Concept Richtlijn Erfelijke darmkanker 2007 versie 7 - Oncoline

Surveillance na colectomieNa subtotale colectomie bestaat een indicatie voor ½-1 jaarlijkse surveillance van hetrectosigmoïd.Na proctocolectomie met ileo-anale pouch bestaat een indicatie voor ½-1 jaarlijksesurveillance van de pouch.Behandeling na colectomieGrotere adenomen (> 5 mm) in restrectum of pouch dienen endoscopisch verwijderd worden.Indien deze op de ileo-anale naad ontstaan, multipel zijn, hooggradige dysplasie vertonenen/of groot zijn moet chirurgische behandeling overwogen worden.Bij patiënten met multipele adenomen in restrectum of pouch kan chemopreventie metbehulp van NSAID’s overwogen worden.Literatuur1. Attanoos R, Billings PJ, Hughes LE, Williams GT. Ileostomy polyps, adenomas, andadenocarcinomas. Gut 1995;37:840-4.2. Aziz O, Athanasiou T, Fazio VW, Nicholls RJ, Darzi AW, Church J et al. Meta-analysis ofobservational studies of ileorectal versus ileal pouch-anal anastomosis for familialadenomatous polyposis. Br J Surg 2006;93:407-17.3. Bertario L, Russo A, Radice P, Varesco L, Eboli M, Spinelli P et al. Genotype andphenotype factors as determinants for rectal stump cancer in patients with familialadenomatous polyposis. Hereditary colorectal tumors registry. Ann Surg 2000;231:538-43.4. Brooker JC, Saunders BP, Shah SG, Thapar CJ, Thomas HJ, Atkin WS et al. Totalcolonic dye-spray increases the detection of diminutive adenomas during routinecolonoscopy: a randomized controlled trial. Gastrointest Endosc 2002;56:333-8.5. Church J, Burke C, McGannon E, Pastean O, Clark B. Predicting polyposis severityproctoscopy: How reliable is it? Dis Colon Rectum 2001;44:1249-54.6. Church J, Burke C, McGannon E, Pastean O, Clark B. Risk of rectal cancer aftercolectomy and ileorectal anastomosis for familial adenomatous polyposis : A function ofavailable surgical options. Dis Colon Rectum 2003;46:1175-81.7. Church J, Simmang C. Standards task Force of the American Society of Colon andRectal Surgeons. Practice parameters for treatment of patients with predominantlycolorectal cancer (Familial Adenomatous Polyposis and Hereditary NonpolyposisColorectal Cancer). Dis Colon Rectum 2003;46:1001-12.8. Church J. In which patients do I perform IRA, and why? Fam. Cancer 2006;5:237-40.9. De Cosse JJ, Bülow S, Neale K, Järvinen HK, Alm T, Hultcrantz R et al. Rectal cancerrisk in patients treated for familial adenomatous polyposis. Br J Surg 1992;79:1372-75.10. Cruz CM, Hylind LM, Romans K, et al. Long term treatment with sulindac in familialadenomatous polyposis: a prospective cohort study. Gastroenterology 2002;122: 641-5.11. Van Duijvendijk P, Vasen HF, Bertario L, Bülow S, Kuijpers JH, Schouten WR et al.Cumulative risk of developing polyps or malignancy at the ileal pouch-anal anastomosisin patients with familial adenomatous polyposis. J Gastrointest Surg 1999;3:325-30.12. Van Duijvendijk P, Slors JF, Taat CW, Oosterveld P, Vasen HF. Functional outcome aftercolectomy and ileorectal anastomosis compared to proctocolectomy and ileal pouch-analanastomosis in familial adenomatous polyposis. Ann Surg 1999;230:648-54.Concept landelijke richtlijn erfelijke darmkanker versie 7 d.d. 7 november 2007.98