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首页> 外文期刊>International journal of colorectal disease. >Risk of cancer and secondary proctectomy after colectomy and ileorectal anastomosis in familial adenomatous polyposis
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Risk of cancer and secondary proctectomy after colectomy and ileorectal anastomosis in familial adenomatous polyposis

机译：家族性腺瘤性息肉病的结肠切除术和回肠直肠吻合术后癌症和继发性直肠切除术的风险

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Purpose: The aim of our retrospective study was to review the outcome of patients undergoing colectomy with ileorectal anastomosis (IRA) due to familial adenomatous polyposis (FAP) in Finland during the last 50 years. Methods: The cumulative risk of rectal cancer and the rate of anus preservation were analyzed. A total of 140 FAP patients with previous colectomy combined with ileorectal anastomosis were included. Kaplan-Meier analysis was performed to evaluate cumulative risks. Results: Secondary proctectomy was performed for 39 (28 %) of 140 patients. The cumulative risk of secondary proctectomy was 53 % at 30 years after colectomy with IRA. A total of 17 (44 %) secondary proctectomies were performed due to cancer or suspicion of cancer, and another 17 (44 %) secondary proctectomies were performed due to uncontrollable rectal polyposis. During our study, the anus preservation rate in secondary proctectomies was 49 %. The cumulative risk of rectal cancer was 24 % at 30 years after colectomy with IRA. Therefore, the cumulative rectal cancer mortality 30 years after colectomy with IRA was 9 %. Conclusions: Proctocolectomy and ileal pouch-anal anastomosis (IPAA) should be favored as a primary operation for patients not having technical or medical contraindications for it because colectomy with IRA carried a rectal cancer risk of 13 % with a mortality of 7 % during our study, and because IPAA is likely to succeed better at earlier phase of the disease. Patients with attenuated FAP had no rectal cancer in our study, and they may form a group where IRA should still be the first choice as an exception.
机译：目的：我们的回顾性研究的目的是回顾过去50年来因家族性腺瘤性息肉病（FAP）接受结肠切除术并进行回肠直肠吻合术（IRA）的患者的结果。方法：分析直肠癌的累积风险和肛门保存率。总共140例先前行结肠切除术并结合回肠直肠吻合术的FAP患者。进行Kaplan-Meier分析以评估累积风险。结果：140例患者中有39例（28％）进行了第二次直肠切除术。 IRA结肠切除术后30年，继发直肠切除术的累积风险为53％。由于癌症或怀疑癌症，共进行了17次（44％）继发性手术，由于无法控制的直肠息肉病，进行了另外17次（44％）的继发性手术。在我们的研究中，二次手术的肛门保存率是49％。 IRA结肠切除术后30年直肠癌的累积风险为24％。因此，IRA结肠切除术后30年的直肠癌累积死亡率为9％。结论：对于没有技术或医学禁忌症的患者，应首选直肠癌切除术和回肠袋肛门吻合术（IPAA）作为主要手术，因为在本研究中，IRA结肠切除术的直肠癌风险为13％，死亡率为7％。 ，因为IPAA在疾病的早期阶段可能会取得更好的成功。 FAP减毒的患者在我们的研究中没有直肠癌，因此他们可能会成为IRA仍应作为例外的首选人群。

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