Complicacções cirúrgicas e risco de câncer retal metacrônico em pacientes com polipose adenomatosa familiar clássica

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Abstract

Introduction: Familial adenomatous polyposis (FAP), an autosomal dominant disease char-acterized by development of numerous adenomatous polyps in the colon and rectum, iscaused by germline mutations in the Adenomatous Polyposis Coli (APC) gene.Methods: To determine the surgical morbidity in patients with classical familial adeno-matous polyposis and determine the incidence of metachronous colorectal cancer (CRC) inthose undergoing total colectomy (TC) with ileorectal anastomosis or restorative total proc-tocolectomy (TPC) and ileal pouch anal anastomosis. We analyzed patients with familialadenomatous polyposis who received treatment and regular follow-up at the A.C. CamargoCancer Center from 1994 to 2013.Results: Operative complications occurred in 22 patients (34.3%), 16 (25%) being early compli-cations and 8 (12.5%) late complications. No mortality occurred as a result of postoperativecomplications. The incidence of metachronous rectal cancer after total proctocolectomywas 2.3% and after total colectomy 18.18% (p = 0.044).Conclusions: In order to provide better quality of life for individuals with familial ade-nomatous polyposis, total colectomy is commonly offered, as this simple technique istraditionally associated with lower rates of postoperative complications and better func-tional outcomes. However, it has become a less attractive technique in patients with familialadenomatous polyposis in its classical or diffuse form, since it has a significantly higherprobability of metachronous rectal cancer.

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Filho, P. R. S., Aguiar, S., Ferreira, F. O., Nakagawa, W. T., Spencer, R. M., Takahashi, R. M., … Lopes, A. (2015). Complicacções cirúrgicas e risco de câncer retal metacrônico em pacientes com polipose adenomatosa familiar clássica. Journal of Coloproctology, 35(1), 8–13. https://doi.org/10.1016/j.jcol.2015.01.006

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