Adenocarcinoma in the anal transitional zone after ileal pouch for ulcerative colitis - Report of a case
Adenocarcinoma in the anal transitional zone after ileal pouch for ulcerative colitis - Report of a case
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DOI：
10.1007/s10350-004-7293-7
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发表时间：
2003-08-01
影响因子：
3.9
通讯作者：
Neill, M
中科院分区：
文献类型：
--
作者：
Bell, SW;Parry, B;Neill, M
本文报告已知的第七例溃疡性结肠炎直肠切除术后发生在回肠袋或其附近的腺癌。这是第二例报告的腺癌在肛门移行区在这种情况下。文献回顾了先前发表的六个案例，以及更广泛的主题--如何最好地管理肛门移行区。结论是，这是一种罕见但灾难性的事件，预后可能很差，可能发生在最初手术后的晚期(超过十年)。所有溃疡性结肠炎患者均应延长回肠袋的使用时间。异型增生的发展需要密切的随访，包括定期的活检，局部切除和眼袋推进可以治疗持续性的异型增生。当手术治疗异型增生或癌症时，应对肛门移行区进行活组织检查或考虑强制粘膜切除术。
This article reports the seventh known case of adenocarcinoma arising in or adjacent to an ileal pouch after proctocolectomy for ulcerative colitis. It is the second reported case of adenocarcinoma in the anal transitional zone in this setting. A literature review is presented of the six previous cases published, and on the wider subject of how to best manage the anal transitional zone. It is concluded that this is a rare, but catastrophic, event with a potentially poor prognosis and can occur late (more than a decade) after the original surgery. All ileal pouches performed for ulcerative colitis should be followed for extended periods. The development of dysplasia necessitates close follow-up, including regular biopsies, and local excision and pouch advancement can manage persistent dysplasia. When operating for dysplasia or cancer, biopsies of the anal transitional zone should be performed or consideration given to mandatory mucosectomy.