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Development of invasive adenocarcinoma following colectomy with ileoanal anastomosis for familial polyposis coli

Report of a case

  • Case Report
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Diseases of the Colon & Rectum

Abstract

PURPOSE: Proctocolectomy with ileoanal anastomosis has gained increasing acceptance for the prophylactic treatment of patients with familial polyposis coli. Longterm surveillance of the ileal pouch and the pouch-anal anastomosis has not been emphasized despite concern regarding retained rectal mucosa following the procedure. METHODS: A 34-year-old patient with a strong family history of familial polyposis coli was treated at 14 years of age by single-stage proctocolectomy with straight ileoanal anastomosis. Follow-up proctoscopic examinations revealed development of adenomatous changes at the ileoanal anastomosis. RESULTS: This report presents a patient with familial polyposis coli who developed invasive adenocarcinoma at the ileoanal anastomosis 20 years after proctocolectomy with ileoanal anastomosis. CONCLUSIONS: We stress the need for lifelong proctoscopic surveillance in patients with familial polyposis coli treated by proctocolectomy with ileoanal anastomosis.

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References

  1. Welling DR, Beart RW Jr. Surgical alternative in the treatment of polyposis coli. Semin Surg Oncol 1987;3:99–104.

    PubMed  CAS  Google Scholar 

  2. McKenney DC. Multiple polyposis: congenital, heredofamilial, malignant. Am J Surg 1939;46:204–16.

    Article  Google Scholar 

  3. Hubbard TB Jr. Familial polyposis of the colon: the fate of the retained rectum after colectomy in children. Am Surg 1957;23:577–86.

    PubMed  Google Scholar 

  4. Bussey HJR. Familial polyposis coli: family studies, histopathology, differential diagnosis, and results of treatment. Baltimore: Johns Hopkins University Press, 1975:69–72.

    Google Scholar 

  5. Bacon HE, Giambalvo GP, Sauer I, Fleming JP, Villalba G. Intestinal polyposis. J Int Coll Surg 1957;28:346–56.

    PubMed  CAS  Google Scholar 

  6. Lockhart-Mummery HE. Intestinal polyposis: the present position. J R Soc Med 1967;60:381–8.

    CAS  Google Scholar 

  7. Moertel CG, Hill JR, Adson MA. Surgical management of multiple polyposis: the problem of cancer in the retained bowel segment. Arch Surg 1970;100:521–5.

    PubMed  CAS  Google Scholar 

  8. Skinner MA, Tyler D, Branum GD, Cucchiaro G, Branum MA, Meyers WC. Subtotal colectomy for familial polyposis. Arch Surg 1990;125:621–4.

    PubMed  CAS  Google Scholar 

  9. Sarre RG, Jagelman DG, Beck GJ,et al. Colectomy with ileorectal anastomosis for familial adenomatous polyposis: the risk of rectal cancer. Surgery 1987;101:20–6.

    PubMed  CAS  Google Scholar 

  10. Jagelman DG. Familial polyposis coli. Surg Clin North Am 1983;63:117–28.

    PubMed  CAS  Google Scholar 

  11. Cohen Z, McLeod RS, Stephen W, Stern HS, O'Connor B, Reznick R. Continuing evolution of the pelvic pouch procedure. Ann Surg 1992;216:506–12.

    PubMed  CAS  Google Scholar 

  12. Safaie-Shirazi S, Soper RT. Endorectal pull-through procedure in the surgical treatment of familial polyposis coli. J Pediatr Surg 1973;8:711–6.

    Article  PubMed  CAS  Google Scholar 

  13. Sugarman HJ, Newsome HH, DeCosta G, Zfass M. Stapled ileoanal anastomosis for ulcerative colitis and familial polyposis without a temporary diverting ileostomy. Ann Surg 1991;213:606–19.

    Article  PubMed  Google Scholar 

  14. Bulow S. Clinical features in familial polyposis coli: results of the danish polyposis register. Dis Colon Rectum 1986;29:102–7.

    PubMed  CAS  Google Scholar 

  15. Kock NG. Intra-abdominal “reservoir” in patients with permanent ileostomy: preliminary observations on a procedure resulting in fecal ’continence’ in five ileostomy patients. Arch Surg 1969;99:223–30.

    PubMed  CAS  Google Scholar 

  16. Pemberton JH, Kelly KA, Beart RW Jr. Achieving ileostomy continence with a prestomal ileal pouch and a stomal occlusive device. Surgery 1983;94:72–7.

    PubMed  CAS  Google Scholar 

  17. Ravitch MM, Sabiston DC Jr. Anal ileostomy with preservation of the sphincter: a proposed operation in patients requiring total colectomy for benign lesions. Surg Gynecol Obstet 1947;84:1095–9.

    CAS  PubMed  Google Scholar 

  18. Wolfstein IH, Bat L, Neumann G. Regeneration of rectal mucosa and recurrent polyposis coli after total colectomy and ileoanal anastamosis. Arch Surg 1982;117:1241–2.

    PubMed  CAS  Google Scholar 

  19. Hampton JM. Rectal mucosal stripping: a technique for preservation of the rectum after total colectomy for chronic ulcerative colitis. Dis Colon Rectum 1976;19:133–5.

    PubMed  CAS  Google Scholar 

  20. Heppell J, Weiland LH, Perrault J, Pemberton JH, Telander RL, Beart RW Jr. Fate of the rectal mucosa after rectal mucosectomy and ileoanal anastomosis. Dis Colon Rectum 1983;26:768–71.

    PubMed  CAS  Google Scholar 

  21. King DW, Lubowski DZ, Cook TA. Anal canal mucosa in restorative proctocolectomy for ulcerative colitis. Br J Surg 1989;76:970–2.

    PubMed  CAS  Google Scholar 

  22. Tsunoda A, Talbot IC, Nicholls RJ. Incidence of dysplasia in the anorectal mucosa in patients having restorative proctocolectomy. Br J Surg 1990;77:506–8.

    PubMed  CAS  Google Scholar 

  23. Stern H, Walfisch S, Müllen B, McLeod R, Cohen 2. Cancer in an ileoanal reservoir: a new late complication? Gut 1990;32:473–5.

    Google Scholar 

  24. Puthu D, Narayanan R, Rao R,et al. Carcinoma of the rectal pouch following restorative proctocolectomy. Dis Colon Rectum 1992;35:257–60.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa

    Jeff C. Hoehner M.D. & Amanda M. Metcalf M.D.

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  1. Jeff C. Hoehner M.D.
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  2. Amanda M. Metcalf M.D.
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Hoehner, J.C., Metcalf, A.M. Development of invasive adenocarcinoma following colectomy with ileoanal anastomosis for familial polyposis coli. Dis Colon Rectum 37, 824–828 (1994). https://doi.org/10.1007/BF02050149

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  • DOI: https://doi.org/10.1007/BF02050149

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