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Postoperative Prognosis of Adenomatosis Coli T. Iwama 1,2 , Y. Mishima 1,2 1The Second Department of Surgery, Tokyo Medical and Dental University 2The Polyposis and Intrstinal Disease Study Center of Tokyo Medical and Dental University pp.659-665
Published Date 1984/6/25
DOI https://doi.org/10.11477/mf.1403107050
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 Postoperative survival rate and cause of death were examined on 513 cases of adenomatosis coli which had been registrated to the Polyposis and Intestinal Disease Study Center of Tokyo Medical and Dental University. Postoperative clinical course including development of desmoid tumor was studied on 65 cases of our institute. Four operative maneuvers were considered. They were subtotal or total colon resection (rectum-preserving operation), resection of total colon and rectum, amputation of rectum and partial or hemicolon resection. Among them, rectum-preserving operation had the lowest cancer rate and its 15 years survival rate was the best. But after three postoperative years, the survival curve of resection of total colon and rectum was the most stable of them. Cumulative rectal cancer development after rectum-preserving operation in our institute was 17.9% at 6 years. Total colectomy, mucosal proctectomy and ileo-anal anastomosis may be a choice of operation.

 Aside from colon cancer, several carcinoma occurred to the patient of adenomatosis coli. They were stomach cancer, cancer of duodenum, cancer of pancreatic head, cancer of small intestine and thyroid cancer. Desmoid tumor developed in five or 8.1% of 62 cases of adenomatosis coli. The mean age of desmoid tumor positive cases was 20.6 years comparing to 30 years of desmoid tumor negative cases. The patient of Gardner's syndrome developed desmoid tumor more frequently than the patient without Gardner's syndrome. All desmoid tumor developed within two years after operation. To detect it in an early stage we must pay attention to the development of desmoid tumor by palpation, ultrasonography and CT scanning.


Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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