{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:13:20Z","timestamp":1789834400023,"version":"4.0.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          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.<\/jats:p><jats:p>\n          Method A single-arm intervention study was conducted at 22 facilities. Participants were patients with FAP, aged \u2265\u200a16 years, who had not undergone colectomy or who had undergone colectomy but had \u2265\u200a10\u200acm of large intestine remaining. For IDP, colorectal polyps of \u2265\u200a10\u200amm were removed, followed by polyps of \u2265\u200a5\u200amm. The primary end point was the presence\/absence of colectomy during a 5-year intervention period.<\/jats:p><jats:p>\n          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\u200a%, 95\u200a% confidence interval [CI] 0.74\u200a%\u20135.18\u200a%) underwent colectomy, and three patients died. Completion of the 5-year intervention period without colectomy was confirmed in 150\u200a\/166 patients who had not undergone colectomy (90.4\u200a%, 95\u200a%CI 84.8\u200a%\u201394.4\u200a%) and in 47\u200a\/56 patients who had previously undergone colectomy (83.9\u200a%, 95\u200a%CI 71.7\u200a%\u201392.4\u200a%).<\/jats:p><jats:p>\n          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.<\/jats:p>","DOI":"10.1055\/a-1945-9120","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T23:21:43Z","timestamp":1665444103000},"page":"344-352","source":"Crossref","is-referenced-by-count":28,"title":["Intensive endoscopic resection for downstaging of polyp burden in patients with familial adenomatous polyposis (J-FAPP Study III): a multicenter prospective interventional study"],"prefix":"10.1055","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct03567863","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Hideki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3979-5560","authenticated-orcid":false,"given":"Masayoshi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Hokkaido, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0480-3957","authenticated-orcid":false,"given":"Shinji","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Endoscopy and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chino","family":"Akiko","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3761-6971","authenticated-orcid":false,"given":"Masahiro","family":"Tajika","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Doyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuji","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Ohda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Horimatsu","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3352-5757","authenticated-orcid":false,"given":"Yasushi","family":"Sano","sequence":"additional","affiliation":[{"name":"Sano Hospital, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohji","family":"Tanakaya","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Ikematsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihisa","family":"Saida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3814-298X","authenticated-orcid":false,"given":"Yoji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Osaka International Cancer Institute (formerly Osaka Medical Center for Cancer and Cardiovascular Diseases), Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kashida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Kiriyama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gunma Chuo Hospital, Gunma, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Hori","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Hospital Organization Shikoku Cancer Center, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyowon","family":"Lee","sequence":"additional","affiliation":[{"name":"Moriguchi Keijinkai Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tashiro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Toshiba Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomu","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tochigi Cancer Center, Tochigi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadao","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Aichi, 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