Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgery Today
Published in: Surgery Today 6/2017

01-06-2017 | Original Article

Current status of prophylactic surgical treatment for familial adenomatous polyposis in Japan

Authors: Masato Yamadera, Hideki Ueno, Hirotoshi Kobayashi, Tsuyoshi Konishi, Fumio Ishida, Tatsuro Yamaguchi, Takao Hinoi, Yasuhiro Inoue, Yukihide Kanemitsu, Naohiro Tomita, Hideyuki Ishida, Kenichi Sugihara

Published in: Surgery Today | Issue 6/2017

Login to get access

Abstract

Purpose

We conducted this study to clarify the current clinical practice of prophylactic colectomy for patients with familial adenomatous polyposis (FAP) in Japan.

Methods

This retrospective multi-center cohort study involved 23 specialized institutions for colorectal disease in Japan. We analyzed the records of 147 patients who underwent prophylactic surgical treatment between 2000 and 2012. Patients were divided into Group 1 (2000–2006) and Group 2 (2007–2012) based on their date of surgery.

Results

Age at the time of prophylactic surgery was 27 and 31 years in Groups 1 and 2, respectively. The proportion of attenuated FAP was significantly lower in Group 2 than in Group 1 (1.0 vs. 13 %, respectively). Pathological examination revealed an increased incidence of malignant polyps in the resected specimens from Group 2 patients (10 vs. 23 %, respectively; P = 0.034). Laparoscopic surgery was more frequent in Group 2 than in Group 1 (61 vs. 40 %, respectively). There was no surgical mortality in either group.

