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Carcinoma in the retained rectum after colectomy for ulcerative colitis

  • Published:
Diseases of the Colon & Rectum

Abstract

A carcinoma arising in an excluded rectal stump 18 years after ileostomy and 14 years after subtotal colectomy has been described. Extent of involvement of the colon, age of the patient at onset of colitis, and duration of symptomatology are factors which have been shown to influence the incidence of carcinoma complicating ulcerative colitis. Fifty-eight similar cases of carcinoma developing in a retained rectum were collected from the literature. The incidence of this complication is approximately 3 per cent. Rectum-sparing operations do not appear to decrease the indicence of malignant transformation in ulcerative colitis. A decision to retain the rectum after colonic resection for ulcerative colitis must take into account both the significant incidence of malignant transformation associated with all rectum-sparing procedures and also the significant incidence of recurrent symptoms following this procedure.

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References

  1. Slaney G, Brooke BN. Cancer in ulcerative colitis. Lancet 1959;2:694–8.

    Article  PubMed  CAS  Google Scholar 

  2. Crohn BB, Rosenberg H. The sigmoidoscope picture of chronic ulcerative colitis (non-specific). Am J Med Sci 1925;170:220–8.

    Article  Google Scholar 

  3. Yeomans FC. Carcinomatous degeneration of rectal adenomas: report of seven cases. JAMA 1927;89:852–5.

    Google Scholar 

  4. Bargen JA. Chronic ulcerative colitis associated with malignant disease. Arch Surg 1928;17:561–76.

    Google Scholar 

  5. Edwards FC, Truelove SC. The course and prognosis of ulcerative colitis. Part IV. Carcinoma of the colon. Gut 1964;5:15–22.

    Google Scholar 

  6. Goldgraber MB, Kirsner JB. Carcinoma of the colon in ulcerative colitis. Cancer 1964;17:657–65.

    Article  PubMed  CAS  Google Scholar 

  7. Bargen JA, Gage RP. Carcinoma and ulcerative colitis: prognosis. Gastroenterology 1960;39:385–93.

    PubMed  CAS  Google Scholar 

  8. Flint GW, Strauss RJ, Platt N, Wise L. Ileorectal anastomosis for inflammatory disease of the colon. Dis Colon Rectum 1977;20:118–25.

    PubMed  CAS  Google Scholar 

  9. de Dombal FT, Watts JM, Watkinson G, Goligher JC. Local complications of ulcerative colitis: stricture, pseudopolyposis and carcinoma of colon and rectum. Br Med J 1966; 1:1442–7.

    PubMed  Google Scholar 

  10. Hinton JM. Risk of malignant change in ulcerative colitis. Gut 1966;7:427–32.

    PubMed  CAS  Google Scholar 

  11. MacDougall IP. Clinical identification of those cases of ulcerative colitis most likely to develop cancer of the bowel. Dis Colon Rectum 1964;7:447–50.

    PubMed  CAS  Google Scholar 

  12. Cattell RB, Boehme EJ. The importance of malignant degeneration as a complication of chronic ulcerative colitis. Gastroenterology 1947;8:695–710.

    Google Scholar 

  13. Mayo CW, Fly OA Jr, Connelly ME. Fate of the remaining rectal segment after subtotal colectomy for ulcerative colitis. Ann Surg 1956;144:753–7.

    Article  PubMed  Google Scholar 

  14. Dawson IM, Pryse-Davies J. The development of carcinoma of the large intestine in ulcerative colitis. Br J Surg 1959;47:113–28.

    Article  PubMed  CAS  Google Scholar 

  15. Hudson CN (for Todd IP). Carcinoma of the rectum following ileoproctostomy and colectomy for ulcerative colitis. Proc R Soc Med 1961;54:514–6.

    Google Scholar 

  16. Dennis CE, Karlson KE. Cancer risk in ulcerative colitis: formidability per patient-year of late disease. Surgery 1961;50:568–71.

    Google Scholar 

  17. Griffen WO Jr, Lillehei RC, Wangensteen OH. Ileoproctostomy in ulcerative colitis: long-term follow-up, extending in early cases to more than 20 years. Surgery 1963;53:705–10.

    PubMed  Google Scholar 

  18. Steedman PK. Carcinoma in an ano-rectal stump years after a total colectomy for ulcerative colitis. Med J Aust 1963;2:407–8.

