Two Cases of Multiple Adenomas in the Ileal Pouch after Total Proctocolectomy in Patients with Familial Adenomatous Polyposis.
- Author:
Jeong Min KANG
1
;
Jeong Sik BYEON
;
Jong Ha PARK
;
Ji Yong AHN
;
Ock Bae KO
;
Seung Jae MYUNG
;
Suk Kyun YANG
;
Jin Ho KIM
Author Information
- Publication Type:Case Report
- Keywords: Familial adenomatous polyposis; Proctocolectomy; Ileal pouch; Adenoma
- From:The Korean Journal of Gastroenterology 2010;56(1):49-53
- CountryRepublic of Korea
- Language:Korean
- Abstract: Familial adenomatous polyposis (FAP) is an inherited disease characterized by the development of hundreds of colorectal adenomas, leading to a 100% lifetime risk of colorectal cancer. A prophylactic colectomy is recommended for patients with FAP to prevent colorectal cancer. Four surgical strategies are available for patients with FAP: proctocolectomy with permanent ileostomy, colectomy with ileorectal anastomosis, proctocolectomy with Koch's pouch continent ileostomy (Koch), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Koch and IPAA, which make ileal pouch, have theoretical advantage of the elimination of the risk of colorectal cancer and adenomas and good functional outcome of reduced defecation frequency. However, recent reports have shown frequent development of adenomas and carcinomas in the ileal pouch after Koch or IPAA. We experienced 2 cases of multiple pouch adenomas after pouch surgery in FAP patients. Both patients were treated with endoscopic mucosal resection without complications. We report these 2 cases with a review of literatures.
