familial adenomatous polyposis: ileo-anal pouch versus ileo-rectal anastomosis
نویسندگان
چکیده
introduction: treatment of familial adenomatous polyposis (fap) is centered on early recognition and curative surgery with either restorative proctocolectomy with ileal-pouch-anal-anastomosis (ipaa) or colectomy with ileorectal anastomosis (ira). in this study we describe the presentation, treatment, and complications of 27 fap patients. method: all patients diagnosed with fap at our center from 2008 to 2012 were included in this case series. either ipaa or ira was used for treatment. complications were recorded for 12 months after the procedure. results: overall 27 patients were included, 12 (44.44%) index patients, and 15 (55.55%) relatives diagnosed by screening. eight index patients presented with rectal bleeding, two with occult fecal blood and two with abdominal masses found to be desmoid tumors . nineteen patients were treated by ipaa, 6 with ira, and 2 were inoperable due to diffuse desmoid tumors. daytime stool frequency was the most common side effect (70.37%), followed by bowel discomfort episodes (55.56%), requiring dietary restrictions (37.4%), passive incontinence (25.93%), soiling (22.22%), nighttime stool frequency (18.52%), flatus incontinence (16.0%), and anastomosis leakage (3.70%). on average patients treated by ipaa experienced less complication than those treated by ira. conclusion: compared with previous reports, this series had older age of diagnosis, higher rate of adenocarcinoma at diagnosis, and fewer side effects after ipaa than ira. the latter may reflect technique improvement with experience, and if supported by future studies, will cement ipaa as the treatment of choice in fap. normal 0 false false false en-us x-none ar-sa normal 0 false false false en-us x-none ar-sa
منابع مشابه
Familial adenomatous polyposis: ileo-anal pouch versus ileo-rectal anastomosis
AIM In this study we describe the presentation, treatment, and complications of 27 FAP patients. BACKGROUND Treatment of Familial adenomatous polyposis (FAP) is centered on early recognition and curative surgery with either restorative proctocolectomy with ileal-pouch-anal-anastomosis (IPAA) or colectomy with ileo-rectal anastomosis (IRA). PATIENTS AND METHODS All patients diagnosed with FA...
متن کاملOpen versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis.
BACKGROUND Restorative proctocolectomy with ileo pouch anal anastomosis (IPAA) is the main surgical treatment for patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). With the advancements of minimal-invasive surgery this demanding operation is increasingly being performed laparoscopically. Therefore, the presumed benefits of the laparoscopic approach need to be syste...
متن کاملRectal eversion and double-stapled ileal pouch anal anastomosis in familial adenomatous polyposis syndrome
INTRODUCTION Surgery is the only treatment option for familial adenomatous polyposis (FAP). Aim of surgery in FAP is to minimize colorectal cancer risk without need for permanent stoma. There are especially two operation options; Total colectomy with ileorectal anastomosis (IRA) and total proctocolectomy with ileo-pouch anal anastomosis (IPAA). We report here a patient with FAP who had resectio...
متن کاملMeta-analysis of observational studies of ileorectal versus ileal pouch-anal anastomosis for familial adenomatous polyposis.
BACKGROUND Surgery for familial adenomatous polyposis (FAP) aims to minimize cancer risk while providing good functional outcome. Colectomy with ileorectal anastomosis and proctocolectomy with ileal pouch-anal anastomosis both offer this, but there is no clear consensus about which is better. METHODS This is a meta-analysis of comparative studies published between 1991 and 2003 reporting earl...
متن کاملIleal-pouch-anal anastomosis after restorative proctocolectomy in patients with ulcerative colitis or familial adenomatous polyposis.
BACKGROUND/AIMS Restorative proctocolectomy is the "golden standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. The two alternative techniques of ileal-pouch-anal anastomosis include hand-made suture and double line stapled suture. The aim of the study was the analysis of postoperative complications and functional results of the two types of anastomosis. M...
متن کاملLaparoscopic Restorative Total Proctocolectomy With Ileal Pouch Anal Anastomosis for Familial Adenomatous Polyposis
BACKGROUND Familial adenomatous polyposis is a hereditary disease characterized by the presence of thousands of colonic adenomas, which, if untreated, invariably undergo malignant transformation. Because this disease manifests at a young age, the laparoscopic approach to perform surgery would be desirable due to its cosmetic benefits. We describe our experience with this procedure and review th...
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عنوان ژورنال:
gastroenterology and hepatology from bed to benchجلد ۷، شماره ۴، صفحات ۲۰۱۴-۷
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