{"title":"家族性腺瘤性息肉病和溃疡性结肠炎并发结直肠癌的回肠袋-肛门吻合术:治疗指南。","authors":"Mohammed Aldakhil, Nasser Alsanea","doi":"10.1093/jscr/rjaf332","DOIUrl":null,"url":null,"abstract":"<p><p>Patients with familial adenomatous polyposis (FAP) or ulcerative colitis (UC) are at increased risk of colorectal cancer (CRC), making surgical decision-making complex. This case series reviews six patients with FAP or UC who developed CRC and underwent ileal pouch-anal anastomosis (IPAA). Two patients with stage III CRC developed metastases, while the remaining four with stage I/II had no recurrence. IPAA is feasible in stage I/II CRC regardless of tumor location. For stage III colon cancer, total proctocolectomy (TPC) with IPAA followed by adjuvant chemotherapy is appropriate. In stage III rectal cancer more than 2 cm from the dentate line, IPAA can follow total neoadjuvant treatment (TNT). For tumors within 2 cm of the dentate line, TPC with end ileostomy is advised. IPAA may be contraindicated in cases with severe proctitis due to bleeding risk or radiation intolerance. Overall, IPAA is a suitable option for selected FAP or UC patients with CRC.</p>","PeriodicalId":47321,"journal":{"name":"Journal of Surgical Case Reports","volume":"2025 5","pages":"rjaf332"},"PeriodicalIF":0.4000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095996/pdf/","citationCount":"0","resultStr":"{\"title\":\"Ileal pouch-anal anastomosis in familial adenomatous polyposis and ulcerative colitis with coexisting colorectal cancer: a guideline for treatment.\",\"authors\":\"Mohammed Aldakhil, Nasser Alsanea\",\"doi\":\"10.1093/jscr/rjaf332\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Patients with familial adenomatous polyposis (FAP) or ulcerative colitis (UC) are at increased risk of colorectal cancer (CRC), making surgical decision-making complex. This case series reviews six patients with FAP or UC who developed CRC and underwent ileal pouch-anal anastomosis (IPAA). Two patients with stage III CRC developed metastases, while the remaining four with stage I/II had no recurrence. IPAA is feasible in stage I/II CRC regardless of tumor location. For stage III colon cancer, total proctocolectomy (TPC) with IPAA followed by adjuvant chemotherapy is appropriate. In stage III rectal cancer more than 2 cm from the dentate line, IPAA can follow total neoadjuvant treatment (TNT). For tumors within 2 cm of the dentate line, TPC with end ileostomy is advised. IPAA may be contraindicated in cases with severe proctitis due to bleeding risk or radiation intolerance. Overall, IPAA is a suitable option for selected FAP or UC patients with CRC.</p>\",\"PeriodicalId\":47321,\"journal\":{\"name\":\"Journal of Surgical Case Reports\",\"volume\":\"2025 5\",\"pages\":\"rjaf332\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2025-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095996/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Surgical Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/jscr/rjaf332\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jscr/rjaf332","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Ileal pouch-anal anastomosis in familial adenomatous polyposis and ulcerative colitis with coexisting colorectal cancer: a guideline for treatment.
Patients with familial adenomatous polyposis (FAP) or ulcerative colitis (UC) are at increased risk of colorectal cancer (CRC), making surgical decision-making complex. This case series reviews six patients with FAP or UC who developed CRC and underwent ileal pouch-anal anastomosis (IPAA). Two patients with stage III CRC developed metastases, while the remaining four with stage I/II had no recurrence. IPAA is feasible in stage I/II CRC regardless of tumor location. For stage III colon cancer, total proctocolectomy (TPC) with IPAA followed by adjuvant chemotherapy is appropriate. In stage III rectal cancer more than 2 cm from the dentate line, IPAA can follow total neoadjuvant treatment (TNT). For tumors within 2 cm of the dentate line, TPC with end ileostomy is advised. IPAA may be contraindicated in cases with severe proctitis due to bleeding risk or radiation intolerance. Overall, IPAA is a suitable option for selected FAP or UC patients with CRC.