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Prevalence of laparoscopic surgical treatment and its clinical outcomes in patients with familial adenomatous polyposis in Japan

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International Journal of Clinical Oncology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 21 March 2016

Abstract

Background

Laparoscopic surgery is becoming the preferred technique for most colorectal interventions. This study aimed to clarify the time trend of surgical treatment for familial adenomatous polyposis (FAP) and its relevance to clinical outcomes in Japan over a 13-year period.

Methods

This was a multicenter retrospective cohort study comprising 23 specialist institutions for colorectal disease and a cohort of 282 FAP patients who underwent total colectomy or proctocolectomy during 2000–2012. Patient clinical backgrounds and surgical outcomes were compared between the first and second halves of the study period.

Results

The proportion of surgical types adopted over the entire study period was 46, 21, 30, and 3 % for ileoanal anastomosis (IAA), ileoanal canal anastomosis, ileorectal anastomosis, and permanent ileostomy, respectively. FAP patients undergoing laparoscopic surgery have increased since 2008 and reached 74 % in the past 3 years. In particular, the number of patients undergoing laparoscopic proctocolectomy with IAA increased approximately four-fold from the first to the second half of the study period. A laparoscopic approach was increasingly used in patients with coexisting colorectal malignancies. Despite this trend, surgical results of the laparoscopic approach between the two study periods showed similar morbidity, pouch operation and stoma closure completion rates. No postoperative mortality was observed in this series, and laparoscopic surgery was comparable to open surgery in terms of stoma closure rate, incidence of intra-abdominal/abdominal desmoid tumors, and postoperative survival rate in both study periods.

Conclusion

Laparoscopic approach is increasingly being adopted for prophylactic FAP surgery in Japan and may provide clinically acceptable practical outcomes.

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Authors and Affiliations

  1. Department of Surgery, National Defense Medical College, Tokorozawa, Saitama, 359-8513, Japan

    Hideki Ueno

  2. Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    Hirotoshi Kobayashi

  3. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Tsuyoshi Konishi

  4. Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan

    Fumio Ishida

  5. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Tatsuro Yamaguchi

  6. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Takao Hinoi

  7. Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan

    Yukihide Kanemitsu

  8. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan

    Yasuhiro Inoue

  9. Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Naohiro Tomita & Nagahide Matsubara

  10. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

    Koji Komori

  11. Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan

    Heita Ozawa

  12. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Takeshi Nagasaka

  13. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Hirotoshi Hasegawa

  14. Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan

    Motoi Koyama

  15. Department of Surgery, Kurume University School of Medicine, Kurume, Japan

    Yoshito Akagi

  16. Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan

    Toshimasa Yatsuoka

  17. Department of Organ Regulatory Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan

    Kensuke Kumamoto

  18. Department of Surgery 2, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Kiyotaka Kurachi

  19. Department of Surgery, Iwakuni Clinical Center, Iwakuni, Japan

    Kohji Tanakaya

  20. Department of Surgery, Tokyo Women’s Medical University Medical Center East, Tokyo, Japan

    Kazuhiko Yoshimatsu

  21. Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Toshiaki Watanabe

  22. Tokyo Medical and Dental University, Tokyo, Japan

    Kenichi Sugihara

  23. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Hideyuki Ishida

Authors
  1. Hideki Ueno
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  2. Hirotoshi Kobayashi
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  3. Tsuyoshi Konishi
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  4. Fumio Ishida
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  5. Tatsuro Yamaguchi
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  6. Takao Hinoi
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  7. Yukihide Kanemitsu
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  8. Yasuhiro Inoue
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  9. Naohiro Tomita
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  11. Koji Komori
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  12. Heita Ozawa
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  13. Takeshi Nagasaka
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  14. Hirotoshi Hasegawa
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  15. Motoi Koyama
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  16. Yoshito Akagi
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  17. Toshimasa Yatsuoka
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  18. Kensuke Kumamoto
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  19. Kiyotaka Kurachi
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  20. Kohji Tanakaya
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  21. Kazuhiko Yoshimatsu
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  22. Toshiaki Watanabe
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  23. Kenichi Sugihara
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  24. Hideyuki Ishida
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Corresponding author

Correspondence to Hideki Ueno.

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The authors declare that they have no conflict of interest.

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Ueno, H., Kobayashi, H., Konishi, T. et al. Prevalence of laparoscopic surgical treatment and its clinical outcomes in patients with familial adenomatous polyposis in Japan. Int J Clin Oncol 21, 713–722 (2016). https://doi.org/10.1007/s10147-016-0953-5

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  • DOI: https://doi.org/10.1007/s10147-016-0953-5

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