The risk of developing rectal cancer after colectomy and ileorectal anastomosis in Danish patients with polyposis coli

1984 ◽  
Vol 27 (11) ◽  
pp. 726-729 ◽  
Author(s):  
Steffen Bülow
Keyword(s):  
Rectal Cancer ◽  
Ileorectal Anastomosis ◽  
Polyposis Coli

Risk factors for rectal cancer morbidity and mortality in patients with familial adenomatous polyposis after colectomy and ileorectal anastomosis

2000 ◽  
Vol 43 (12) ◽  
pp. 1719-1725 ◽  
Author(s):  
Jan A. Björk ◽  
Helena I. Åkerbrant ◽  
Lennart E. Iselius ◽  
Rolf W. Hultcrantz
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Familial Adenomatous Polyposis ◽  
Ileorectal Anastomosis ◽  
Morbidity And Mortality ◽  
Adenomatous Polyposis ◽  
Cancer Morbidity

Risk of Rectal Cancer in Patients After Colectomy and Ileorectal Anastomosis for Familial Adenomatous Polyposis

2003 ◽  
Vol 46 (9) ◽  
pp. 1175-1181 ◽  
Author(s):  
James Church ◽  
Carol Burke ◽  
Ellen McGannon ◽  
Olivia Pastean ◽  
Bryan Clark
Keyword(s):  
Rectal Cancer ◽  
Familial Adenomatous Polyposis ◽  
Ileorectal Anastomosis ◽  
Adenomatous Polyposis

Fate of the Rectum after Colectomy with Ileorectal Anastomosis in Ulcerative Colitis

2005 ◽  
Vol 94 (1) ◽  
pp. 40-42 ◽  
Author(s):  
A. Lepistö ◽  
H. J. Järvinen
Keyword(s):  
Ulcerative Colitis ◽  
Rectal Cancer ◽  
Success Rate ◽  
Ileorectal Anastomosis ◽  
Colonic Cancer ◽  
Common Indication ◽  
Kaplan Meier ◽  
Advanced Colonic Cancer

Objective: Aim of the study was to evaluate the cumulative success of colectomy and ileorectal anastomosis in 20 patients with ulcerative colitis. Patients and Methods: Data were collected from patient histories and cumulative success was calculated by the Kaplan-Meier method. Results: Seven of 20 (35 %) ileorectal anastomoses were lost. Cumulative success rate was 84 % at 5 years, 69 % at 10 years and 56 % at 20 years. Most common indication for proctectomy was disabling proctitis. Other reasons for failure were postoperative ileal necrosis and persisting presacral infection. Patients with advanced colonic cancer managed relatively well with ileorectal anastomosis until death. No cases of rectal cancer were detected during postoperative follow-up but one moderate dysplasia was treated locally. Conclusion: Ileorectal anastomosis can be chosen for patients who are not suitable for ileoanal operation. Rectal endoscopies are mandatory postoperatively.

scholarly journals Surgical treatment of familial adenomatous polyposis: ileoretal anastomosis or restorative proctolectomy?

2009 ◽  
Vol 46 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Fábio Guilherme Campos ◽  
Rodrigo Oliva Perez ◽  
Antônio Rocco Imperiale ◽  
Víctor Edmond Seid ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileorectal Anastomosis ◽  
Cumulative Risk ◽  
Oncological Outcome ◽  
Ileal Reservoir ◽  
Adenomatous Polyposis ◽  
Operative Complications

