title: Patterns of Adenoma Recurrence in Familial Adenomatous Polyposis Patients after Ileal Pouch-Anal Anastomosis.
abstract: OBJECTIVE
  This study aims at identifying the risk factors for the development of pre-cancerous pouch and/or cuff adenomas post ileal pouch anal anastomosis (IPAA) in familial adenomatous polyposis patients.
  
  
  METHODS
  We retrospectively studied 59 patients operated at a single medical center during a 26-year period. Data on the timing and location of adenoma recurrence were recorded and possible correlations with patients' gender, age, presence of desmoid tumor, duodenal adenomas, type of anastomosis and number of operation stages were analyzed.
  
  
  RESULTS
  Thirty-five (59%) patients had at least one adenoma in either the cuff or the pouch, including 20 with isolated cuff adenomas, 4 with isolated pouch adenomas and 11 patients with adenomas in both the pouch and cuff. There was no significant correlation between gender, age at surgery, type of anastomosis, number of operative stages and the development of pouch or cuff adenomas. Desmoid tumor and pouch adenomas were significantly correlated with cuff adenomas formation. Duodenal adenomas were associated with pouch adenomas. There was some relationship between the development of cuff adenomas and the burden of colonic polyps, as well as the presence of duodenal adenomas.
  
  
  CONCLUSIONS
  Adenomas in both the pouch and cuff commonly occur following IPAA, mandating lifelong annual endoscopic surveillance.
authors.affiliation: Colorectal Unit, Division of Surgery, Tel Aviv Medical Center, Affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Goldstein
authors.forename: Revital
authors.initials: R
authors.lastname: Kariv
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Klausner
authors.forename: Hagit
authors.initials: H
authors.lastname: Tulchinsky
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D039021:Colonic Pouches / Q000473:pathology*; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000150:complications*; D005260:Female; D018221:Fibromatosis, Abdominal / Q000150:complications; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016737:Proctocolectomy, Restorative; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult