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International Journal of Colorectal Disease

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01-05-2022 | Rectal Cancer | Original Article

Long-term prognosis of familial adenomatous polyposis with or without mucosectomy

Authors: Kyota Tatsuta, Mayu Sakata, Yoshifumi Morita, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Atsuko Fukazawa, Kiyotaka Kurachi, Hiroya Takeuchi

Published in: International Journal of Colorectal Disease | Issue 5/2022

Abstract

Purpose

This study primarily aimed to compare the long-term prognosis of patients who underwent total colectomy/proctocolectomy with or without mucosectomy to the dentate line for the diagnosis of familial adenomatous polyposis (FAP).

Methods

Patients who underwent total colectomy/proctocolectomy for FAP between January 1979 and December 2020 and were followed up at Hamamatsu University Hospital were included in this study. Those who underwent total proctocolectomy with hand-sewn ileal pouch–anal anastomosis were defined as the mucosectomy group. Those who underwent total colectomy or total proctocolectomy using the stapled ileal pouch–anal anastomosis approach were defined as the no mucosectomy group.

Results

A total of 61 individuals (37 families) were diagnosed during the surveillance period (median, 191 months). Between the mucosectomy (n = 24) and no mucosectomy groups (n = 34), metachronous rectal cancer was significantly more common in the no mucosectomy group (21% in no mucosectomy vs. 0% in mucosectomy, P = 0.02). Overall survival in the no mucosectomy group was worse than that in the mucosectomy group (84.5% in no mucosectomy vs. 100% in mucosectomy at 120 months, 81.1% vs. 90.0% at 240 months, 50.6% vs. 75.0% at 360 months, P = 0.09). Cox regression analysis revealed an independent effect of not performing mucosectomy on overall survival (P = 0.03).

Conclusion

Long-term surveillance revealed that colectomy or total proctocolectomy without mucosectomy had a negative impact on the overall survival of patients with FAP. Therefore, we recommend total proctocolectomy with mucosectomy, i.e., hand-sewn ileal pouch–anal anastomosis, for FAP.

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Title: Long-term prognosis of familial adenomatous polyposis with or without mucosectomy
Authors: Kyota Tatsuta
Mayu Sakata
Yoshifumi Morita
Hirotoshi Kikuchi
Yoshihiro Hiramatsu
Atsuko Fukazawa
Kiyotaka Kurachi
Hiroya Takeuchi
Publication date: 01-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Proctocolectomy
Colectomy
Colectomy
Proctocolectomy
Familial Adenomatous Polyposis
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 5/2022
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-022-04154-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term prognosis of familial adenomatous polyposis with or without mucosectomy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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