直近一年間の累計
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ID 118007
著者
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
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
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
Endoscopy
ISSN
0013726X
14388812
cat書誌ID
AA00635110
AA12760142
出版者
Georg Thieme Verlag
55
4
開始ページ
344
終了ページ
352
発行日
2022-10-10
権利情報
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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出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
医学系