Pouch Neoplasia Following IPAA in Patients with Underlying Inflammatory Bowel Diseases
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.
KeywordsDysplasia Histopathology Ileal pouch Inflammatory bowel disease Neoplasia Pouchoscopy Surveillance
Anal transitional zone
Endoscopic mucosal resection
Inflammatory bowel disease
Indefinite for dysplasia
Ileal pouch-anal anastomosis
Primary sclerosing cholangitis
The authors declared no financial conflict of interest.