title: [Two cases of multiple adenomas in the ileal pouch after total proctocolectomy in patients with familial adenomatous polyposis].
abstract: Familial adenomatous polyposis (FAP) is an inherited disease characterized by the development of hundreds of colorectal adenomas, leading to a 100% lifetime risk of colorectal cancer. A prophylactic colectomy is recommended for patients with FAP to prevent colorectal cancer. Four surgical strategies are available for patients with FAP: proctocolectomy with permanent ileostomy, colectomy with ileorectal anastomosis, proctocolectomy with Kochs pouch continent ileostomy (Koch), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Koch and IPAA, which make ileal pouch, have theoretical advantage of the elimination of the risk of colorectal cancer and adenomas and good functional outcome of reduced defecation frequency. However, recent reports have shown frequent development of adenomas and carcinomas in the ileal pouch after Koch or IPAA. We experienced 2 cases of multiple pouch adenomas after pouch surgery in FAP patients. Both patients were treated with endoscopic mucosal resection without complications. We report these 2 cases with a review of literatures.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Kang
authors.forename: Jeong Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Jong Ha
authors.initials: JH
authors.lastname: Park
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Ock Bae
authors.initials: OB
authors.lastname: Ko
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000601:surgery; D011125:Adenomatous Polyposis Coli / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D039021:Colonic Pouches; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000601:surgery; D016737:Proctocolectomy, Restorative