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KMID : 0614620100560010049
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Korean Journal of Gastroenterology
2010 Volume.56 No. 1 p.49 ~ p.53
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Two Cases of Multiple Adenomas in the Ileal Pouch after Total Proctocolectomy in Patients with Familial Adenomatous Polyposis
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Kang Jeong-Min
Byeon Jeong-Sik
Park Jong-Ha
Ahn Ji-Yong
Ko Ock-Bae
Myung Seung-Jae
Yang Suk-Kyun
Kim Jin-Ho
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Abstract
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Familial adenomatous polyposis (FAP) is an inherited disease characterized by the development of hundreds of colorectal adenomas, leading to a 100% lifetime risk of colorectal cancer. A prophylactic colectomy is recommended for patients with FAP to prevent colorectal cancer. Four surgical strategies are available for patients with FAP: proctocolectomy with permanent ileostomy, colectomy with ileorectal anastomosis, proctocolectomy with Koch’s pouch continent ileostomy (Koch), and restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Koch and IPAA, which make ileal pouch, have theoretical advantage of the elimination of the risk of colorectal cancer and adenomas and good functional outcome of reduced defecation frequency. However, recent reports have shown frequent development of adenomas and carcinomas in the ileal pouch after Koch or IPAA. We experienced 2 cases of multiple pouch adenomas after pouch surgery in FAP patients. Both patients were treated with endoscopic mucosal resection without complications. We report these 2 cases with a review of literatures.
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KEYWORD
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Familial adenomatous polyposis, Proctocolectomy, Ileal pouch, Adenoma
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