Familial adenomatous polyposis: proctocolectomy with an ileal pouch versus rectal preservation
Rodríguez SanJuán, J.C.; Casanova Rituerto, D.; Martino Fernández, E.; Fernández Escalante, J.C.; Gómez Fleitas, J.M.; Herrera Noreña, L.; Olmedo Mendicoague, F.; Naranjo Gómez, A.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 82(3): 159-163
1992
ISSN/ISBN: 1130-0108 PMID: 1329886 Document Number: 396029
We assess postoperative complications and functional results of surgery in familial adenomatous polyposis (FAP): Group I (n = 11): restorative proctocolectomy with ileoanal anastomosis (RPIA); Group II (n = 8): colectomy with ileorectal anastomosis (IRA): we also have evaluated the presence of malignancy in the rectum in the latter group. Group I: pelvic abscess (9.1%); intestinal obstruction (9.1%), both requiring reintervention. There was complete anal continence in 81.8%; only one patient needed catheter drainage of the reservoir (9.1%). There were two cases of pouchitis (16.7%). Group II: One patient suffered anastomotic leakage (12.5%) and another one a leakage of the loop ileostomy closure, with and secondary, abdominal abscess (12.5%). There was no incontinence. In spite of periodic endoscopic surveillance rectal adenocarcinoma appeared in 347 patients with complete follow-up (42.9%). Because of the risk of rectal malignancy with IRA and the good functional results of RPIA we consider the latter as the procedure of choice and also advisable the transformation of IAR into RPIA.