Cumulative incidence and risk factors for pouch adenomas associated with familial adenomatous polyposis following restorative proctocolectomy
作者机构：Division of Colon and Rectal SurgeryDepartment of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2022年第28卷第30期
页 面：4152-4162页
核心收录：
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Adenomatous polyposis coli Familial adenomatous polyposis Adenoma Intestinal polyps Proctocolectomy,restorative Ileal pouch anal anastomosis
摘 要：BACKGROUND The emergence of restorative total proctocolectomy has significantly reduced the lifetime colorectal cancer risk associated with familial adenomatous polyposis(FAP).However,adenomas may develop in the ileal pouch over time and may even progress to *** evaluated the cumulative incidence,time to development,and risk factors associated with ileal pouch *** To evaluate the cumulative incidence,time to development,and risk factors associated with pouch *** In this retrospective,observational study conducted at a tertiary center,95 patients with FAP who underwent restorative proctocolectomy at our center between 1989 and 2018 were consecutively *** mean follow-up period was 88 *** Pouch adenomas were found in 24(25.3%)patients,with a median time of 52 mo to their first *** adenomas were detected in most patients(95.9%).There were no high-grade dysplasia or *** the 24 patients with pouch adenomas,13 had all detected adenomas *** the 13 patients who underwent complete adenoma removal,four(38.5%)developed *** 11(45.8%)patients with numerous polyps within the pouch,seven(63.6%)exhibited progression of pouch *** cumulative risks of pouch adenoma development at 5,10,and 15 years after pouch surgery were 15.2%,29.6%,and 44.1%,*** colorectal polyposis(with more than 1000 polyps)was a significant risk factor for pouch adenoma development(hazard ratio,2.49;95% confidence interval:1.04-5.96;P=0.041).CONCLUSION Pouch adenomas occur at a fairly high rate in association with FAP after restorative proctocolectomy,and a high colorectal polyp count is associated with pouch adenoma development.
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