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Pouch Neoplasia Following IPAA in Patients with Underlying Inflammatory Bowel Diseases

  • Freeha Khan
  • Bo ShenEmail author
Chapter

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.

Keywords

Dysplasia Histopathology Ileal pouch Inflammatory bowel disease Neoplasia Pouchoscopy Surveillance 

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

Notes

Disclosure

The authors declared no financial conflict of interest.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Center for Inflammatory Bowel Disease, Digestive Disease and Surgery Institute-A31Cleveland ClinicClevelandUSA

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