Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
April 2016 Issue Vol. 5(4), pp. 130-135
Copyright © 2016 Global Advanced Research Journals

 

Full Length Research Paper

Ileoneorectal anastomosis for surgical treatment of familial adenomatous polyposis in children

Pedro Luiz Toledo de Arruda Lourenção*, Amanda André Monteiro, Marcos Curcio Angelini, Rozemeire Garcia Marques, Antônio Marcos Rodrigues and Erika V. Paiva Ortolan

Discipline of Pediatric Surgery, Surgery Department, Botucatu Medical School, UNESP Univ Estadual Paulista.

*Corresponding Author E-mail: plourencao@gmail.com; Telephone: (55) 14-3880 1421; Fax: (55) 14-3815 7428

Accepted 26 April, 2016

Abstract

Van Laarhoven et al. proposed restorative proctocolectomy with ileoneorectal anastomosis (INRA) to treat familial adenomatous polyposis (FAP). Although it is considered a reproducible surgical technique with low complication rates, there have been few reports of its use in the literature, with no reports addressing pediatric patients. Our pediatric surgery group has been using this technique since 2005. The aim of this study was to analyze the clinical and functional results obtained from the use of this technique to treat children with FAP. Clinical data were retrieved from the children’s medical records. The patients were interviewed regarding their medical conditions, and they received a physical examination to assess their clinical condition, defecation patterns and aspects related to quality of life. Eight patients with a diagnosis of FAP underwent surgical treatment with INRA. The average age was 12.25 (± 2.9) years. The median operative time was 465 minutes, and times ranged from 240 minutes to 600 minutes. There were no intraoperative complications. Three patients required reoperation (2 by flanges and 1 by twisting of the protective ileostomy). The median follow-up time was 36 months (5–120 months). Most patients (57%) presented with regular bowel movements, soft stools and a stool frequency of up to 5 times per day. Two patients had soiling (1 case with daily losses and 1 case with weekly losses). Total proctocolectomy with INRA proved to be a safe and effective technique for the treatment of children with FAP, and it offered satisfactory clinical results.

Keywords: familial adenomatous polyposis; children; surgery; restorative proctocolectomy; ileoneorectal anastomosis.

List of Abbreviation

FAP, Familial adenomatous polyposis; IRA, total colectomy with ileum rectum anastomosis; IPAA, restorative proctocolectomy with an ileo pouch anal anastomosis; INRA, restorative proctocolectomy with ileoneorectal anastomosis.


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