TY - JOUR
T1 - Prevalence of laparoscopic surgical treatment and its clinical outcomes in patients with familial adenomatous polyposis in Japan
AU - Ueno, Hideki
AU - Kobayashi, Hirotoshi
AU - Konishi, Tsuyoshi
AU - Ishida, Fumio
AU - Yamaguchi, Tatsuro
AU - Hinoi, Takao
AU - Kanemitsu, Yukihide
AU - Inoue, Yasuhiro
AU - Tomita, Naohiro
AU - Matsubara, Nagahide
AU - Komori, Koji
AU - Ozawa, Heita
AU - Nagasaka, Takeshi
AU - Hasegawa, Hirotoshi
AU - Koyama, Motoi
AU - Akagi, Yoshito
AU - Yatsuoka, Toshimasa
AU - Kumamoto, Kensuke
AU - Kurachi, Kiyotaka
AU - Tanakaya, Kohji
AU - Yoshimatsu, Kazuhiko
AU - Watanabe, Toshiaki
AU - Sugihara, Kenichi
AU - Ishida, Hideyuki
N1 - Publisher Copyright:
© 2016, Japan Society of Clinical Oncology.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Laparoscopic surgery is becoming the preferred technique for most colorectal interventions. This study aimed to clarify the time trend of surgical treatment for familial adenomatous polyposis (FAP) and its relevance to clinical outcomes in Japan over a 13-year period. Methods: This was a multicenter retrospective cohort study comprising 23 specialist institutions for colorectal disease and a cohort of 282 FAP patients who underwent total colectomy or proctocolectomy during 2000–2012. Patient clinical backgrounds and surgical outcomes were compared between the first and second halves of the study period. Results: The proportion of surgical types adopted over the entire study period was 46, 21, 30, and 3 % for ileoanal anastomosis (IAA), ileoanal canal anastomosis, ileorectal anastomosis, and permanent ileostomy, respectively. FAP patients undergoing laparoscopic surgery have increased since 2008 and reached 74 % in the past 3 years. In particular, the number of patients undergoing laparoscopic proctocolectomy with IAA increased approximately four-fold from the first to the second half of the study period. A laparoscopic approach was increasingly used in patients with coexisting colorectal malignancies. Despite this trend, surgical results of the laparoscopic approach between the two study periods showed similar morbidity, pouch operation and stoma closure completion rates. No postoperative mortality was observed in this series, and laparoscopic surgery was comparable to open surgery in terms of stoma closure rate, incidence of intra-abdominal/abdominal desmoid tumors, and postoperative survival rate in both study periods. Conclusion: Laparoscopic approach is increasingly being adopted for prophylactic FAP surgery in Japan and may provide clinically acceptable practical outcomes.
AB - Background: Laparoscopic surgery is becoming the preferred technique for most colorectal interventions. This study aimed to clarify the time trend of surgical treatment for familial adenomatous polyposis (FAP) and its relevance to clinical outcomes in Japan over a 13-year period. Methods: This was a multicenter retrospective cohort study comprising 23 specialist institutions for colorectal disease and a cohort of 282 FAP patients who underwent total colectomy or proctocolectomy during 2000–2012. Patient clinical backgrounds and surgical outcomes were compared between the first and second halves of the study period. Results: The proportion of surgical types adopted over the entire study period was 46, 21, 30, and 3 % for ileoanal anastomosis (IAA), ileoanal canal anastomosis, ileorectal anastomosis, and permanent ileostomy, respectively. FAP patients undergoing laparoscopic surgery have increased since 2008 and reached 74 % in the past 3 years. In particular, the number of patients undergoing laparoscopic proctocolectomy with IAA increased approximately four-fold from the first to the second half of the study period. A laparoscopic approach was increasingly used in patients with coexisting colorectal malignancies. Despite this trend, surgical results of the laparoscopic approach between the two study periods showed similar morbidity, pouch operation and stoma closure completion rates. No postoperative mortality was observed in this series, and laparoscopic surgery was comparable to open surgery in terms of stoma closure rate, incidence of intra-abdominal/abdominal desmoid tumors, and postoperative survival rate in both study periods. Conclusion: Laparoscopic approach is increasingly being adopted for prophylactic FAP surgery in Japan and may provide clinically acceptable practical outcomes.
KW - Desmoid tumor
KW - Familial adenomatous polyposis (FAP)
KW - Laparoscopic surgery
KW - Total colectomy
KW - Total proctocolectomy
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U2 - 10.1007/s10147-016-0953-5
DO - 10.1007/s10147-016-0953-5
M3 - Article
C2 - 26820718
AN - SCOPUS:84955575567
VL - 21
SP - 713
EP - 722
JO - International Journal of Clinical Oncology
JF - International Journal of Clinical Oncology
SN - 1341-9625
IS - 4
ER -