ArticleJournal of surgical case reports2025
Ileal pouch-anal anastomosis in familial adenomatous polyposis and ulcerative colitis with coexisting colorectal cancer: a guideline for treatment.
Article in Journal of surgical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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