Abstract:
BACKGROUND:The appearance of a carcinoma in the ileal pouch after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative proctocolitis is rare. Most of these adenocarcinomas previously described in literature develop from residual viable rectal mucosa. We report a case of an adenocarcinoma arising in all probability from the ileal pouch after malignant transformation of the ileal pouch mucosa based on a chronic atrophic pouchitis. PATIENT AND METHODS:A 34-year-old man developed an adenocarcinoma after a double-stapled ileorectal J-pouch for ulcerative colitis (UC) proceeded from malignant ileal transformation. Before surgery, he had a 20-year history of UC refractory to medical therapy, but no occurrence of backwash ileitis, dysplasia or colitis-associated illness. He experienced severe pouchitis after IPAA since the ileostomy closure. Carcinoma was ensured by endoscopy, and the patient underwent an abdominoperineal pouch extirpation combined with excision of perirectal tissues and anal canal. Histology after surgery showed a pT4,pN2(4/16)pM0,G3 adenocarcinoma with global severe chronic atrophic pouchitis (CAP), villous atrophy and malignant ileal transformation. No metaplasia of the rectal mucosa was found, not even malignant epithelial transformation of the anal canal. CONCLUSION:This case suggests that a malignant transformation of the ileal pouch mucosa may occur as a pure complication of severe CAP, even in the absence of backwash ileitis or a previous history of cancer. The absence of metaplasia of the rectal mucosa revealed the passage from CAP to dysplastic epithelium and to cancer. A multifactorial development of carcinogenesis is supposed, but we emphasize the importance of severe CAP, and that careful surveillance is needed in patients after IPAA. We must submit that this is just a case report and cannot stand for general cancer development in ulcerative colitis, but it may point out the risk factor of chronic inflammation and leads the surgeon to skillful working when building the pouch.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Knupper N,Straub E,Terpe HJ,Vestweber KHdoi
10.1007/s00384-005-0063-8subject
Has Abstractpub_date
2006-07-01 00:00:00pages
478-82issue
5eissn
0179-1958issn
1432-1262journal_volume
21pub_type
杂志文章abstract::With the introduction of total mesorectal excision (TME) for treatment of rectal cancer, the prognosis of patients with rectal cancer is improved. With this better prognosis, there is a growing awareness about the quality of life of patients after rectal carcinoma. Laparoscopic total mesorectal excision (LTME) for rec...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-005-0009-1
更新日期:2006-05-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1341-2
更新日期:2012-03-01 00:00:00
abstract:PURPOSE:Bilirubin is known to have antioxidant effects. Several pieces of evidence regarding association between serum bilirubin and UC exist. Three studies found that serum bilirubin was inversely associated with severity of ulcerative colitis (UC), but no evidence regarding an association between serum bilirubin and ...
journal_title:International journal of colorectal disease
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更新日期:2021-02-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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abstract:PURPOSE:No consensus exists regarding the use of preoperative bowel preparation for patients undergoing a low anterior resection (LAR). Several comparative studies show similar outcomes when a single time enema (STE) is compared with mechanical bowel preparation (MBP). It is hypothesized that STE is comparable with MBP...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03651-6
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND AIMS:This study evaluated the postoperative complications and clinical results of restorative proctocolectomy without diverting ileostomy for ulcerative colitis. PATIENTS AND METHODS:One hundred selected patients had a hand-sewn ileal J-pouch anal anastomosis with mucosectomy using an ultrasonically act...
journal_title:International journal of colorectal disease
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doi:10.1007/s00384-003-0538-4
更新日期:2004-05-01 00:00:00
abstract:AIM:An illustration of the diagnosis and management of tailgut cysts. MATERIALS AND METHODS:Two cases of tailgut cyst and a review of the literature. RESULTS:A female patient presented with acute urinary retention with a retrorectal mass felt during rectal examination and confirmed on ultrasound and magnetic resonanc...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-008-0598-6
更新日期:2009-03-01 00:00:00
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journal_title:International journal of colorectal disease
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doi:10.1007/s00384-003-0490-3
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journal_title:International journal of colorectal disease
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doi:10.1007/s00384-015-2356-x
更新日期:2015-12-01 00:00:00
abstract::The abdominal distribution of orally ingested radioopaque markers is used to assess total and segmental colonic transit in constipated patients, but interpretation may depend on whether studies are carried out on a full colon or one cleared of faeces. We asked 25 severely constipated patients (age 18-74; 22 F, 3 M) to...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00299331
更新日期:1993-07-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究
doi:10.1007/s00384-019-03496-8
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:Since colorectal endoscopic submucosal dissection (ESD) requires higher-level skills than endoscopic mucosal resection (EMR), it is recommended to acquire sufficient experience in gastric ESD prior to attempting colorectal ESD. We evaluated the ability of experienced endoscopists with limited experience in gast...
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更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Aberrant activation of the Wnt/β-catenin pathway plays a major role in the development of colorectal carcinoma (CRC). Axin 2 is a key protein of this pathway and is upregulated in CRC. Here, we investigated RNA- and protein expression of axin 2 in CRC tissues at the single cell level. Moreover, the association ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1709-6
更新日期:2013-11-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-020-03686-9
更新日期:2020-09-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-016-2672-9
更新日期:2017-01-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050059
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Neoadjuvant chemoradiation (nCRT) followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. This prospective study evaluates the effect of nCRT on postoperative anorectal function and continence. PATIENTS AND METHODS:Group A consisted of 12 patie...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-007-0322-y
更新日期:2007-11-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0132-7
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050147
更新日期:1998-01-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01648441
更新日期:1986-07-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1972-1
更新日期:2014-09-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-05-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1833-y
更新日期:2014-04-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:2014-08-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0258-7
更新日期:2007-09-01 00:00:00
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1317-2
更新日期:2012-03-01 00:00:00
abstract::In the past, it has been noted that experimental tumour cells inoculated into the peritoneal cavity or into the lumen of the bowel will grow at a recently formed colonic anastomosis. However, it has previously been unclear whether the healing process enhances tumour growth or whether the presence of a suture line mere...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF01649697
更新日期:1989-08-01 00:00:00