Prevalence and Morphology of Pouch and Ileal Adenomas in Familial Adenomatous Polyposis

• Published in: Diseases of the colon & rectum Vol. 48; no. 4; pp. 816 - 823
• Main Authors: Groves, Christopher J, Beveridge, Iain G, Swain, David J, Saunders, Brian P, Talbot, Ian C, Nicholls, John R, Phillips, Robin K
• Format: Journal Article
• Language: English
• Published: Secaucus, NJ The ASCRS 01.04.2005; Springer; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adenoma - epidemiology; Adenoma - etiology; Adenomatous Polyposis Coli - complications; Adenomatous Polyposis Coli - surgery; Adolescent; Adult; Age Factors; Aged; Anastomosis, Surgical; Biological and medical sciences; Colonic Pouches - pathology; Endoscopy, Gastrointestinal; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Genotype; Humans; Ileal Neoplasms - epidemiology; Ileal Neoplasms - etiology; Male; Medical sciences; Middle Aged; Phenotype; Prevalence; Proctocolectomy, Restorative; Prospective Studies; Risk Factors; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tumors; Prevalence; Ileal neoplasms; Restorative; Adenoma; Familial adenomatous polyposis coli; Epidemiology; Ileum; Genetic disease; Adenomatous polyposis coli; Treatment; Surgery; Morphology; Rectum; Digestive diseases; Intestinal disease; Proctocolectomy; Benign neoplasm; Colon
• ISSN: 0012-3706; 1530-0358
• DOI: 10.1007/s10350-004-0835-1

PURPOSE: METHODS: RESULTS:Adenomatous polyps were found in the pouches of 34 patients (57 percent). A total of 362 polyps were identified (range, 0-50 per patient). A logistic regression model confirmed that there was a significant association between the increasing age of the patient and the presence of pouch adenomas (P < 0.02) and the length of follow-up since pouch surgery (P < 0.05). There was no apparent relationship between the development of pouch adenomas and the severity of either colonic or duodenal polyposis and there were no clear genotype or phenotype correlations. Most polyps were tubular adenomas with mild dysplasia, but 11 patients had more advanced histology, including two patients with large villous adenomas. Nonpouch ileal mucosa was spared from visually observed adenomas, with only 1 of 48 (2 percent) patients with ileorectal anastomosis adenomas and 0 of 20 (0 percent) younger, precolectomy patients having terminal ileal adenomas. However, microadenomas were present on random biopsy in 4 percent to 5 percent of nonpouch ileum. CONCLUSION: