The prognosis of clinical course and the analysis of the frequency of the inflammation and dysplasia in the intestinal J-pouch at the patients after restorative proctocolectomy due to FAP.
The prognosis of clinical course and the analysis of the frequency of the inflammation and dysplasia in the intestinal J-pouch at the patients after restorative proctocolectomy due to FAP.
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DOI：
10.1007/s00384-011-1241-5
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发表时间：
2011-09
影响因子：
2.8
通讯作者：
Drews M
中科院分区：
文献类型：
--
作者：
Banasiewicz T;Marciniak R;Kaczmarek E;Krokowicz P;Paszkowski J;Lozynska-Nelke A;Gronek P;Plawski A;Drews M
家族性腺瘤性息肉病（FAP）的主要手术方法是J形贮袋直肠结肠切除术和回肠临时袢式造口术。本研究的目的是分析FAP患者在恢复性直肠结肠切除术后肠囊发育不良和炎症的发生率以及临床病程的预后。分析了1985-2009年间接受恢复性直肠结肠切除术的165例FAP患者（86例女性和79例男性，平均年龄22.49 ± 12岁）。对2004-2009年随访观察的临床资料进行评价。对所有患者进行临床检查和内镜检查，并进行息肉切除术和/或囊袋粘膜活检。回肠贮袋-肛门吻合术后发生贮袋炎的平均时间为6个月。低度异型增生的平均时间为14个月。与单纯结肠袋炎相比，上述手术后低度异型增生的时间差异很大。高度异型增生的平均时间为16个月，肿瘤形成甚至为19个月。据估计，术后第一年内发生的早期结肠袋炎发生在5%的患者中，低度异型增生发生在4年后的7%的病例中，高度异型增生发生在7年后的约10%的患者中，肿瘤发生在15%的病例中。总之，全国范围内的息肉病登记是控制FAP患者的最佳方法。定期终身内窥镜监测提供了早期发现异型增生的机会，并可防止肿瘤形成。
The main operative method in familial adenomatous polyposis (FAP) patients is restorative proctocolectomy with “J”-shaped pouch and temporary loop ileostomy. The aim of the study was the analysis of the frequency of the dysplasia and inflammation in the intestinal pouch and prognosis of the clinical course in FAP patients after restorative proctocolectomy. A group of 165 FAP patients (86 females and 79 males, mean age 22.49 ± 12) subjected to a restorative proctocolectomy in the years 1985–2009 was analyzed. Clinical data coming from follow-up observation in the period of 2004–2009 were evaluated. In all patients, clinical examination and endoscopy with polypectomy and/or biopsy of pouch mucosa were done. The mean time of pouchitis occurrence after an ileal pouch-anal anastomosis was 6 months. Mean time for low-grade dysplasia was 14 months. The time difference of low-grade dysplasia after the above procedure as compared to pouchitis alone was substantial. Mean time for high-grade dysplasia was 16 months and for neoplasia even 19 months. It was estimated that early pouchitis happening within the first year after surgery occurs in 5% of patients, low-grade dysplasia 4 years later in 7% of cases, high-grade dysplasia 7 years later in around 10% of patients and neoplasia 14 years after surgery in 15% of cases. In conclusion, the Polyposis Registry encompassing whole country is the best way of controlling FAP patients. The regular lifelong endoscopic monitoring gives the opportunity of the early detection of the dysplasia and can protect against neoplasia.
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影响因子：
8.9
作者：
SANDBORN, WJ;TREMAINE, WJ;PHILLIPS, SF
通讯作者：
PHILLIPS, SF
影响因子：
9.6
作者：
Aziz, O;Athanasiou, T;Tekkis, PP
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Tekkis, PP
影响因子：
3.9
作者：
Remzi, FH;Fazio, VW;Lavery, IC
通讯作者：
Lavery, IC
影响因子：
12.6
作者：
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通讯作者：
Vasen, Hans F. A.
影响因子：
9.3
作者：
Moussata, D.;Nancey, S.;Saurin, J. C.
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Saurin, J. C.