The ileo neo rectal anastomosis (INRA) in patients with familial adenomatous polyposis: clinical results at two years.
BACKGROUND
Ileo neo rectal anastomosis (INRA) is a promising alternative for patients with familial adenomatous polyposis (FAP) to restorative proctocolectomy with its morbidity and unpredictable functional outcome to colectomy with ileo rectal anastomosis (IRA) with the continuing risk of rectal cancer. The aims of the present study were to evaluate the function of the neorectum, to assess the morbidity and complications of the operation and to determine the incidence of neorectal polyps.


METHODS
Data of all patients having INRA, including bowel function and complications, were prospectively recorded. The reservoir capacity was determined repeatedly by physiologic tests. The anal sphincter complex was assessed by manometry and ultrasound examination. Evaluation of the neorectal mucosa was performed by endoscopy.


RESULTS
Six patients underwent the INRA procedure for FAP. Median defaecation frequency two years postoperatively was 5.5/24 h (range 4-7) including 1/night (range 0-2). Endoscopic examination showed normal mucosa and no evidence of polyp formation in all patients.


CONCLUSIONS
INRA affords a good functional reservoir and is accompanied by few reservoir-related complications. At a minimum follow up period of two years, no growth of polyps in the neorectum occurred.
Strijbos
S A M
SA
Department of Surgery, University Medical Centre, Utrecht, the Netherlands.
Hueting
W E
WE
Schipper
M E I
ME
Oostvogel
H J M
HJ
van Vroonhoven
Th J M V
TJ
Gooszen
H G
HG
van Laarhoven
C J H M
CJ
D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003082:Colectomy; D003113:Colonoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome