Division of Colorectal Surgery, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.
Division of Gastroenterology, Hepatology, and Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.
Lancet Gastroenterol Hepatol. 2022 Sep;7(9):871-893. doi: 10.1016/S2468-1253(22)00039-5. Epub 2022 Jul 5.
Surveillance pouchoscopy is recommended for patients with restorative proctocolectomy with ileal pouch-anal anastomosis in ulcerative colitis or familial adenomatous polyposis, with the surveillance interval depending on the risk of neoplasia. Neoplasia in patients with ileal pouches mainly have a glandular source and less often are of squamous cell origin. Various grades of neoplasia can occur in the prepouch ileum, pouch body, rectal cuff, anal transition zone, anus, or perianal skin. The main treatment modalities are endoscopic polypectomy, endoscopic ablation, endoscopic mucosal resection, endoscopic submucosal dissection, surgical local excision, surgical circumferential resection and re-anastomosis, and pouch excision. The choice of the treatment modality is determined by the grade, location, size, and features of neoplastic lesions, along with patients' risk of neoplasia and comorbidities, and local endoscopic and surgical expertise.
建议对溃疡性结肠炎或家族性腺瘤性息肉病行回肠贮袋肛管吻合术的患者进行储袋内镜检查，监测间隔取决于肿瘤发生风险。贮袋内的肿瘤主要来源于腺体，而来源于鳞状细胞者较少见。各种级别的肿瘤可发生于贮袋前肠、贮袋体、直肠袖口、肛门移行区、肛门或肛周皮肤。主要的治疗方式包括内镜下息肉切除术、内镜下消融术、内镜黏膜切除术、内镜黏膜下剥离术、外科局部切除术、外科环形切除术和再吻合术以及贮袋切除术。治疗方式的选择取决于肿瘤病变的分级、位置、大小和特征，以及患者的肿瘤发生风险和合并症，还有局部内镜和外科专业知识。
