete Anal Canal Mucosementioning

confidence: 96%

“…Moreover, daytime contin ence tends to be c loser to normal than nighttime continence, hut nighttime cont inence a lso improves dramatically with time and is superior m young men, patients with polyposis and those with less diarrhea prcoperativcly than in older women, coli tis patients and those with more stools prcoperatively (5). One would predict that the risk of adenocarcinoma developing after !PAA is nonexistent, but, to dare, three patient~ have dcvelt)peJ adcnocarcinomas of the anorcctal area after deoanal anastomosis (13)(14)(15). In at least one patient, a long rectal mucosectomy had been performed ( l 3), and in at least another one, severe dysplasia of the rec-260 tum was present at the time the muco~al proctectomy was performed ( 14 ).…”

Section: !Leal Pouch-anal Anastomosis With Complete Anal Canal Mucosementioning

confidence: 99%

Ileoanal Pouches - Is Mucosectomy Essential?

Dozios

Juhász

1993

Canadian Journal of Gastroenterology

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(IPAA) with mucosectomy after pmctocolectomy eradicates ulcerative proctocolitis, restores anorcctal function, and avoids a permanent denstomy. Its disadvantages include increased stooling frequency, imperfect continence especially at night, and rouchitis. Heal pouch-disral rectal anastomosis (IP()RA) without mucosectomy promises to 1mprnve nighrtime continence by preserving the mucosa of the anal tramitional zone. Thus far, in controlled trials stool frequency anJ contmcnce after ll'DRA do not differ from that reported after IPAA with mucosect()lny. It is unlikely that the risk of pt)uchitis will be diminished. However, the drawbacks of IPDRA relate to the residual diseased muco~a which may predispose patients to recurrent procticis anJ associated symptoms, mcluding persistent extracolonic manifestations, leading ultimately to poor functional results and mcrcascJ risk of cancer. Therefore, !PAA with complete mucosectomy is preferable tu IPDRA and continues to he the procedure of choice; it cures patients of the colitis, has broader indications, and appears to provide postoperative neorectal function comparnhle to that offered by ll'DRA.

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Carcinoma of the rectal pouch following restorative proctocolectomy

Cited by 133 publications

References 16 publications

Development of invasive adenocarcinoma in a long-standing kock continent ileostomy

Development of invasive adenocarcinoma in a long-standing kock continent ileostomy

Carcinoma of Pelvic Pouch following Restorative Proctocolectomy: Report of a Case and Review of the Literature

Ileoanal Pouches - Is Mucosectomy Essential?

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