Early postoperative and long-term oncological outcomes of laparoscopic treatment for patients with familial adenomatous polyposis.
10.4174/jkss.2012.83.5.288
- Author:
Hye Jin KIM
1
;
Gyu Seog CHOI
;
Jun Seok PARK
;
Soo Yeun PARK
;
Wohn Ho CHOI
;
Jong Pil RYUK
Author Information
1. Colorectal Cancer Center, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, Daegu, Korea. kyuschoi@mail.knu.ac.kr
- Publication Type:Original Article
- Keywords:
Laparoscopic total proctocolectomy;
Ileal pouch-anal anastomosis;
Familial adenomatous polyposis
- MeSH:
Adenocarcinoma;
Adenomatous Polyposis Coli;
Disease-Free Survival;
Fibromatosis, Aggressive;
Follow-Up Studies;
Humans;
Mucous Membrane;
Operative Time;
Postoperative Complications;
Recurrence;
Survival Rate
- From:Journal of the Korean Surgical Society
2012;83(5):288-297
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the short- and long-term outcomes of laparoscopic total proctocolectomy with ileal pouch-anal anastomosis (TPC/IPAA) for treatment of familial adenomatous polyposis (FAP). Also, we assessed the oncologic outcomes in FAP patients with coexisting malignancy. METHODS: From August 1999 to September 2010, 43 FAP patients with or without coexisting malignancy underwent TPC/IPAA by a laparoscopic-assisted or hand-assisted laparoscopic surgery. RESULTS: The median age was 33 years (range, 18 to 58 years) at the time of operation. IPAA was performed by a hand-sewn method in 21 patients (48.8%). The median operative time was 300 minutes (range, 135 to 610 minutes), which reached a plateau after 22 operations. Early postoperative complications within 30 days occurred in 7 patients (16.3%) and long-term morbidity occurred in 15 patients (34.9%) including 6 (14.0%) with desmoid tumors and 3 (7.0%) who required operative treatment. Twenty-two patients (51.2%) were diagnosed with coexisting colorectal malignancy. The median follow-up was 58.5 months (range, 7.9 to 97.8 months). There was only 1 case of local recurrence in the pelvic cavity. No cases of adenocarcinoma at the residual rectal mucosa developed. 5-year disease-free survival rate for 22 patients who had coexisting malignancy was 86.5% and 5-year overall survival rate was 92.6%. Three patients died from pulmonary or hepatic metastasis. CONCLUSION: Laparoscopic TPC/IPAA in patients with FAP is feasible and offers favorable postoperative outcomes. It also delivered acceptable oncological outcomes in patients with coexisting malignancy. Therefore, laparoscopic TPC/IPAA may be a favorable treatment option for FAP.
