These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Surgical treatment and long-term outcome of patients with familial adenomatous polyposis: 16 years experience at the Tel Aviv Sourasky Medical Center.
    Author: Tulchinsky H, Keidar A, Goldman G, Klausner JM, Rabau M.
    Journal: Isr Med Assoc J; 2005 Feb; 7(2):82-5. PubMed ID: 15729956.
    Abstract:
    BACKGROUND: Restorative proctocolectomy eliminates the risk of colorectal cancer in patients with familial adenomatous polyposis. Complications and extra-intestinal manifestations are inherent to the procedure. OBJECTIVES: To evaluate operative procedures, complications, early and late results and long-term functional outcome in FAP patients operated in our department. METHODS: The study group included all patients with FAP who were operated between 1988 and 2003. Demographic data, length of follow-up, complications, colorectal cancer, pouch function and extracolonic manifestations were recorded. RESULTS: Median age at surgery was 33 years (range 13-61 years). The final operative breakdown was: 48 proctocolectomies, 41 ileal pouch-anal anastomoses, 2 Kock's pouch, 5 permanent ileostomies, and 2 colectomies with ileorectal anastomosis. There was no perioperative mortality. Early and late complications occurred in 20 and 9 patients, respectively. Twelve patients required reoperation. Colorectal carcinoma was diagnosed in eight patients, three of whom were in an advanced stage. The mean follow-up was 74 months (range 3-288 months). Four patients were lost to follow-up. Extracolonic manifestations developed in 38 patients, including desmoid tumors (in 12), duodenal adenomas (in 9), pouch adenomas (in 5), and rectal stump adenomas (in 3). Two patients died (4%) because of desmoid tumor and malignant fibrous histiocytoma. At last follow-up, 37 IPAA patients have (median) six bowel movements/24 hours and good fecal control. CONCLUSIONS: Restorative proctocolectomy can be performed with low mortality, acceptable morbidity, and good functional results. Patients should be closely followed after surgery for development of other manifestations of the syndrome. Relatives of the affected patients should be referred to a specialist multidisciplinary clinic.
    [Abstract] [Full Text] [Related] [New Search]