Familial adenomatous polyposis surgery: Difference between revisions

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==Overview==
==Overview==
[[Surgery]] is the mainstay of treatment for familial adenomatous polyposis. The preferred [[surgery]] technique is [[Laparoscopic surgery|laparoscopic]] total [[proctocolectomy]] with ileal pouch anal [[anastomosis]] (IPAA) and mucosectomy.
[[Surgery]] is the mainstay of treatment for familial adenomatous polyposis (FAP). The preferred [[surgery]] technique is [[Laparoscopic surgery|laparoscopic]] total [[proctocolectomy]] with ileal pouch anal [[anastomosis]] (IPAA) and mucosectomy. Another technique is total [[colectomy]] with ileorectal [[anastomosis]].
==Indications==
==Indications==
*Surgery is recommended in patients with:<ref name="KennedyPotter2014">{{cite journal|last1=Kennedy|first1=Raelene D.|last2=Potter|first2=D. Dean|last3=Moir|first3=Christopher R.|last4=El-Youssef|first4=Mounif|title=The natural history of familial adenomatous polyposis syndrome: A 24year review of a single center experience in screening, diagnosis, and outcomes|journal=Journal of Pediatric Surgery|volume=49|issue=1|year=2014|pages=82–86|issn=00223468|doi=10.1016/j.jpedsurg.2013.09.033}}</ref><ref name="pmid10630758">{{cite journal |vauthors=King JE, Dozois RR, Lindor NM, Ahlquist DA |title=Care of patients and their families with familial adenomatous polyposis |journal=Mayo Clin. Proc. |volume=75 |issue=1 |pages=57–67 |year=2000 |pmid=10630758 |doi=10.4065/75.1.57 |url=}}</ref>
Surgery is recommended in patients with FAP who present with:<ref name="KennedyPotter2014">{{cite journal|last1=Kennedy|first1=Raelene D.|last2=Potter|first2=D. Dean|last3=Moir|first3=Christopher R.|last4=El-Youssef|first4=Mounif|title=The natural history of familial adenomatous polyposis syndrome: A 24year review of a single center experience in screening, diagnosis, and outcomes|journal=Journal of Pediatric Surgery|volume=49|issue=1|year=2014|pages=82–86|issn=00223468|doi=10.1016/j.jpedsurg.2013.09.033}}</ref><ref name="pmid10630758">{{cite journal |vauthors=King JE, Dozois RR, Lindor NM, Ahlquist DA |title=Care of patients and their families with familial adenomatous polyposis |journal=Mayo Clin. Proc. |volume=75 |issue=1 |pages=57–67 |year=2000 |pmid=10630758 |doi=10.4065/75.1.57 |url=}}</ref>
**Diffuse [[Polyp|polyposis]]  
*Diffuse [[Polyp|polyposis]]  
**High-grade [[dysplasia]] on [[colonoscopy]]
*High-grade [[dysplasia]] on [[colonoscopy]]
**Invasive [[adenocarcinoma]] on [[colonoscopy]]
*Invasive [[adenocarcinoma]] on [[colonoscopy]]
==Surgery==
==Surgery==
* [[Surgery]] is the mainstay of treatment for familial adenomatous polyposis.  
[[Surgery]] is the mainstay of treatment for familial adenomatous polyposis.
* The preferred surgical technique is:
* The preferred surgical technique for FAP is:
** Laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy which has:<ref name="KennedyPotter2014">{{cite journal|last1=Kennedy|first1=Raelene D.|last2=Potter|first2=D. Dean|last3=Moir|first3=Christopher R.|last4=El-Youssef|first4=Mounif|title=The natural history of familial adenomatous polyposis syndrome: A 24year review of a single center experience in screening, diagnosis, and outcomes|journal=Journal of Pediatric Surgery|volume=49|issue=1|year=2014|pages=82–86|issn=00223468|doi=10.1016/j.jpedsurg.2013.09.033}}</ref>
** Laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy which has:<ref name="KennedyPotter2014">{{cite journal|last1=Kennedy|first1=Raelene D.|last2=Potter|first2=D. Dean|last3=Moir|first3=Christopher R.|last4=El-Youssef|first4=Mounif|title=The natural history of familial adenomatous polyposis syndrome: A 24year review of a single center experience in screening, diagnosis, and outcomes|journal=Journal of Pediatric Surgery|volume=49|issue=1|year=2014|pages=82–86|issn=00223468|doi=10.1016/j.jpedsurg.2013.09.033}}</ref>
*** Good patient satisfaction
*** Good patient satisfaction
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*** No [[Colon (anatomy)|colorectal]] occurrence or recurrence
*** No [[Colon (anatomy)|colorectal]] occurrence or recurrence
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* Other surgical techniques include:
* Other surgical techniques include:
** Total [[colectomy]] with ileorectal [[anastomosis]]
** Total [[colectomy]] with ileorectal [[anastomosis]]
 
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Oncology]]
[[Category:Up-To-Date]]
[[Category:Surgery]]

Latest revision as of 21:43, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Mohamad Alkateb, MBBCh [3]

Overview

Surgery is the mainstay of treatment for familial adenomatous polyposis (FAP). The preferred surgery technique is laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy. Another technique is total colectomy with ileorectal anastomosis.

Indications

Surgery is recommended in patients with FAP who present with:[1][2]

Surgery

Surgery is the mainstay of treatment for familial adenomatous polyposis.

  • The preferred surgical technique for FAP is:
    • Laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy which has:[1]
      • Good patient satisfaction
      • Excellent functional outcome
      • Few postoperative complications
      • No colorectal occurrence or recurrence

{{#ev:youtube|bDXsdaZl9hQ}} {{#ev:youtube|4l1qS1waolA}}

{{#ev:youtube|nDuKZAibgrc}}

References

  1. 1.0 1.1 Kennedy, Raelene D.; Potter, D. Dean; Moir, Christopher R.; El-Youssef, Mounif (2014). "The natural history of familial adenomatous polyposis syndrome: A 24year review of a single center experience in screening, diagnosis, and outcomes". Journal of Pediatric Surgery. 49 (1): 82–86. doi:10.1016/j.jpedsurg.2013.09.033. ISSN 0022-3468.
  2. King JE, Dozois RR, Lindor NM, Ahlquist DA (2000). "Care of patients and their families with familial adenomatous polyposis". Mayo Clin. Proc. 75 (1): 57–67. doi:10.4065/75.1.57. PMID 10630758.

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