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Langenbeck's Archives of Surgery

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01-02-2018 | ORIGINAL ARTICLE

Postoperative outcome and quality of life after surgery for FAP-associated duodenal adenomatosis

Authors: Petra Ganschow, Thilo Hackert, Marcel Biegler, Pietro Contin, Ulf Hinz, Markus W. Büchler, Martina Kadmon

Published in: Langenbeck's Archives of Surgery | Issue 1/2018

Abstract

Introduction

Prophylactic colon surgery has increased life expectancy of familial adenomatous polyposis patients. Extracolonic manifestations are life limiting, above all duodenal adenomas. Severe duodenal adenomatosis or cancer may necessitate pancreas-preserving total duodenectomy or partial pancreatico-duodenectomy, mostly after previous proctocolectomy and often after limited local resections of duodenal adenomas.

Scarce information on long-term postoperative outcome and quality of life after surgery for duodenal adenomatosis is available. Aim of the present study was to analyze perioperative and long-term outcome after PD and PPTD for FAP-associated duodenal adenomatosis, including QoL and recurrence of adenomas in the neoduodenum after PPTD.

Material, methods and patients

Thirty-eight patients, 27 after pancreas-preserving duodenectomy and 11 after partial pancreaticoduodenectomy, were included.

Results

Pancreas-preserving total duodenectomy was associated with shorter operation time and less blood loss than partial pancreatico-duodenectomy. Clinically relevant pancreatic fistula occurred in 31.5%. In-hospital mortality was 5.3%. Long-term follow-up revealed recurrent pancreatitis after pancreas-preserving total duodenectomy in 22% of patients, two (7.4%) required re-operation. Recurrent adenomatosis was detected in 26% of patients. Quality of life was comparable to the German normal population after both surgical procedures. Patients with postoperative complications showed worse results than those without complications. Disease-specific 10-year survival rate with respect to duodenal adenomatosis was 100%.

Conclusion

Surgery for FAP-associated duodenal adenomatosis and cancer can be carried out with reasonable morbidity rates despite previous proctocolectomy. Long-term outcome, quality of life, and survival rates are favorable.

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Title: Postoperative outcome and quality of life after surgery for FAP-associated duodenal adenomatosis
Authors: Petra Ganschow
Thilo Hackert
Marcel Biegler
Pietro Contin
Ulf Hinz
Markus W. Büchler
Martina Kadmon
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 1/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1625-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Postoperative outcome and quality of life after surgery for FAP-associated duodenal adenomatosis

Abstract

Introduction

Material, methods and patients

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Material, methods and patients

Results

Conclusion

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