    PubMed  CAS  Google Scholar 

  19. Moss GS, Keddie N. Fate of rectal stump in ulcerative colitis. Arch Surg 1965;91:967–70.

    PubMed  CAS  Google Scholar 

  20. Muir EG. Rectal carcinoma seventeen years after ileorectal anastomosis. Proc R Soc Med 1966;59:617–8.

    PubMed  CAS  Google Scholar 

  21. Daly DW, Brooke BN. Ileostomy and excision of the large intestine for ulceraive colitis. Lancet 1967;2:62–4.

    Article  PubMed  CAS  Google Scholar 

  22. Hughes ES, Russell IS. Ileorectal anastomosis for ulcerative colitis. Dis Colon Rectum 1967;10:35–9.

    PubMed  CAS  Google Scholar 

  23. Korelitz BI, Dyck WP, Klion FM. Fate of the rectum and distal colon after subtotal colectomy for ulcerative colitis. Gut 1969;10:198–201.

    PubMed  CAS  Google Scholar 

  24. Sprechler M, Baden H. Ileorectal anastomosis for ulcerative colitis (letter). Br Med J 1971;2:527.

    PubMed  CAS  Google Scholar 

  25. Adson MA, Cooperman AM, Farrow GM. Ileorectostomy for ulcerative disease of the colon. Arch Surg 1972;104:424–8.

    PubMed  CAS  Google Scholar 

  26. Ritchie JK. Colectomy and anastomosis for inflammatory bowel disease (communication). Arch Mal App Dig 1974;63:588.

    CAS  Google Scholar 

  27. Aylett SG. Rectal conservation in the surgical treatment of ulcerative colitis. Arch Mal App Dig 1974;63:585–7.

    CAS  Google Scholar 

  28. Grüner OP, Flatmark A, Naas R, Fretheim B, Gjone E. Ileorectal anastomosis in ulcerative colitis: results in 57 patients. Scand J Gastroenterol 1975;10:641–6.

    PubMed  Google Scholar 

  29. Black BM, Scholl PR. Surgical treatment of chronic ulcerative colitis: the skin-grafted ileac stoma. 1954;68:454–62.

  30. Goligher JC, de Dombal FT, Graham NG, Watkison G. Early surgery in the management of severe ulcerative colitis. Br Med J 1967;3:193–5.

    PubMed  CAS  Google Scholar 

  31. Scarborough RA. Surgical treatment of chronic ulcerative colitis. Am J Surg 1955;89:1224–9.

    Article  PubMed  CAS  Google Scholar 

  32. Aylett SO. Conservative surgery in the treatment of ulcerative colitis. Br Med J 1953;2:1348–51.

    Article  PubMed  CAS  Google Scholar 

  33. Aylett SO. Diffuse ulcerative colitis and its treatment by ileorectal anastomosis. Ann R Coll Surg Engl 1960;27:260–84.

    PubMed  CAS  Google Scholar 

  34. Aylett S. Ulcerative colitis treated by total colectomy and ileorectal anastomosis: a ten-year review (abridge). Proc R Soc Med 1963;56:183–90.

    PubMed  CAS  Google Scholar 

  35. Aylett SO. Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileo-rectal anastomosis. Br Med J 1966;1:1001–5.

    PubMed  CAS  Google Scholar 

  36. Vink M, Beerstecher HJ. A critical evaluation and analysis of total colectomy and ileorectal anastomosis for patients with ulcerative colitis. Arch Chir Neerl 1973;25:107–17.

    PubMed  CAS  Google Scholar 

  37. Counsell PB, Dukes CE. The association of chronic ulcerative colitis and carcinoma of the rectum and colon. Br J Surg 1952;39:485–95.

    Article  PubMed  CAS  Google Scholar 

  38. Morson BC, Pang LS. Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut 1967;8:423–34.

    PubMed  CAS  Google Scholar 

  39. Katz S, Sherlock P, Winawer SJ. Rectocolonic exfoliative cytology: a new approach. Am J Dig Dis 1972;17:1109–16.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Long Island Jewish-Hillside Medical Center, 11040, New Hyde Park, New York

    L. M. Kurtz M.D., G. W. Flint M.D., N. Platt M.D. & L. Wise M.D.

  2. The Health Sciences Center, State University of New York at Stony Brook, New York

    L. M. Kurtz M.D., G. W. Flint M.D., N. Platt M.D. & L. Wise M.D.

Authors
  1. L. M. Kurtz M.D.
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  2. G. W. Flint M.D.
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  3. N. Platt M.D.
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  4. L. Wise M.D.
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Kurtz, L.M., Flint, G.W., Platt, N. et al. Carcinoma in the retained rectum after colectomy for ulcerative colitis. Dis Colon Rectum 23, 346–350 (1980). https://doi.org/10.1007/BF02586843

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  • DOI: https://doi.org/10.1007/BF02586843

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