[Familial adenomatous polyposis: proctocolectomy with an ileal pouch versus rectal preservation].
We assess postoperative complications and functional results of surgery in familial adenomatous polyposis (FAP): Group I (n = 11): restorative proctocolectomy with ileoanal anastomosis (RPIA); Group II (n = 8): colectomy with ileorectal anastomosis (IRA): we also have evaluated the presence of malignancy in the rectum in the latter group. Group I:


RESULTS
pelvic abscess (9.1%); intestinal obstruction (9.1%), both requiring reintervention. There was complete anal continence in 81.8%; only one patient needed catheter drainage of the reservoir (9.1%). There were two cases of pouchitis (16.7%). Group II: One patient suffered anastomotic leakage (12.5%) and another one a leakage of the loop ileostomy closure, with and secondary, abdominal abscess (12.5%). There was no incontinence. In spite of periodic endoscopic surveillance rectal adenocarcinoma appeared in 347 patients with complete follow-up (42.9%). Because of the risk of rectal malignancy with IRA and the good functional results of RPIA we consider the latter as the procedure of choice and also advisable the transformation of IAR into RPIA.
Rodríguez SanJuán
J C
JC
Servicio de Cirugía General, Hospital Universitario Marqués de Valdecilla, Santander.
Casanova Rituerto
D
D
Martino Fernández
E
E
Fernández Escalante
J C
JC
Gómez Fleitas
J M
JM
Herrera Noreña
L
L
Olmedo Mendicoague
F
F
Naranjo Gómez
A
A
D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality; D011125:Adenomatous Polyposis Coli / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000367:Age Factors; D003082:Colectomy / Q000706:statistics & numerical data; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D016737:Proctocolectomy, Restorative / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000401:mortality; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
Poliposis adenomatosa familiar: proctocolectomía con reservorio ileal frente a preservación rectal.