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International Journal of Clinical Oncology

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01-08-2016 | Original Article

Prevalence of laparoscopic surgical treatment and its clinical outcomes in patients with familial adenomatous polyposis in Japan

Authors: Hideki Ueno, Hirotoshi Kobayashi, Tsuyoshi Konishi, Fumio Ishida, Tatsuro Yamaguchi, Takao Hinoi, Yukihide Kanemitsu, Yasuhiro Inoue, Naohiro Tomita, Nagahide Matsubara, Koji Komori, Heita Ozawa, Takeshi Nagasaka, Hirotoshi Hasegawa, Motoi Koyama, Yoshito Akagi, Toshimasa Yatsuoka, Kensuke Kumamoto, Kiyotaka Kurachi, Kohji Tanakaya, Kazuhiko Yoshimatsu, Toshiaki Watanabe, Kenichi Sugihara, Hideyuki Ishida

Published in: International Journal of Clinical Oncology | Issue 4/2016

Abstract

Background

Laparoscopic surgery is becoming the preferred technique for most colorectal interventions. This study aimed to clarify the time trend of surgical treatment for familial adenomatous polyposis (FAP) and its relevance to clinical outcomes in Japan over a 13-year period.

Methods

This was a multicenter retrospective cohort study comprising 23 specialist institutions for colorectal disease and a cohort of 282 FAP patients who underwent total colectomy or proctocolectomy during 2000–2012. Patient clinical backgrounds and surgical outcomes were compared between the first and second halves of the study period.

Results

The proportion of surgical types adopted over the entire study period was 46, 21, 30, and 3 % for ileoanal anastomosis (IAA), ileoanal canal anastomosis, ileorectal anastomosis, and permanent ileostomy, respectively. FAP patients undergoing laparoscopic surgery have increased since 2008 and reached 74 % in the past 3 years. In particular, the number of patients undergoing laparoscopic proctocolectomy with IAA increased approximately four-fold from the first to the second half of the study period. A laparoscopic approach was increasingly used in patients with coexisting colorectal malignancies. Despite this trend, surgical results of the laparoscopic approach between the two study periods showed similar morbidity, pouch operation and stoma closure completion rates. No postoperative mortality was observed in this series, and laparoscopic surgery was comparable to open surgery in terms of stoma closure rate, incidence of intra-abdominal/abdominal desmoid tumors, and postoperative survival rate in both study periods.

Conclusion

Laparoscopic approach is increasingly being adopted for prophylactic FAP surgery in Japan and may provide clinically acceptable practical outcomes.

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Title: Prevalence of laparoscopic surgical treatment and its clinical outcomes in patients with familial adenomatous polyposis in Japan
Authors: Hideki Ueno
Hirotoshi Kobayashi
Tsuyoshi Konishi
Fumio Ishida
Tatsuro Yamaguchi
Takao Hinoi
Yukihide Kanemitsu
Yasuhiro Inoue
Naohiro Tomita
Nagahide Matsubara
Koji Komori
Heita Ozawa
Takeshi Nagasaka
Hirotoshi Hasegawa
Motoi Koyama
Yoshito Akagi
Toshimasa Yatsuoka
Kensuke Kumamoto
Kiyotaka Kurachi
Kohji Tanakaya
Kazuhiko Yoshimatsu
Toshiaki Watanabe
Kenichi Sugihara
Hideyuki Ishida
Publication date: 01-08-2016
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 4/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0953-5

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