Abstract | PURPOSE: METHODS: Patients undergoing primary prophylactic surgery for familial adenomatous polyposis between 1950 and 1999 were categorized according to the year of their surgery: prepouch era (before 1983) or pouch era (after 1983). Patients undergoing colectomy and ileorectal anastomosis were the focus of the study, and rate of proctectomy and the incidence of rectal cancer were recorded for each group. Data on the severity of the polyposis for each group were abstracted. RESULTS: A total of 197 patients underwent ileorectal anastomosis, 62 in the prepouch era (median follow-up, 212 months; interquartile range, 148 months) and 135 in the pouch era (median follow-up, 60 months; interquartile range, 80 months). Patients in the prepouch era came to surgery at the same median age as those in the pouch era (median age 23.0 years, interquartile ranges 15.5 years for prepouch and 17 years for pouch). Similar proportions of patients in the prepouch era had severe polyposis (49 percent) as in the pouch era (44 percent), although all severely affected patients had an ileorectal anastomosis in the prepouch era vs. 39 percent in the pouch era. Twenty (32 percent) prepouch-era patients underwent proctectomy compared with three (2 percent) pouch-era patients. No pouch-era patient had rectal cancer on follow-up; eight (12.9 percent) prepouch-era patients did. CONCLUSION:
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Authors | James Church, Carol Burke, Ellen McGannon, Olivia Pastean, Bryan Clark |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 46
Issue 9
Pg. 1175-81
(Sep 2003)
ISSN: 0012-3706 [Print] United States |
PMID | 12972960
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adenomatous Polyposis Coli
(complications, surgery)
- Adult
- Anastomosis, Surgical
(methods)
- Colectomy
- Colonic Pouches
- Female
- Follow-Up Studies
- Humans
- Ileum
(surgery)
- Male
- Proportional Hazards Models
- Rectal Neoplasms
(etiology, prevention & control, surgery)
- Rectum
(surgery)
- Registries
- Risk Factors
- Time Factors
- Treatment Outcome
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