Conclusion

Prophylactic surgery for FAP results in good short-term surgical outcomes in Japan. The current surgical approach is characterized by limited surgical indications for patients with attenuated FAP, delayed timing of colectomy, and the increasing standardization of laparoscopic surgery.
Literature
1.
Bisgaard ML, Fenger K, Bulow S, Niebuhr E, Mohr J. Familial adenomatous polyposis (FAP): frequency, penetrance, and mutation rate. Hum Mutat. 1994;3:121–5.CrossRefPubMed
2.
Murata M, Utsunomiya J, Iwama T, Tanimura M. Frequency of adenomatosis coli in Japan. Jinrui Idengaku Zasshi. 1981;26:19–30 (in Japanese).CrossRefPubMed
3.
Bussey HJR. Familial polyposis coli. Baltimore: Johns Hopkins University Press; 1975.
4.
Hata Keisuke, Yamamoto Yoko, Kiyomatsu Tomomichi, Tanaka Toshiaki, Kazama Shinsuke, Nozawa Hiroaki, et al. Hereditary gastrointestinal cancer. Surg Today. 2016;46:1115–22.CrossRefPubMed
5.
Labayle D, Fischer D, Vielh P, Drouhin F, Pariente A, Bories C, et al. Sulindac causes regression of rectal polyps in familial adenomatous polyposis. Gastroenterology. 1991;101:635–9.CrossRefPubMed
6.
Japanese Society for Cancer of the Colon and Rectum. JSCCR guidelines 2012 for the clinical practice of hereditary colorectal cancer. Tokyo: Kanehara & Co. Ltd; 2012.
7.
Utsunomiya J, Yamamura T, Kusunoki M, Shoji Y, Horai T, Ikeuchi H, et al. Ileoanal anastomosis and ileoanal canal anastomosis in Japan: comparative retrospective study. J Gastroenterol. 1995;30(Suppl 8):128–30.PubMed
8.
Vasen HF, van Duijvendijk P, Buskens E, Bulow C, Bjork J, Jarvinen HJ, et al. Decision analysis in the surgical treatment of patients with familial adenomatous polyposis: a Dutch-Scandinavian collaborative study including 659 patients. Gut. 2001;49:231–5.CrossRefPubMedPubMedCentral
9.
Van Duijvendijk P, Slors JF, Taat CW, Oosterveld P, Vasen HF. Functional outcome after colectomy and ileorectal anastomosis compared with proctocolectomy and ileal pouch-anal anastomosis in familial adenomatous polyposis. Ann Surg. 1999;230:648–54.CrossRefPubMedPubMedCentral
10.
Tonelli F, Ficari F, Bargellini T, Valanzano R. Ileal pouch adenomas and carcinomas after restorative proctocolectomy for familial adenomatous polyposis. Dis Colon Rectum. 2012;55:322–9.CrossRefPubMed
11.
Iwama T, Tamura K, Morita T, Hirai T, Hasegawa H, Koizumi K, et al. A clinical overview of familial adenomatous polyposis derived from the database of the Polyposis Registry of Japan. Int J Clin Oncol. 2004;9:308–16.CrossRefPubMed
12.
Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. 7th ed. Tokyo: Kanehara & Co., Ltd.; 2006.
13.
Nielsen M, Bik E, Hes FJ, Breuning MH, Vasen HF, Bakker E, et al. Genotype-phenotype correlations in 19 Dutch cases with APC gene deletions and a literature review. Eur J Human Genet. 2007;15:1034–42.CrossRef
14.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications. A new proposal with evaluation in a cohort of 6,336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
15.
Katayama Hiroshi, Kurokawa Yukinori, Nakamura Kenichi, Ito Hiroyuki, Kanemitsu Yukihide, Masuda Norikazu, et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016;46:668–85.CrossRefPubMed
16.
Plawski A, Banasiewicz T, Borun P, Kubaszewski L, Krokowicz P, Skrzypczak-Zielinska M, et al. Familial adenomatous polyposis of the colon. Hered Cancer ClinPract. 2013;11:15.CrossRef
17.
Knudsen AL, Bisgaard ML, Bulow S. Attenuated familial adenomatous polyposis (AFAP). A review of the literature. Fam Cancer. 2003;2:43–55.CrossRefPubMed
18.
19.
Knudsen AL, Bulow S, Tomlinson I, Moslein G, Heinimann K, Cristensen IJ. Attenuated familial adenomatous polyposis: results from an international collaborative study. Colorectal Dis 2010;12(10 Online):e243–9.
20.
Burt RW, Leppert MF, Slattery ML, Samowitz WS, Spirio LN, Kerber RA, et al. Genetic testing and phenotype in a large kindred with attenuated familial adenomatous polyposis. Gastroenterology. 2004;127:444–51.CrossRefPubMed
21.
Ishikawa H, Mutoh M, Iwama T, Suzuki S, Abe T, Takeuchi Y, et al. Endoscopic management of familial adenomatous polyposis in patients refusing colectomy. Endoscopy. 2016;48:51–5.CrossRefPubMed
22.
Japanese Society for Cancer of the Colon and Rectum. General rules for clinical and pathological studies on cancer of the colon, rectum and anus. 7th ed. Tokyo: Kanehara & Co., Ltd.; 2009.
23.
Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal carcinoma. 8th ed. Tokyo: Kanehara & Co., Ltd.; 2013.
24.
Vasen HF, Möslein G, Alonso A, Aretz S, Bernstein I, Bertario L, et al. Guidelines for the clinical management of familial adenomatous polyposis (FAP). Gut. 2008;57:704–13.CrossRefPubMed
25.
Heimann TM, Bolnick K, Aufses AH Jr. Results of surgical treatment for familial polyposis coli. Am J Surg. 1986;152:276–8.CrossRefPubMed
26.
King JE, Dozois RR, Lindor NM, Ahlquist DA. Care of patients and their families with familial adenomatous polyposis. Mayo Clin Proc. 2000;75:57–67.CrossRefPubMed
27.
28.
McNicol FJ, Kennedy RH, Phillips RKS, Clark SK. Laparoscopic total colectomy and ileorectal anastomosis (IRA), supported by an increased recovery programme in cases of familial adenomatous polyposis. Colorectal Dis. 2011;14:458–62.CrossRef
29.
Vitellaro M, Bonfanti G, Sala P, Poiasina E, Barisella M, Signoroni S, et al. Laparoscopic colectomy and restorative proctocolectomy for familial adenomatous polyposis. Surg Endosc. 2011;25:1866–75.CrossRefPubMed
30.
Campos FG, Araujo SE, Melani AG, Pandini LC, Nahas SC, Cecconello I. Surgical outcomes of laparoscopic colorectal resections for familial adenomatous polyposis. Surg Laparosc Endosc Percutan Tech. 2011;21:327–33.CrossRefPubMed
31.
Kim HJ, Choi GS, Park JS, Park SY, Choi WH, Ryuk JP. Early postoperative and long–term oncological outcomes of laparoscopic treatment for patients with familial adenomatous polyposis. J Korean Surg Soc. 2012;83:288–97.CrossRefPubMedPubMedCentral
32.
Watanabe M. 12th national survey of endoscopic surgery in Japan. J Jpn Endosc Surg 2014;19:541–4 (in Japanese)
Metadata
Title
Current status of prophylactic surgical treatment for familial adenomatous polyposis in Japan
Authors
Masato Yamadera
Hideki Ueno
Hirotoshi Kobayashi
Tsuyoshi Konishi
Fumio Ishida
Tatsuro Yamaguchi
Takao Hinoi
Yasuhiro Inoue
Yukihide Kanemitsu
Naohiro Tomita
Hideyuki Ishida
Kenichi Sugihara
Publication date
01-06-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1431-4

Other articles of this Issue 6/2017

Surgery Today 6/2017 Go to the issue

Original Article

Is routine abdominal drainage necessary after liver resection?

Original Article

What is the predictor of surgical mortality in adult colorectal perforation? The clinical characteristics and results of a multivariate logistic regression analysis

Original Article

New-onset diabetes mellitus after living-donor liver transplantation: association with graft synthetic function

Original Article

Treatment of simultaneously discovered lung cancer and cardiovascular disease: a 20-year single-institution experience

Original Article

Immune function monitoring in lung transplantation using adenosine triphosphate production: time trends and relationship to postoperative infection

Review Article

Subsequent biliary cancer originating from remnant intrapancreatic bile ducts after cyst excision: a literature review