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Pouch Neoplasia Following IPAA in Patients with Underlying Inflammatory Bowel Diseases

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Cancer Screening in Inflammatory Bowel Disease

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Abstract

Patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis for underlying inflammatory bowel disease are at a low risk for developing low-grade dysplasia (LGD), high-grade dysplasia (HGD), or even adenocarcinoma in the pouch. However, those with a precolectomy colitis-associated neoplasia are at a high risk for pouch neoplasia. Patients with pouch adenocarcinoma have poor prognosis. A combined clinical, endoscopic, and histologic examination plays an essential role in diagnosis and management. Surveillance pouchoscopy is recommended for patients with a preoperative colitis-associated neoplasia.

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Abbreviations

ATZ:

Anal transitional zone

CAN:

Colitis-associated neoplasia

CD:

Crohn’s disease

CRC:

Colorectal cancer

EMR:

Endoscopic mucosal resection

HGD:

High-grade dysplasia

IBD:

Inflammatory bowel disease

IND:

Indefinite for dysplasia

IPAA:

Ileal pouch-anal anastomosis

LGD:

Low-grade dysplasia

PSC:

Primary sclerosing cholangitis

UC:

Ulcerative colitis

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Disclosure

The authors declared no financial conflict of interest.

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Authors and Affiliations

  1. Center for Inflammatory Bowel Disease, Digestive Disease and Surgery Institute-A31, Cleveland Clinic, Cleveland, OH, USA

    Freeha Khan & Bo Shen

Authors
  1. Freeha Khan
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  2. Bo Shen
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Correspondence to Bo Shen .

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Editors and Affiliations

  1. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Joseph D. Feuerstein

  2. Center for Inflammatory Bowel Disease, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Adam S. Cheifetz

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Khan, F., Shen, B. (2019). Pouch Neoplasia Following IPAA in Patients with Underlying Inflammatory Bowel Diseases. In: Feuerstein, J., Cheifetz, A. (eds) Cancer Screening in Inflammatory Bowel Disease . Springer, Cham. https://doi.org/10.1007/978-3-030-15301-4_6

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  • DOI: https://doi.org/10.1007/978-3-030-15301-4_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15300-7

  • Online ISBN: 978-3-030-15301-4

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