Skip to main content
SpringerLink
Log in

Deciding on an IRA vs. IPAA for FAP

  • Chapter
  • First Online:
Difficult Decisions in Colorectal Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Familial adenomatous polyposis (FAP) is a dominantly inherited form of cancer predisposition due to a germline mutation in the colorectal cancer gateway gene, APC. The syndrome usually presents as colorectal adenomatous polyposis of varying severity, which, if untreated, will lead to colorectal cancer at a young age. While other organs are also affected by the cancer predisposition, by far the most serious threat to life and lifestyle comes from the large bowel. This is therefore the initial focus of treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ripa R, Bisgaard ML, Bulow S, Nielsen FC. De novo mutations in familial adenomatous polyposis (FAP). Eur J Hum Genet. 2002;10:631–7.

    Article  CAS  PubMed  Google Scholar 

  2. Kartheuser AH, Parc R, Penna CP, Tiret E, Frileux P, Hannoun L, Nordlinger B, Loygue J. Ileal pouch-anal anastomosis as the first choice operation in patients with familial adenomatous polyposis: a ten-year experience. Surgery. 1996;119(6):615–23.

    Article  CAS  PubMed  Google Scholar 

  3. Koskenvuo L, Renkonen-Sinisalo L, Jarvinen HJ, Lepisto A. Risk of cancer and secondary proctectomy after colectomy and ileorectal anastomosis in familial adenomatous polyposis. Int J Colorectal Dis. 2014;29:225–30.

    Article  CAS  PubMed  Google Scholar 

  4. Church J, Burke C, McGannon E, Pastean O, Clark B. Risk of rectal cancer in patients after colectomy and ileorectal anastomosis for familial adenomatous polyposis: a function of available surgical options. Dis Colon Rectum. 2003;46:1175–81.

    Article  PubMed  Google Scholar 

  5. Soravia C, O’Connor BI, Berk T, McLeod RS, Cohen Z. Functional outcome of conversion of ileorectal anastomosis to ileal pouch-anal anastomosis in patients with familial adenomatous polyposis and ulcerative colitis. Dis Colon Rectum. 1999;42:903–8.

    Article  CAS  PubMed  Google Scholar 

  6. Penna C, Kartheuser A, Parc R, Tiret E, Frileux P, Hannoun L, Nordlinger B. Secondary proctectomy and ileal pouch-anal anastomosis after ileorectal anastomosis for familial adenomatous polyposis. Br J Surg. 1993;80:1621–3.

    Article  CAS  PubMed  Google Scholar 

  7. von Roon AC, Tekkis PP, Lovegrove RE, Neale KF, Phillips RK, Clark SK. Comparison of outcomes of ileal pouch-anal anastomosis for familial adenomatous polyposis with and without previous ileorectal anastomosis. Br J Surg. 2008;95:494–8.

    Article  Google Scholar 

  8. Church J. Ileoanal pouch neoplasia in familial adenomatous polyposis: an underestimated threat. Dis Colon Rectum. 2005;48(9):1708–13.

    Article  PubMed  Google Scholar 

  9. Ozdemir Y, Kalady MF, Aytac E, Kiran RP, Erem HH, Church JM, Remzi FH. Anal transitional zone neoplasia in patients with familial adenomatous polyposis after restorative proctocolectomy and IPAA: incidence, management, and oncologic and functional outcomes. Dis Colon Rectum. 2013;56(7):808–14.

    Article  PubMed  Google Scholar 

  10. Boostrom SY, Mathis KL, Pendlimari R, Cima RR, Larson DW, Dozois EJ. Risk of neoplastic change in ileal pouches in familial adenomatous polyposis. J Gastrointest Surg. 2013;17(10):1804–8.

    Article  PubMed  Google Scholar 

  11. Saigusa N, Kurahashi T, Nakamura T, Sugimura H, Baba S, Konno H, Nakamura S. Functional outcome of stapled ileal pouch-anal canal anastomosis versus handsewn pouch-anal anastomosis. Surg Today. 2000;30(7):575–81.

    Article  CAS  PubMed  Google Scholar 

  12. Schluender SJ, Mei L, Yang H, Fleshner PR. Can a meta-analysis answer the question: is mucosectomy and handsewn or double-stapled anastomosis better in ileal pouch-anal anastomosis? Am Surg. 2006;72(10):912–6.

