Risk of cancer in the rectal remnant after ileorectal anastomosis in patients with familial adenomatous polyposis: Single center experience

Yuji Maehata, Motohiro Esaki, Shotaro Nakamura, Minako Hirahashi, Takashi Ueki, Mitsuo Iida, Takanari Kitazono, Takayuki Matsumoto

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Abstract

Background and Aim We aimed to evaluate the long-term risk of cancer in the rectal remnant in patients with familial adenomatous polyposis after ileorectal anastomosis. Methods Cumulative incidence and clinicopathological characteristics of cancer in the rectal remnant were retrospectively investigated in 27 patients with familial adenomatous polyposis who had undergone ileorectal anastomosis. Results During the follow-up period ranging from 3.0 to 35.0 years (median, 21.1 years), cancer in the rectal remnant developed in 10 patients. Cumulative risk of cancer in the rectal remnant 30 years after surgery was 57%. Five patients had metastases and three patients died of cancer in the rectal remnant after proctectomy. There was a trend towards a higher incidence of cancer in the rectal remnant in patients with small-intestinal adenoma and congenital hypertrophy of the retinal pigment epithelium. Multivariate analysis revealed that the ocular lesion was an independent risk factor associated with cancer in the rectal remnant. Conclusion Subtotal colectomy with ileorectal anastomosis does not seem to be an appropriate prophylactic surgery in patients with familial adenomatous polyposis.

Original languageEnglish
Pages (from-to)471-478
Number of pages8
JournalDigestive Endoscopy
Volume27
Issue number4
DOIs
Publication statusPublished - May 1 2015

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All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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