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. Author manuscript; available in PMC: 2014 May 7.
Published in final edited form as: World J Colorectal Surg. 2013;3(2):art1.

Table 3.

Summary of published data on the incidence of adenomas following prophylactic surgery for FAP. This table underscores the fact that mucosectomy does not necessarily prevent the development of adenomas in the ATZ.

Author Nature of study Age at FAP diaqnosis/vears Operatio technique Interval, surgery to adenoma/vears Age at adenoma diagnosis Number of patients operated, followed and studied (n=1412) Number of patients developed adenomas (n=515, (36%) Location Histology
Hamilton, 197929 Prospective series IRA 2 and 26 Not reported 9 Pouch mucosa and ARS Adenomas
Beart, 198233 Case report 22 KP 16 48 1 1 Kock continent ileostomy Tubulovillous adenoma
Wolfstein, 198294 Retrospective IAA 3 2 2 Rectal mucosa Adenomas 8 and 12 cm
Jarvinen, 198395 Retrospective IRA Not reported 5 1 ARS Adenomas
Burt,198496 Retrospective IRA 11 6 ARS Adenomas
Shepherd, 198719 Retrospective RPC 1 12 2 Pouch mucosa Adenomas (LGD)
Stryker, 198737 Case report KP 12 33 1 1 Reservoir adenomas Tubulovillous adenomas
Myrhoj, 198923 Case report IAA 25 12 1 1 IAA Adenomas to 12 cm (LGD)
Nugent, 199262 Retrospective 26 IRA 30 56 222 5 Pouch mucosa Adenomas (LGD)
Nugent, 199330 Retrospective RPC 0.1, 0.25 and 1 Mean 28 (range, 12–65) 50 38 Pouch mucosa Adenomas
Bertoni, 199528 Retrospective IRA Not reported 17 9 ARS Adenomas
Church, 199631 Case report RPC Not reported 1 1 Pelvic pouch mucosa Adenomas
Wu, 199879 Retrospective RPC Not reported 26 11 Pouch mucosa, gut above pouch & ATZ Adenomas
Van Duijvendijk, 199973 Retrospective Not reported RPC (6 mucosectomized & 7 stapled anastomoses 38 (range 22–60) Median, 35(16–60) 126 13 Anastomotic site Adenomas, 4 moderate dysplasia, 4 mild dysplasia and 4 severe dysplasia
Valle, 200197 Retrospective RPC 5 Not reported 1 1 Diffuse Adenomas
Thompson-Fawcett, 200120 Retrospective 5 KP, 28 RPC 7 33 21 Pouch mucosa Adenomas 1 to 3 mm
Pare, 200121 Retrospective RPC initial procedure, in 19 converted IRA to a RPC Mean ± SDE, 7.1 ± 4.5) 27 (range,9–67; mean ± SDE, 28±12) 85 30 Pouch mucosa Adenomas (in 28 grossly vissible (one HGD, 21 LGD) <->5mm,and in 2 microadenomas)
Polese, 200398 Retrospective series Not reported RPC 0.3 to 12 9 and 11 46 (9 handsewn / 37 stapled IPAA) 2 Pouch mucosa & at the margin Adenomas
Beveridge, 200432 Case report Median 35 (range, 32–38) RPC 4 and 10 32 and 38 2 2 Lower pouch 2 cm of terminal cuff - behind a fold in the upper pouch. Terminal ileum & rectal glandular mucosa from incomplete MU Adenoma 3 cm × 2 cm & 2 cm × 2 cm large. Tubulovillous adenomas Microadenomas
Groves, 200522 Retrospective Median, 25 (range, 13 to 45) IRA Mean 12 (range 0 to 39) 18 to 65 30 IPAA and 30 conversional IRA 34 ARS Adenomas (5 patients had > 1 cm)
Von Roon, 200774 and 201125 Retrospective and Retrospective Mean, 32.6±10.8 and 32.6±11.9 (range 17–63) RPC (121(64%) were hand- sewn and 54 (29%) stapled)).
W-pouch, n=57; J-pouch, 102; and S-pouch, n=10) and RPC + MUC
Mean 10.4 (mucosectomy group) and 7.2 (stapled group) and 7,7,8, 12, 13, 11, 11, 12, 23&13 Mean 10 (range, 2 to 23) and 28.7±12 (mean±SD) 91 of 189 and 189 of 189 (out of 1,652) 24 and 96 Handsewn vs. stapled (19% vs. 38%; p= 0.047) Adenomas and adenomas (9 patients had > 10 mm)
Adenomas: 18/23 (78%)(1 HGD & 16 LGD)
Moussata, 200853 Retrospective 42.6±11.7 (mean±SD) IPAA (23)
IRA(n=21)
4.7 ±3.3 (mean ±SD)
16.4 (mean ± SD)
28.7±12 (mean±SD) 44 18
10
Pouch mucosa
ARS
Adenomas: 16/21 (77%)(2 HGD & 8 LGD) & lymphoid nodular hyperplasis in 6
Tonellie, 201217 Prospective 32.6±11.9 (range 17–63) RPC+MUC(51); IRA (18, later RPC) 11 (range 1–24). Mean endoscopic session was 9, range, 3–22 the number of adenomas ranged 1–47 per patient 69 25 All adenomas found in Pouch-body mucosa Adenomas
Pommaret, 201382 Retrospective Not reported IPAA 118, IRA 13, 8 DI Median 15 25 (range, 9–61) 139 85 Pouch mucosa, ARS, afferent ileal loop, DI Adenomas (7 HGD)
Wasmuth, 201349 Retrospective Mean 20 (range, 10–49) IPAA (61); IPAA+MUC (39); IPAA-MUC (22) (15 stapled and 7 handsewn)) MUC and without MUC
Mean 15.5 and 13.7
15.5 for mucosectomy and 13.7 for without mucosectomy 61 28 Anastomotic site Adenomas and in 1 patient without mucosectomy had cancer (Dukes A)
Boostrom, 201365 Retrospective Median, 26 (range, 4–60) RPC(J-pouch, n=104; Kock pouch, n=9; S-pouch, n=3 & W-pouch, n=1) Range, 11–59 Median, 11 (range, 2–35.3) 117 39 14 pouch, 2 pre-pouch ileum, 3 anastomotic site, 1 Kock nipple valve, 6 pouch and anastomosis, 2 pouch and pre-pouch ileum and 9 not described. Tubular adenoma (n=22) and tubulovillous adenoma (n=8). Low-grade-dysplasia (n=30), non-dysplastic (n=2) and adenocarcinoma (n=1)

Abbreviations:

HGD = High-grade dysplasia, LGD = Low-grade dysplasia, ARS= Anorectal segment, IRA = lleorectal anastomosis, RPC = Restorative proctocolectomy, IPAA = ileal pouch-anal anastomosis, MUC = Mucosectomy, IPAA+MUC = ileal pouch-anal anastomosis with mucosectomy; IPAA-MUC = ileal pouch-anal anastomosis without mucosectomy; ARS = Anorectal segment, DI=Definite ileostomy.