    PubMed  Google Scholar 

  13. Ganschow P, Warth R, Hinz U, Büchler MW, Kadmon M. Early postoperative complications after stapled vs handsewn restorative proctocolectomy with ileal pouch-anal anastomosis in 148 patients with familial adenomatous polyposis coli: a matched-pair analysis. Colorectal Dis. 2014;16(2):116–22.

    Article  CAS  PubMed  Google Scholar 

  14. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, Nicholls RJ, Fazio VW, Tekkis PP. A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg. 2006;244:18–26.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ko CY, Rusin LC, Schoetz Jr DJ, Moreau L, Coller JA, Murray JJ, Roberts PL, Arnell TD. Does better functional result equate with better quality of life? Implications for surgical treatment in familial adenomatous polyposis. Dis Colon Rectum. 2000;43:829–35.

    Article  CAS  PubMed  Google Scholar 

  16. Church J, O’Malley M, LaGuardia L, Xhaja X, Burke C, Kalady M. Technical problems with ileal pouches in patients with familial adenomatous polyposis. Fam Cancer. 2011;10 Suppl 1:S18.

    Google Scholar 

  17. Soravia C, Klein L, Berk T, O’Connor BI, Cohen Z, McLeod RS. Comparison of ileal pouch-anal anastomosis and ileorectal anastomosis in patients with familial adenomatous polyposis. Dis Colon Rectum. 1999;42(8):1028–33.

    Article  CAS  PubMed  Google Scholar 

  18. Leonard D, Wolthuis A, D’Hoore A, Bruyninx L, Van De Stadt J, Van Cutsem E, Kartheuser A. Different surgical strategies in the treatment of familial adenomatous polyposis: what’s the role of the ileal pouch-anal anastomosis? Acta Gastroenterol Belg. 2011;74:427–34.

    CAS  PubMed  Google Scholar 

  19. Tonelli F, Valanzano R, Monaci I, Mazzoni P, Anastasi A, Ficari F. Restorative proctocolectomy or rectum-preserving surgery in patients with familial adenomatous polyposis: results of a prospective study. World J Surg. 1997;21:653–8.

    Article  CAS  PubMed  Google Scholar 

  20. Koskenvuo L, Mustonen H, Renkonen-Sinisalo L, Järvinen HJ, Lepistö A. Comparison of proctocolectomy and ileal pouch-anal anastomosis to colectomy and ileorectal anastomosis in familial adenomatous polyposis. Fam Cancer. 2015;14(2):221–7.

    Article  CAS  PubMed  Google Scholar 

  21. Bjork J, Akerbrant H, Iselius L, Svenberg T, Oresland T, Pahlman L, Hultcrantz R. Outcome of primary and secondary ileal pouch-anal anastomosis and ileorectal anastomosis in patients with familial adenomatous polyposis. Dis Colon Rectum. 2001;44:984–92.

    Article  CAS  PubMed  Google Scholar 

  22. Kartheuser A, Stangherlin P, Brandt D, Remue C, Sempoux C. Restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis revisited. Fam Cancer. 2006;5:241–60.

    Article  PubMed  Google Scholar 

  23. Vasen HF, van Duijvendijk P, Buskens E, Bulow C, Bjork J, Jarvinen HJ, Bulow S. Decision analysis in the surgical treatment of patients with familial adenomatous polyposis: a Dutch-Scandinavian collaborative study including 659 patients. Gut. 2001;49:231–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Aziz O, Athanasiou T, Fazio VW, Nicholls RJ, Darzi AW, Church J, Phillips RK, Tekkis PP. Meta-analysis of observational studies of ileorectal versus ileal pouch-anal anastomosis for familial adenomatous polyposis. Br J Surg. 2006;93:407–17.

    Article  CAS  PubMed  Google Scholar 

  25. da Luz Moreira A, Church JM, Burke CA. The evolution of prophylactic colorectal surgery for familial adenomatous polyposis. Dis Colon Rectum. 2009;52:1481–6.

    Article  PubMed  Google Scholar 

  26. Church J, Burke C, McGannon E, Pastean O, Clark B. Predicting polyposis severity by proctoscopy: how reliable is it? Dis Colon Rectum. 2001;44(9):1249–54.

