Document Detail

Familial adenomatous polyposis: prevalence of adenomas in the ileal pouch after restorative proctocolectomy.
MedLine Citation:
PMID:  11224623     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the prevalence of adenomas in ileal pouches from patients with familial adenomatous polyposis (FAP) and to determine whether a correlation exists between the presence of pouch adenomas and duodenal adenomas and the site of the adenomatous polyposis coli gene mutation.
SUMMARY BACKGROUND DATA: Restorative proctocolectomy can markedly reduce the risk of colorectal adenocarcinoma in FAP patients. However, adenomas with the potential to progress to adenocarcinoma can develop in the duodenum, ileum, and continent ileostomy after restorative proctocolectomy. More recently, adenomas have been described in the ileal pouch after ileoanal anastomosis.
METHODS: Pouch endoscopy was offered to 167 patients with FAP who had undergone restorative proctocolectomy between January 1984 and December 1996.
RESULTS: Adenomas were found in 35% of the 85 ileal pouches examined. No invasive carcinomas were noted. The risk of developing one or more adenomas at 5, 10, and 15 years was 7%, 35%, and 75%, respectively. Patients with adenomas were more likely to have duodenal and ampullary adenomas. No correlation was detected between adenoma development and the site of the adenomatous polyposis coli mutation.
CONCLUSIONS: Adenomas are frequently found in the ileal pouch of patients after restorative proctocolectomy for FAP. Regular endoscopic surveillance of the pouch is recommended at a frequency similar to that of upper gastrointestinal endoscopy.
Y R Parc; S Olschwang; B Desaint; G Schmitt; R G Parc; E Tiret
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  233     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-06     Completed Date:  2001-04-05     Revised Date:  2013-06-11    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  360-4     Citation Subset:  AIM; IM    
Department of Digestive Surgery, Hôpital Saint-Antoine AP-HP, University Pierre et Marie Curie, Paris, France.
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MeSH Terms
Adenomatous Polyposis Coli / diagnosis,  epidemiology*,  genetics,  surgery*
Endoscopy, Gastrointestinal
Middle Aged
Mutation / genetics
Paris / epidemiology
Postoperative Complications* / diagnosis,  epidemiology*,  physiopathology
Proctocolectomy, Restorative*
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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