Prevalence and Morphology of Pouch and Ileal Adenomas in Familial Adenomatous Polyposis

Abstract

The risk of pouch cancer in familial adenomatous polyposis is unclear, but follow-up periods since surgery remain relatively short. Long-term endoscopic surveillance of familial adenomatous polyposis pouches is thus recommended along with evaluation of potential therapeutic options for pouch adenomas.

Progression to advanced neoplasia is infrequent in post colectomy familial adenomatous polyposis patients under endoscopic surveillance

“…This contrasts with prior reports of up to 57% in similar cohorts, which may be due to the post operative timing of the respective studies [9,21]. Initial [22].…”

“…Anastomotic polyp prevalence with either a double stapled or a hand sewn anastomosis with mucosectomy is reported to be 31% and 10%, respectively [12]. Regardless of surgical technique, anastomotic site and pouch adenocarcinoma have been described [9,[13][14][15][16][17]. However, the incidence and natural history of IPAA neoplasia is poorly understood and not well defined [18].…”

“…Schulz et al report 22.8% at 5 years post IPAA [8]. While at a median of 6 years post operatively, Groves and colleagues highlight that ileal adenoma prevalence in pouch and non pouch ileal mucosa at 57% and 10%, respectively [9].…”

Meta-analysis of observational studies of ileorectal versus ileal pouch–anal anastomosis for familial adenomatous polyposis

“…Other mutations that have been implicated in this regard include those at codons 1309 and 1328, again suggesting the need for IPAA 8 . Nevertheless, Groves et al 53 recently assessed the prevalence of pouch adenomas in 60 patients with FAP and did not find any genotype-phenotype correlation that predicted their development.…”

The Impact of Technical Factors on Outcome of Restorative Proctocolectomy for Familial Adenomatous Polyposis

“…29 This study deliberately did not examine the incidence of adenomatous polyps in the pouch, because this subject has been addressed in detail by a separate study from this institution. 30 Seven percent of patients in the current study developed desmoid tumors. This figure is similar to the rate of 6 percent reported by the Mayo Clinic 25 and less than the rate of 16 percent reported by the Paris group.…”