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Current status of prophylactic surgical treatment for familial adenomatous polyposis in Japan

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Abstract

Purpose

We conducted this study to clarify the current clinical practice of prophylactic colectomy for patients with familial adenomatous polyposis (FAP) in Japan.

Methods

This retrospective multi-center cohort study involved 23 specialized institutions for colorectal disease in Japan. We analyzed the records of 147 patients who underwent prophylactic surgical treatment between 2000 and 2012. Patients were divided into Group 1 (2000–2006) and Group 2 (2007–2012) based on their date of surgery.

Results

Age at the time of prophylactic surgery was 27 and 31 years in Groups 1 and 2, respectively. The proportion of attenuated FAP was significantly lower in Group 2 than in Group 1 (1.0 vs. 13 %, respectively). Pathological examination revealed an increased incidence of malignant polyps in the resected specimens from Group 2 patients (10 vs. 23 %, respectively; P = 0.034). Laparoscopic surgery was more frequent in Group 2 than in Group 1 (61 vs. 40 %, respectively). There was no surgical mortality in either group.

Conclusion

Prophylactic surgery for FAP results in good short-term surgical outcomes in Japan. The current surgical approach is characterized by limited surgical indications for patients with attenuated FAP, delayed timing of colectomy, and the increasing standardization of laparoscopic surgery.

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Abbreviations

FAP:

Familial adenomatous polyposis

IPAA:

Ileal pouch anal anastomosis

IRA:

Ileorectal anastomosis

IACA:

Ileoanal canal anastomosis

IAA:

Ileoanal anastomosis

APC:

Adenomatous polyposis coli

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Acknowledgments

We thank the following investigators in the “multi-institutional retrospective cohort study for FAP” by JSCCR for collecting the data on patients with FAP: Dr. N. Matsubara, Hyogo College of Medicine, Hyogo; Dr. K. Komori, Aichi Cancer Center Hospital, Aichi; Dr. H. Ozawa, Tochigi Cancer Center, Tochigi; Dr. T. Nagasaka, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Dr. H. Hasegawa, Keio University School of Medicine, Tokyo; Dr. M. Koyama, Hirosaki University Graduate School of Medicine, Aomori; Dr. Y. Akagi, Kurume University School of Medicine, Fukuoka; Dr. T. Yatsuoka, Saitama Cancer Center, Saitama; Dr. K. Kumamoto, Fukushima Medical University School of Medicine, Fukushima; Dr. K. Kurachi, Hamamatsu University School of Medicine, Shizuoka; Dr. K. Tanakaya, Iwakuni Clinical Center, Yamaguchi; Dr. K. Yoshimatsu, Tokyo Women’s Medical University Medical Center East, Tokyo; Dr. T. Watanabe, Graduate School of Medicine, The University of Tokyo, Tokyo.

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Authors and Affiliations

  1. Department of Surgery, National Defense Medical College, Saitama, Japan

    Masato Yamadera & Hideki Ueno

  2. Center for Minimally Invasive Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    Hirotoshi Kobayashi

  3. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Tsuyoshi Konishi

  4. Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan

    Fumio Ishida

  5. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Tatsuro Yamaguchi

  6. Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Takao Hinoi

  7. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan

    Yasuhiro Inoue

  8. Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan

    Yukihide Kanemitsu

  9. Department of Surgery, Hyogo College of Medicine, Hyogo, Japan

    Naohiro Tomita

  10. Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Hideyuki Ishida

  11. Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan

    Kenichi Sugihara

Authors
  1. Masato Yamadera
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  2. Hideki Ueno
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  3. Hirotoshi Kobayashi
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  9. Yukihide Kanemitsu
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  10. Naohiro Tomita
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  11. Hideyuki Ishida
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Corresponding author

Correspondence to Hideki Ueno.

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Yamadera, M., Ueno, H., Kobayashi, H. et al. Current status of prophylactic surgical treatment for familial adenomatous polyposis in Japan. Surg Today 47, 690–696 (2017). https://doi.org/10.1007/s00595-016-1431-4

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  • DOI: https://doi.org/10.1007/s00595-016-1431-4

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