| Theme | Gastrointestinal polyposis -- progress in the diagnosis and treatment | |
|---|---|---|
| Title | Surgical treatment of gastrointestinal polyposis | |
| Publish Date | 2016/05 | |
| Author | Toshiro Ogura | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Noriyasu Chika | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Jun Sobajima | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Toru Ishiguro | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Minoru Fukuchi | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Yoichi Kumagai | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Keiichiro Ishibashi | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Erito Mochiki | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| Author | Hideyuki Ishida | Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University |
| [ Summary ] | The lifetime risk of colorectal cancer in patients with familial adenomatous polyposis (FAP) reaches almost 100 %. To prevent colorectal cancer, total proctocolectomy has been recommended as a standard surgical treatment for patients with FAP. Although the purpose of prophylactic proctocolectomy is to prevent colorectal cancer, the choice of a surgical procedure is based on patient and medical factors such as age, sphincter function, cosmetic concerns, fertility, potential complications of each procedure, and the availability of postoperative surveillance. Since duodenal carcinoma is one of the major causes of death in FAP patients, it is important to control duodenal polyposis. We discussed management and the Spigelman classification for duodenal lesions. Spigelman stage IV and V duodenal adenomatosis should be treated properly. In addition to pancreatoduodenectomy, pancreas-sparing duodenectomy, which preserves pancreatic function and prevents postoperative long-term complications such as steatohepatitis or recurrent cholangitis, is one of the many options available to prevent mortality due to Spigelman stage IV duodenal cancer in FAP patients. | |