ID | 118007 |
Author |
Ishikawa, Hideki
Kyoto Prefectural University of Medicine
Yamada, Masayoshi
National Cancer Center Hospital
Tanaka, Shinji
Hiroshima University
Chino, Akiko
Cancer Institute Hospital
Tajika, Masahiro
Aichi Cancer Center Hospital
Doyama, Hisashi
Ishikawa Prefectural Central Hospital
Takayama, Tetsuji
Tokushima University
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Ohda, Yoshio
Hyogo College of Medicine
Horimatsu, Takahiro
Kyoto University
Sano, Yasushi
Sano Hospital
Tanakaya, Kohji
National Hospital Organization Iwakuni Clinical Center
Ikematsu, Hiroaki
National Cancer Center Hospital East
Saida, Yoshihisa
Toho University
Ishida, Hideyuki
Saitama Medical University
Takeuchi, Yoji
Osaka International Cancer Institute
Kashida, Hiroshi
Kindai University
Kiriyama, Shinsuke
Gunma Chuo Hospital
Hori, Shinichiro
National Hospital Organization Shikoku Cancer Center
Lee, Kyowon
Moriguchi Keijinkai Hospital
Tashiro, Jun
Toshiba Hospital
Kobayashi, Nozomu
Tochigi Cancer Center
Nakajima, Takeshi
National Cancer Center Hospital
Suzuki, Sadao
Nagoya City University
Mutoh, Michihiro
Kyoto Prefectural University of Medicine|National Cancer Center
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Content Type |
Journal Article
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Description | Background
Total colectomy is the standard treatment for familial adenomatous polyposis (FAP). Recently, an increasing number of young patients with FAP have requested the postponement of surgery or have refused to undergo surgery. We aimed to evaluate the effectiveness of intensive endoscopic removal for downstaging of polyp burden (IDP) in FAP. Method A single-arm intervention study was conducted at 22 facilities. Participants were patients with FAP, aged ≥ 16 years, who had not undergone colectomy or who had undergone colectomy but had ≥ 10 cm of large intestine remaining. For IDP, colorectal polyps of ≥ 10 mm were removed, followed by polyps of ≥ 5 mm. The primary end point was the presence/absence of colectomy during a 5-year intervention period. Results 222 patients were eligible, of whom 166 had not undergone colectomy, 46 had undergone subtotal colectomy with ileorectal anastomosis, and 10 had undergone partial resection of the large intestine. During the intervention period, five patients (2.3 %, 95 % confidence interval [CI] 0.74 %–5.18 %) underwent colectomy, and three patients died. Completion of the 5-year intervention period without colectomy was confirmed in 150 /166 patients who had not undergone colectomy (90.4 %, 95 %CI 84.8 %–94.4 %) and in 47 /56 patients who had previously undergone colectomy (83.9 %, 95 %CI 71.7 %–92.4 %). Conclusion IDP in patients with mild-to-moderate FAP could have the potential to be a useful means of preventing colorectal cancer without implementing colectomy. However, if the IDP protocol was proposed during a much longer term, it may not preclude the possibility that a large proportion of colectomies may still need to be performed. |
Journal Title |
Endoscopy
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ISSN | 0013726X
14388812
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NCID | AA00635110
AA12760142
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Publisher | Georg Thieme Verlag
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Volume | 55
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Issue | 4
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Start Page | 344
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End Page | 352
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Published Date | 2022-10-10
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Rights | This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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language |
eng
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departments |
Medical Sciences
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