[Two cases of multiple adenomas in the ileal pouch after total proctocolectomy in patients with familial adenomatous polyposis].
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.
Kang
Jeong Min
JM
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Byeon
Jeong Sik
JS
Park
Jong Ha
JH
Ahn
Ji Yong
JY
Ko
Ock Bae
OB
Myung
Seung-Jae
SJ
Yang
Suk-Kyun
SK
Kim
Jin-Ho
JH
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