Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium.

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. Copyright © 2022 Elsevier Ltd. All rights reserved.

Citation

Ravi P Kiran, Gursimran S Kochhar, Revital Kariv, Douglas K Rex, Akira Sugita, David T Rubin, Udayakumar Navaneethan, Tracy L Hull, Huaibin Mabel Ko, Xiuli Liu, Lisa A Kachnic, Scott Strong, Marietta Iacucci, Willem Bemelman, Philip Fleshner, Rachael A Safyan, Paulo G Kotze, André D'Hoore, Omar Faiz, Simon Lo, Jean H Ashburn, Antonino Spinelli, Charles N Bernstein, Sunanda V Kane, Raymond K Cross, Jason Schairer, James T McCormick, Francis A Farraye, Shannon Chang, Ellen J Scherl, David A Schwartz, David H Bruining, Jessica Philpott, Stuart Bentley-Hibbert, Dino Tarabar, Sandra El-Hachem, William J Sandborn, Mark S Silverberg, Darrell S Pardi, James M Church, Bo Shen. Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium. The lancet. Gastroenterology & hepatology. 2022 Sep;7(9):871-893

Mesh Tags

PMID: 35798022

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