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Purpose <p>Assess the safety of single-stage laparoscopic proctocolectomy with ileal pouch-anal anastomosis (LPC-IPAA) in children with familial adenomatous polyposis (FAP).</p> Methods <p>Medical records for all patients with FAP who underwent LPC-IPAA between 1/1/2013 and 8/1/2024 at a pediatric center were reviewed. Baseline characteristics, postoperative complications, and functional outcomes were assessed.</p> Results <p>Thirty-nine patients met inclusion criteria. Mean age was 14.9 years (range 9.4–21.5) and mean BMI was 23.0 (range 15.3–47.0). Follow-up averaged 2.8 years (SD 2.9). Mean operative time was 228.4&#xa0;min (SD 44.5) in the stapled group (<i>n</i> = 32) and 316.1&#xa0;min (SD 43.1) in the hand-sewn group (<i>n</i> = 7) (<i>p</i> &lt; 0.001). There were no anastomotic leaks. One patient developed a postoperative abscess. Six (15%) developed presumed pouchitis, 4 of whom were in the hand-sewn group and all successfully treated with antibiotics. Six patients (15%) developed an anastomotic stricture – all in the stapled group – and responded well to anal dilation. No patient required treatment for fecal incontinence.</p> Conclusion <p>LPC-IPAA in adolescents and young adults with FAP can safely be performed in a single operation and is associated with favorable functional outcomes.</p>

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Single-stage laparoscopic proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis

  • 期刊论文

  • 发表日期：

    2025年11月15日

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  • Andrew Mudreac,
  • Spencer E. Kim,
  • Kara Kennedy,
  • William R. Johnston,
  • Rosa Hwang,
  • Peter Mattei

摘要

Purpose

Assess the safety of single-stage laparoscopic proctocolectomy with ileal pouch-anal anastomosis (LPC-IPAA) in children with familial adenomatous polyposis (FAP).

Methods

Medical records for all patients with FAP who underwent LPC-IPAA between 1/1/2013 and 8/1/2024 at a pediatric center were reviewed. Baseline characteristics, postoperative complications, and functional outcomes were assessed.

Results

Thirty-nine patients met inclusion criteria. Mean age was 14.9 years (range 9.4–21.5) and mean BMI was 23.0 (range 15.3–47.0). Follow-up averaged 2.8 years (SD 2.9). Mean operative time was 228.4 min (SD 44.5) in the stapled group (n = 32) and 316.1 min (SD 43.1) in the hand-sewn group (n = 7) (p < 0.001). There were no anastomotic leaks. One patient developed a postoperative abscess. Six (15%) developed presumed pouchitis, 4 of whom were in the hand-sewn group and all successfully treated with antibiotics. Six patients (15%) developed an anastomotic stricture – all in the stapled group – and responded well to anal dilation. No patient required treatment for fecal incontinence.

Conclusion

LPC-IPAA in adolescents and young adults with FAP can safely be performed in a single operation and is associated with favorable functional outcomes.