    Article  CAS  PubMed  Google Scholar 

  27. Wu JS, Paul P, McGannon EA, Church JM. APC genotype, polyp number and surgical options in familial adenomatous polyposis. Ann Surg. 1998;227(1):57–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Nieuwenhuis MH, Bulow S, Bjork J, Jarvinen HJ, Bulow C, Bisgaard ML, Vasen HFA. Genotype predicting phenotype in familial adenomatous polyposis: a practical application to the choice of surgery. Dis Colon Rectum. 2009;52:1259–63.

    Article  PubMed  Google Scholar 

  29. Vogel J, Church JM, LaGuardia L. Minimally invasive pouch surgery predisposes to desmoid tumor formation in patients with familial adenomatous polyposis. Dis Colon Rectum. 2005;48:662–3.

    Google Scholar 

  30. Filippakis GM, Zografos G, Pararas N, Lanitis S, Georgiadou D, Filippakis MG. Spontaneous regression of rectal polyps following abdominal colectomy and ileorectal anastomosis for familial adenomatous polyposis, without sulindac treatment: report of four cases. Endoscopy. 2007;39:665–8.

    Article  CAS  PubMed  Google Scholar 

  31. Ganschow P, Pfeiffer U, Hinz U, Leowardi C, Herfarth C, Kadmon M. Quality of life ten and more years after restorative proctocolectomy for patients with familial adenomatous polyposis coli. Dis Colon Rectum. 2010;53:1381–7.

    Article  PubMed  Google Scholar 

  32. Hassan I, Chua HK, Wolff BG, Donnelly SF, Dozois RR, Larson DR, Schleck CD, Nelson H. Quality of life after ileal pouch-anal anastomosis and ileorectal anastomosis in patients with familial adenomatous polyposis. Dis Colon Rectum. 2005;48:2032–7.

    Article  PubMed  Google Scholar 

  33. Günther K, Braunrieder G, Bittorf BR, Hohenberger W, Matzel KE. Patients with familial adenomatous polyposis experience better bowel function and quality of life after ileorectal anastomosis than after ileoanal pouch. Colorectal Dis. 2003;5:38–44.

    Article  PubMed  Google Scholar 

  34. Van Duijvendijk P. Quality of life after total colectomy with ileorectal anastomosis or proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis. Br J Surg. 2000;87:590–6.

    Article  PubMed  Google Scholar 

  35. Wuthrich P, Gervaz P, Ambrosetti P, Soravia C, Morel P. Functional outcome and quality of life after restorative proctocolectomy and ileo-anal pouch anastomosis. Swiss Med Wkly. 2009;139(13–14):193–7.

    PubMed  Google Scholar 

  36. Ganschow P, Treiber I, Hinz U, Leowardi C, Büchler MW, Kadmon M. Residual rectal mucosa after stapled vs. handsewn ileal J-pouch-anal anastomosis in patients with familial adenomatous polyposis coli (FAP) – a critical issue. Langenbecks Arch Surg. 2015;400(2):213–9.

    Article  PubMed  Google Scholar 

  37. Vitellaro M, Sala P, Signoroni S, Radice P, Fortuzzi S, Civelli EM, Ballardini G, Kleiman DA, Morrissey KP, Bertario L. Risk of desmoid tumours after open and laparoscopic colectomy in patients with familial adenomatous polyposis. Br J Surg. 2014;101(5):558–65.

    Article  CAS  PubMed  Google Scholar 

  38. Lefevre JH, Parc Y, Kernéis S, Goasguen N, Benis M, Parc R, Tiret E. Risk factors for development of desmoid tumours in familial adenomatous polyposis. Br J Surg. 2008;95(9):1136–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Sandford R. Weiss Center for Hereditary Colorectal Cancer, Cleveland Clinic Foundation, Cleveland, OH, USA

    James Church MBChB, FRACS

Authors
  1. James Church MBChB, FRACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James Church MBChB, FRACS .

Editor information

Editors and Affiliations

  1. Medical Center, University of Chicago, Chicago, Illinois, USA

    Neil Hyman

  2. Medical Center, University of Chicago, Chicago, Illinois, USA

    Konstantin Umanskiy

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Church, J. (2017). Deciding on an IRA vs. IPAA for FAP. In: Hyman, N., Umanskiy, K. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-40223-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40223-9_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40222-2

  • Online ISBN: 978-3-319-40223-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation