title: The ileo neo-rectal anastomosis in patients with familial adenomatous polyposis: a prospective case series with long-term follow up.
abstract: OBJECTIVE
  In patients with familial adenomatous polyposis (FAP), removal of the colonic mucosa is essential to reduce the lifetime risk of developing cancer). For this purpose, ileo-pouch anal anastomosis (IPAA) has been the gold standard, but morbidity related to the dissection of the pelvis remains substantial. In an attempt to reduce the procedure-related complications of pelvic dissection, ileoneo-rectal anastomosis (INRA) has been developed. In this case series of FAP patients, the long-term functional results, morbidity and quality of life (QoL) of the INRA procedure were evaluated and compared with its early outcome.
  
  
  METHODS
  Long-term follow up of a consecutive group of eight FAP patients with an INRA procedure (between 1998 and 2005) was undertaken. Data on functional results, complications, manometry and endoscopy were recorded prospectively.
  
  
  RESULTS
  Eight patients with FAP underwent the INRA procedure. The median number of defaecations over 24 h was five. No pelvic sepsis or bladder dysfunction occurred. One patient, in whom concomitant Crohn's disease was diagnosed in retrospect, was converted to IPAA. In the INRA patients, no sexual dysfunction occurred. Endoscopic examination showed normal mucosa without any evidence of polyp formation.
  
  
  CONCLUSIONS
  Restorative surgery by means of the INRA procedure yields good functional results in FAP patients, without any pelvic dissection-related morbidity or regrowth of polyps in the neo-rectum.
authors: Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. s.dezeeuw@chir.umcn.nl
authors: S
authors: S
authors: de Zeeuw
authors: J T
authors: JT
authors: Heikens
authors: H G
authors: HG
authors: Gooszen
authors: C J H M
authors: CJ
authors: van Laarhoven
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D001003:Anal Canal / Q000503:physiopathology; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy; D003672:Defecation; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery* / Q000637:transplantation; D007413:Intestinal Mucosa / Q000637:transplantation*; D008297:Male; D008365:Manometry; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors