Feinberg S M, Jagelman D G, Sarre R G, McGannon E, Fazio V W, Lavery I C, Weakley F L, Easley K A
Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio 44106.
Dis Colon Rectum. 1988 Mar;31(3):169-75. doi: 10.1007/BF02552541.
One hundred sixteen patients were reviewed after abdominal colectomy and ileorectal anastomosis (IRA) for familial polyposis to determine the rate of postoperative spontaneous regression of rectal polyps. The failure of the IRA procedure was correlated with the preoperative number of rectal polyps and the degree of rectal polyp regression. Spontaneous resolution of rectal polyps occurred in 64 percent of the patients (complete 38 percent, partial 26 percent). In those patients initially having complete resolution, 55 percent redeveloped polyps during follow-up. With a mean follow-up of 9.3 years, seven patients have developed rectal cancer. Rectal cancer development was more common in those patients who had innumerable rectal polyps prior to IRA. Initial polyp regression did not preclude later development of rectal cancer. There were 11 deaths during the follow-up period, but only one of these was from rectal cancer. Abdominal colectomy and IRA is an effective treatment for familial polyposis. Spontaneous regression of polyps occurred in 64 percent of patients, but continuous and complete follow-up is necessary to fulgurate recurrent polyps and to screen for the development of cancer.
对116例行腹会阴联合直肠切除术及回肠直肠吻合术（IRA）治疗家族性腺瘤性息肉病的患者进行回顾性研究，以确定直肠息肉术后自发消退的发生率。IRA手术失败与术前直肠息肉数量及直肠息肉消退程度相关。64%的患者直肠息肉出现自发消退（完全消退38%，部分消退26%）。在最初完全消退的患者中，55%在随访期间息肉复发。平均随访9.3年，7例患者发生直肠癌。直肠癌在IRA术前有无数直肠息肉的患者中更常见。最初息肉消退并不能排除随后发生直肠癌。随访期间有11例死亡，但仅1例死于直肠癌。腹会阴联合直肠切除术及IRA是治疗家族性腺瘤性息肉病的有效方法。64%的患者息肉出现自发消退，但需要持续、完整的随访以烧灼复发性息肉并筛查癌症的发生。
