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

Roon, Alexander C. von; Tekkis, Paris; Clark, Susan; Heriot, Alexander G.; Lovegrove, Richard E.; Truvolo, Simona; Nicholls, R. J.; Phillips, R. K. S.

doi:10.1007/s10350-006-0872-z

Cited by 26 publications

(19 citation statements)

References 30 publications

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“…reported such risk as 10% at 7 years after hand‐sewn IPAA with mucosectomy. Furthermore, another study revealed that development of cancer was not different between the two anastomotic techniques 30. In light of these findings, all patients with FAP should undergo endoscopic surveillance at regular intervals regardless of the anastomotic procedure.…”

Section: Discussionmentioning

confidence: 89%

Postoperative complications after stapled and hand‐sewn ileal pouch‐anal anastomosis for familial adenomatous polyposis: A multicenter study

Konishi

Ishida

Ueno

et al. 2017

Annals of Gastroent Surgery

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Ileal pouch‐anal anastomosis (IPAA) after total proctocolectomy (TPC) can be conducted with either hand‐sewn or stapled anastomosis for patients with familial adenomatous polyposis (FAP). Although stapled IPAA without mucosectomy has a higher risk for developing adenomas in the remnant mucosa, it is the simpler procedure with potential benefit in short‐term outcomes. However, it remains controversial as to whether stapled IPAA has any advantages in reducing postoperative complications. The aim of the present study was to compare the postoperative complications and short‐term outcomes of stapled and hand‐sewn IPAA for patients with FAP, using a multicenter cohort sample in Japan. Data of 143 patients with FAP who underwent TPC with stapled IPAA (n=37) and hand‐sewn IPAA (n=106) at 23 institutions between 2000 and 2012 were collected. Postoperative complications, proportion of ostomy, fecal continence and overall survival were compared. Overall rates of the Clavien‐Dindo grade II‐IV complications were not different between the two groups (19% in stapled vs 25% in hand‐sewn, P=.42), with significantly fewer pouch‐related complications including leakage, pelvic abscess, vaginal fistula and anastomotic stricture in stapled IPAA (none in stapled vs 11% in hand‐sewn, P=.036). There was no mortality. Proportion of ostomy at 12 months was similar (2.7% in stapled vs 4.3% in hand‐sewn, P=.26). Mean Wexner score was similar. (0.47 in stapled vs 2.0 in hand‐sewn, P=.12). Five‐year overall survival excluding Stage IV patients was 96% in both groups. Stapled IPAA is a safe option in patients with FAP with a potential benefit in reducing pouch‐related complications.

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Section: Discussionmentioning

confidence: 89%

Postoperative complications after stapled and hand‐sewn ileal pouch‐anal anastomosis for familial adenomatous polyposis: A multicenter study

Konishi

Ishida

Ueno

et al. 2017

Annals of Gastroent Surgery

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“…9,46,[50][51][52] Our group has personally witnessed one case that represent 3.8% of our RPC cases. 9 Another source of concern for FAP patients is the development of ileostomy carcinomas.…”

Section: Discussionmentioning

confidence: 97%

Rectal and Pouch Recurrences After Surgical Treatment for Familial Adenomatous Polyposis

Campos

Imperiale

Seid

et al. 2009

Journal of Gastrointestinal Surgery

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(1) Within the present series, FAP patients presented a high incidence of associated CRC and diagnosis was generally established after the third decade of life; (2) operative complications occurred in about one third of the patients, being more frequent after the confection of an ileal reservoir; (3) rectal cancer after IRA was detected in 16.6% of patients and it was associated with greater age and previous colonic carcinoma; (4) both continuous and long-term surveillance of the rectal stump and ileal pouch are necessary during follow-up.

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“…The rate of 47.6% of our patients who had at least one episode of pouchitis and our pouch failure rate of 7.6% are both in accordance with other long-term follow-up studies on IPAA for ulcerative colitis. 8,12,17,21,35,[42][43][44][45] The very low rate of local septic complications in our series probably results from various technical aspects: One reason might be the preservation of the mesorectal fat by performing the rectal dissection close to the bowel wall. This results in a small funnel-like cavity in which the pouch sits more tightly in the pelvis than after total mesorectal excision.…”

Section: Discussionmentioning

confidence: 92%

“…They range between 0% and 12.6% in a series in which patients with FAP were included, exclusively. [33][34][35] For studies in which only or predominantly patients with inflammatory bowel diseases were included, the leakage rates are somewhat higher, ranging between 2.7% and 15%. 1,7,19,36,37 Other local septic complications are pelvic abscesses without anastomotic leakage, fistulas, and pouch necroses.…”

Section: Discussionmentioning

confidence: 98%

Does Mesorectal Preservation Protect the Ileoanal Anastomosis after Restorative Proctocolectomy?

Rink

Radinski

Vestweber

2009

Journal of Gastrointestinal Surgery

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

Cited by 26 publications

References 30 publications

Postoperative complications after stapled and hand‐sewn ileal pouch‐anal anastomosis for familial adenomatous polyposis: A multicenter study

Postoperative complications after stapled and hand‐sewn ileal pouch‐anal anastomosis for familial adenomatous polyposis: A multicenter study

Rectal and Pouch Recurrences After Surgical Treatment for Familial Adenomatous Polyposis

Does Mesorectal Preservation Protect the Ileoanal Anastomosis after Restorative Proctocolectomy?

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