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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2022; 28(30): 4152-4162
Published online Aug 14, 2022. doi: 10.3748/wjg.v28.i30.4152
Published online Aug 14, 2022. doi: 10.3748/wjg.v28.i30.4152
Cumulative incidence and risk factors for pouch adenomas associated with familial adenomatous polyposis following restorative proctocolectomy
Hyo Seon Ryu, Chang Sik Yu, Young Il Kim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Jin Cheon Kim, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea
Author contributions: Ryu HS designed and performed the research and wrote the paper; Yu CS designed the research and supervised the report; Kim YI, Lee JL, Kim CW, Yoon YS, Park IJ, Lim SB, and Kim JC provided clinical advice and supervised the report.
Institutional review board statement: The protocol for this research project has been approved by a suitably constituted ethics committee of the institution (Committee of Asan Medical Center, Approval No. 2021-0309), and it conforms to the provisions of the Declaration of Helsinki.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: This study did not receive a specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang Sik Yu, MD, PhD, Professor, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. csyu@amc.seoul.kr
Received: March 3, 2022
Peer-review started: March 3, 2022
First decision: April 11, 2022
Revised: April 24, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: August 14, 2022
Peer-review started: March 3, 2022
First decision: April 11, 2022
Revised: April 24, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: August 14, 2022
Core Tip
Core Tip: This is a retrospective study that evaluated the cumulative incidence and risk factors for pouch adenoma in association with familial adenomatous polyposis following restorative proctocolectomy. The incidence of pouch adenoma was 25.3%, and the cumulative risk 15 years after pouch surgery was 44.1%. Severe colorectal polyposis was a significant risk factor for pouch adenoma development. In our series, 62% of adenomas did not recur after endoscopic removal, but 63% of patients under observation showed progression. There was no spontaneous adenoma diminution or disappearance. Close endoscopic pouch surveillance is essential, and new pouch adenoma management guidelines are needed.