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The prevalence of dysplasia in the ileoanal pouch following restorative proctocolectomy for ulcerative colitis with associated dysplasia.
MedLine Citation:
PMID:  21689341     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: A recent systematic review indicated that dysplasia present before restorative proctocolectomy (RPC) is a predictor of subsequent dysplasia in the pouch. This prospective study was carried out to assess the prevalence of dysplasia in the ileal pouch in patients having RPC for ulcerative colitis (UC) with co-existing dysplasia in the operation specimen. METHOD: Eligible patients were invited for a surveillance endoscopy. The afferent and blind efferent ileal loop, ileoanal pouch and rectal cuff were examined by standard endoscopy using a dye-spray technique with methylene blue. Mucosal abnormalities were biopsied and random biopsies were taken from the afferent and blind ileal loop, pouch and rectal cuff each. RESULTS: 44 patients (25 male, mean 49 yrs) underwent pouch endoscopy at a mean interval from RPC of 8.6 years. Dysplasia was detected in two (4.5%) patients. In one, low-grade dysplasia was found in the rectal cuff and in the other low-grade dysplasia was detected in random biopsies in the pouch and the efferent ileal loop. CONCLUSION: This prospective pouch-endoscopy study detected dysplasia in less than 5% of patients over nearly ten years. The benefit of routine surveillance for dysplasia in the pouch is uncertain, as the significance of low-grade dysplasia in the pouch is not clear.
Authors:
T Kuiper; M S Vlug; F J C van den Broek; K M A J Tytgat; S van Eeden; P Fockens; W A Bemelman; E Dekker
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-16
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  -     ISSN:  1463-1318     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-6-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Department of gastroenterology and hepatology, Academic Medical Centre, University of Amsterdam, the Netherlands Department of Surgery, Academic Medical Centre, University of Amsterdam, the Netherlands Department of Pathology, Academic Medical Centre, University of Amsterdam, the Netherlands.
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