{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T15:57:00Z","timestamp":1791993420065,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,11,25]],"date-time":"2021-11-25T00:00:00Z","timestamp":1637798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Total colectomy with ileorectal anastomosis (TC\u2010IRA) is a surgical option for patients with familial adenomatous polyposis (FAP). Regular endoscopic surveillance of the rectum is recommended to prevent rectal cancer. We aimed to document polyp progression in the rectum following TC\u2010IRA and evaluate the role of polypectomy during surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients with FAP who underwent TC\u2010IRA between 1990 and 2017 were identified. Demographic, endoscopic and genetic data were retrieved. Cumulative rectal adenoma (polyp) counts were obtained, whilst accounting for any polypectomies during the study period. The rate of polyp progression and factors influencing secondary proctectomy were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and ninety\u2010nine patients fulfilled our inclusion criteria, of which 44% were male. The median age at colectomy was 19 (range 11\u201370) years and median preoperative rectal polyp count was 7 (range 0\u201350). All patients had an <jats:italic>APC<\/jats:italic> pathogenic variant, of which 151 (79%) were 5' of the mutation cluster region (MCR), 19 (10%) in the MCR, six (3%) were 3' of the MCR and 15 (8%) had a gross deletion. After a median follow\u2010up of 8.6 (range1\u201327) years and a median of 11 (range 2\u201337) flexible sigmoidoscopies per patient, the median rate of polyp progression was 5.5 polyps\/year (range 0\u201370.2). There was no evidence of polyp regression. Eight (4%) patients underwent secondary proctectomy for neoplasia, of which one (0.5%) had rectal adenocarcinoma. A total of 13,527 polyps were removed, a median of 35 polyps\/patient (range 0\u2013829). The rate of polyp progression was not significantly associated with genotypic or phenotypic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Progression of rectal adenoma burden following TC\u2010IRA appears to be slow and dependent on the length of follow\u2010up. In the modern era of stringent endoscopic surveillance and therapeutic procedures such as cold snare polypectomy, the rate of secondary proctectomy and the risk of rectal cancer after TC\u2010IRA are very low. These findings are important when counselling patients with regard to the choice of surgery for FAP and implementing endoscopic surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15981","type":"journal-article","created":{"date-parts":[[2021,11,6]],"date-time":"2021-11-06T05:20:58Z","timestamp":1636176058000},"page":"277-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Regular endoscopic surveillance and polypectomy is effective in managing rectal adenoma progression following colectomy and ileorectal anastomosis in patients with familial adenomatous polyposis"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0161-5141","authenticated-orcid":false,"given":"Chukwuemeka C.","family":"Anele","sequence":"first","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinpo","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Medicine Imperial College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Martin","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menna","family":"Hawkins","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ripple","family":"Man","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K.","family":"Clark","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar D.","family":"Faiz","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Latchford","sequence":"additional","affiliation":[{"name":"The Polyposis Registry St Mark's Hospital London North West University Healthcare NHS Trust  Harrow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1105-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236857"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800791136"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003840050070"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-013-1796-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-008-9307-3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236857"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6710-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7202"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181ab58fb"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8612989"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-104114"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-861295"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000912"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.435"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90408-1"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002247"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02552541"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800580202"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i11.3220"},{"issue":"5","key":"e_1_2_9_22_1","first-page":"655","article-title":"A randomized placebo\u2010controlled prevention trial of aspirin and \/ or resistant starch in young people with familial adenomatous polyposis","volume":"4","author":"Burn J","year":"2011","journal-title":"Cancer"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.05.021"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1970.01340220197033"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2000.20180"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049317"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000114216.90947.f6"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-005-5672-4"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236696"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02235487"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5276"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6710-2"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198305000-00008"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-9098(200005)74:1<15::AID-JSO4>3.0.CO;2-Z"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-008-9203-y"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02234779"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2018.05.021"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15981","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.15981","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.15981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T01:14:49Z","timestamp":1692839689000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.15981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,25]]},"references-count":36,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1111\/codi.15981"],"URL":"https:\/\/doi.org\/10.1111\/codi.15981","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,25]]},"assertion":[{"value":"2021-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}