Early surgical and functional outcomes of totalproctocolectomy and ileal pouch in patients with familialadenomatous polyposis

Abstract

Familial adenomatous polyposisis the most common adenomatous polyposis illnesses. It is an inherited autosomal illness described by the early beginning of hundreds to thousands of adenomatous polyps throughout the colon. If left untreated, all patients with this syndrome usually have cancer of the colon by age35-40years.The aim of current study was toexplore how and why a disease (FAP) process is started or maintained in a given population or place. A prospective cross-sectional study carried out in Gastroenterology and Hepatology Centre at Teaching Hospital and Baghdad Teaching Hospital/Baghdad, Iraq. Data collection extended from 1st of august 2016 to 1st of February 2018. Data collected included patient's name, age, gender, phone number and address, family history, past medical and past surgical history, clinical examination. In addition, investigations performed included hematological, biochemical, radiological and endoscopic tests. Also, information gathered from the patients before surgical interference. Patients underwent 3 surgical options according to biopsy results and surgeon's preference intra-operatively. The latter included total proctocolectomy with ileum-anal pouch anastomosis, total colectomy with ileum rectal anastomosis or total proctocolectomy with continent ileostomy. A total of 11 patients (6 males and 5females) aged 18-44 years old. Family history was positive in 10 patients, and negative in one male patient. Complications occurred in an equal frequency for fistula, stricture, leak and sepsis with a 9.1% for each, while there were no complications of ischemia, paucities and obstruction. Also, 45.5% of patients developed ileal pouch-related complications, as perianal sepsis in 18.2%, wound infection in 18.2%and intra-abdominal abscess in 9.1%. Moreover, Ileostomy was done for 7 patients (54%). Restorative proctocolectomy with ileal pouch anal anastomosis is the procedure of choice for patients with familial adenomatous polyposis.