IPAA Is More “Desmoidogenic” Than Ileorectal Anastomosis in Familial Adenomatous Polyposis
This study aimed to investigate the surgical risk factors for desmoid formation.
DESIGN:
This was a retrospective, single-center, registry-based cohort study.
SETTINGS:
This study was conducted at a single academic institution with a prospectively maintained hereditary colorectal cancer database between 1995 and 2015.
PATIENTS:
All patients with familial polyposis (total 345) who underwent either proctocolectomy with a pouch or colectomy with an ileorectal anastomosis during the study period and met inclusion criteria were selected.
MAIN OUTCOME MEASURES:
The development of symptomatic abdominal desmoid disease was the primary end point. Associations between desmoid formation and resection type, surgical approach, and other patient factors were analyzed.
RESULTS:
A total of 172 (49%) patients underwent proctocolectomy/ileoanal pouch, whereas 173 (51%) underwent total colectomy/ileorectal anastomosis. Overall, 100 (28.9%) developed symptomatic desmoids after surgery. On univariable analysis, open surgery and pouch surgery were associated with desmoid development, along with extracolonic manifestations, family history of desmoids, mutation location, and a high desmoid risk score. On multivarible analysis, proctocolectomy with pouch was most strongly associated with desmoid disease (p
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Benign Source Type: research
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