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International Journal of Colorectal Disease

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Open Access 01-12-2024 | Familial Adenomatous Polyposis | RESEARCH

Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study

Authors: Kyota Tatsuta, Mayu Sakata, Moriya Iwaizumi, Kazuya Okamoto, Shigeto Yoshii, Masashi Mori, Yutaro Asaba, Takashi Harada, Mikihiro Shimizu, Kiyotaka Kurachi, Hiroya Takeuchi

Published in: International Journal of Colorectal Disease | Issue 1/2024

Abstract

Purpose

The long-term prognosis of stapled and hand-sewn ileal pouch–anal anastomoses in familial adenomatous polyposis patients in Japan remains unknown. This study aimed to compare the overall survival in familial adenomatous polyposis patients who underwent stapled or hand-sewn ileal pouch–anal anastomosis.

Methods

This multicenter retrospective study was conducted at 12 institutions in Shizuoka Prefecture, Japan. The clinical outcomes of 53 eligible familial adenomatous polyposis patients who underwent stapled (n = 24) and hand-sewn (n = 29) ileal pouch–anal anastomosis were compared.

Results

The median follow-up duration was 171.5 months. The incidence of adenoma in the remnant rectum or anal transitional zone and metachronous rectal cancer was significantly more common in stapled ileal pouch–anal anastomosis (adenoma: stapled, 45.8%, vs. hand-sewn, 10.3%, p = 0.005; metachronous rectal cancer: 29.2%, vs. none, p = 0.002). The number of deaths was remarkably higher in stapled ileal pouch–anal anastomosis (p = 0.002). Metachronous rectal cancer was the most common cause of death. Overall survival was worse in stapled ileal pouch–anal anastomosis than in hand-sewn ileal pouch–anal anastomosis (120 months, 90.7% vs. 96.6%; 240 months, 63.7% vs. 96.6%; p = 0.044). Cox regression analysis revealed the independent effects of preoperative advanced colorectal cancer and stapled ileal pouch–anal anastomosis on overall survival.

Conclusion

Stapled ileal pouch–anal anastomosis negatively affected the overall survival of familial adenomatous polyposis patients. Therefore, hand-sewn ileal pouch–anal anastomosis is recommended for better prognosis in these patients.

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Title: Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study
Authors: Kyota Tatsuta
Mayu Sakata
Moriya Iwaizumi
Kazuya Okamoto
Shigeto Yoshii
Masashi Mori
Yutaro Asaba
Takashi Harada
Mikihiro Shimizu
Kiyotaka Kurachi
Hiroya Takeuchi
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Familial Adenomatous Polyposis
Rectal Cancer
Rectal Cancer
Pouchoscopy
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 1/2024
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-024-04608-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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