CONTEXT: Controversy regarding the best operative choice for familial adenomatous polyposis lays between the morbidity of restorative proctocolectomy and the supposed mortality due to rectal cancer after ileorectal anastomosis. OBJECTIVES: To evaluate operative complications and oncological outcome after ileorectal anastomosis and restorative proctocolectomy. METHODS: Charts from patients treated between 1977 and 2006 were retrospectively analyzed. Clinical and endoscopic data, results of treatment, pathological reports and information regarding early and late outcome were recorded. RESULTS: Eighty-eight patients - 41 men (46.6%) and 47 women (53.4%) - were assisted. At diagnosis, 53 patients (60.2%) already had associated colorectal cancer. Operative complications occurred in 25 patients (29.0 %), being 17 (19.7%) early and 8 (9.3%) late complications. There were more complications after restorative proctocolectomy (48.1%) compared to proctocolectomy with ileostomy (26.6%) and ileorectal anastomosis (19.0%) (P = 0,03). There was no operative mortality. During the follow-up of 36 ileorectal anastomosis, cancer developed in the rectal cuff in six patients (16,6%). Cumulative cancer risk after ileorectal anastomosis was 17.2% at 5 years, 24.1% at 10 years and 43.1% at 15 years of follow-up. Age-dependent cumulative risk started at 30 years (4.3%), went to 9.6% at 40 years, 20.9% at 40 years and 52% at 60 years. Among the 26 patients followed after restorative proctocolectomy, it was found cancer in the ileal pouch in 1 (3.8%). CONCLUSIONS: 1. Operative complications occurred in about one third of the patients, being more frequently after the confection of ileal reservoir; 2. greater age and previous colonic carcinoma were associated with the development of rectal cancer after ileorectal anastomosis; 3. patients treated by restorative proctocolectomy are not free from the risk of pouch degeneration; 4. the disease complexity and the various risk factors (clinical, endoscopic, genetic) indicate that the best choice for operative treatment should be based on individual features discussed by a specialist; 5. all patients require continuous and long-term surveillance during postoperative follow-up.

scholarly journals P758 Ileorectal anastomosis vs. ileal pouch-anal anastomosis for the surgical treatment of ulcerative colitis: A Markov decision analysis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S605-S605
Author(s):  
A De Buck Van Overstraeten ◽  
M Brar ◽  
S Khorasani ◽  
F Dossa ◽  
P Myrelid
Keyword(s):  
Ulcerative Colitis ◽  
Rectal Cancer ◽  
Sensitivity Analysis ◽  
Time Horizon ◽  
Ileal Pouch ◽  
Ileorectal Anastomosis ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Anal Anastomosis ◽  
Quality Adjusted Life

Abstract Background Ileorectal anastomosis (IRA) in patients with ulcerative colitis (UC) results in decreased postoperative morbidity and better functional outcome but leads to increased risk for rectal cancer compared with ileal pouch-anal anastomosis (IPAA). This study aims to compare IRA with IPAA in UC, using decision analysis. Methods A Markov simulation model was designed to simulate clinical events of IRA and IPAA over a time horizon of 40 years with time cycles of 1 year (Figure 1). The base case was a 35-year-old patient with ulcerative colitis and relatively preserved rectum. Probabilities and utilities, required to populate the model, were derived from observational studies, identified after a systematic literature search using MEDLINE. Primary outcomes were life years (LY) and quality-adjusted life years (QALY). Deterministic sensitivity analyses were performed to assess the impact of changing variables on the preferred treatment. Monte Carlo probabilistic sensitivity analysis, using 10 000 samples, was performed to account for uncertainty of variables. Prevalence of rectal cancer, IPAA and IRA failure and the stoma rate were calculated at the end of the time horizon, using markov cohort analysis. Results The model resulted in lower LY (36.22 vs. 37.02) and higher QALYs (33.42 vs. 31.57) for IRA. The results of the Monte Carlo probabilistic sensitivity analysis demonstrated that IRA was the preferred treatment option in 63% of the samples, accounting for a clinical significant margin of 0.25 QALY (Figure 2). The model was also sensitive to the utility of IRA, IPAA and end-ileostomy. A higher proportion of IRA patients will develop rectal cancer (7.6% vs. 3.2%) and 43.5% of all IRA patients will end with an ileostomy as opposed to 23.0% of all IPAA patients. The study was limited by characteristics inherent to modeling studies, including assumptions necessary to build the model, data input based on best available but often limited evidence and unavoidable extra- and interpolation of data. Conclusion IRA was the preferred treatment option when quality-adjusted life years was the outcome, with higher life years for IPAA. This model highlights that both surgical strategies are useful in ulcerative colitis patients with relatively spared rectum.

Long-Term Outcome of Metachronous Rectal Cancer Following Ileorectal Anastomosis for Familial Adenomatous Polyposis

2009 ◽  
Vol 14 (3) ◽  
pp. 500-505 ◽  
Author(s):  
Tomohiro Yamaguchi ◽  
Seiichiro Yamamoto ◽  
Shin Fujita ◽  
Takayuki Akasu ◽  
Yoshihiro Moriya
Keyword(s):  
Rectal Cancer ◽  
Familial Adenomatous Polyposis ◽  
Ileorectal Anastomosis ◽  
Adenomatous Polyposis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Metachronous Rectal Cancer
Sign in / Sign up

Export Citation Format

Share Document