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Title of Journal: Int J Colorectal Dis

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Abbravation: International Journal of Colorectal Disease

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Springer-Verlag

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10.1016/0002-9394(85)90532-X

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1432-1262

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Inflammatory bowel diseaseassociated colorectal c

Authors: Amosy E M’Koma Harold L Moses Samuel E Adunyah
Publish Date: 2011/02/11
Volume: 26, Issue: 5, Pages: 533-552
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Abstract

Colorectal cancer CRC the most lethal longterm complication of inflammatory bowel disease IBD is the culmination of a complex sequence of molecular and histologic derangements of the colon epithelium that are initiated and at least partially sustained by prolonged chronic inflammation Dysplasia the earliest histologic manifestation of this process plays an important role in cancer prevention by providing the first clinical alert that this sequence is under way and by serving as an endpoint in colonoscopic surveillance of patients at high risk for CRC Restorative proctocolectomy RPC is indicated for patients with IBD specifically for ulcerative colitis that is refractory to medical treatment emergency conditions and/or in case of neoplastic transformation Even after RPC with mucosectomy pouchrelated carcinomas have recently been reported with increasing frequency since the first report in 1984 We review IBDassociated CRC and pouchrelated neoplasia prevalence adverse events risk factors and surveillancesWe found 12 studies from retrospective series and 15 case reports To date there are 43 reported cases of pouchrelated cancers Thirtytwo patients had cancer in the anal transit zone ATZ of these 28 patients had mucosectomy Eleven patients had cancer found in the pouch bodyRPC with mucosectomy does not necessarily eliminate risks There is little evidence to support routine surveillance of pouch mucosa and the ATZ except for patients associated with histological type C changes sclerosing cholangitis and unremitting pouchitis

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