Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium,The Lancet Gastroenterology & Hepatology

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Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium
The Lancet Gastroenterology & Hepatology ( IF 30.9 ) Pub Date : 2022-07-05 , DOI: 10.1016/s2468-1253(22)00039-5
Ravi P Kiran ₁ , Gursimran S Kochhar ₂ , Revital Kariv ₃ , Douglas K Rex ₄ , Akira Sugita ₅ , David T Rubin ₆ , Udayakumar Navaneethan ₇ , Tracy L Hull ₈ , Huaibin Mabel Ko ₉ , Xiuli Liu ₁₀ , Lisa A Kachnic ₁₁ , Scott Strong ₁₂ , Marietta Iacucci ₁₃ , Willem Bemelman ₁₄ , Philip Fleshner ₁₅ , Rachael A Safyan ₁₆ , Paulo G Kotze ₁₇ , André D'Hoore ₁₈ , Omar Faiz ₁₉ , Simon Lo ₂₀ , Jean H Ashburn ₂₁ , Antonino Spinelli ₂₂ , Charles N Bernstein ₂₃ , Sunanda V Kane ₂₄ , Raymond K Cross ₂₅ , Jason Schairer ₂₆ , James T McCormick ₂₇ , Francis A Farraye ₂₈ , Shannon Chang ₂₉ , Ellen J Scherl ₃₀ , David A Schwartz ₃₁ , David H Bruining ₂₄ , Jessica Philpott ₃₂ , Stuart Bentley-Hibbert ₃₃ , Dino Tarabar ₃₄ , Sandra El-Hachem ₂ , William J Sandborn ₃₅ , Mark S Silverberg ₃₆ , Darrell S Pardi ₂₄ , James M Church ₁ , Bo Shen ₃₇

Affiliation

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.
Department of Gastroenterology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Indiana University School of Medicine, Indianapolis, IN, USA.
Department of Clinical Research and Department of inflammatory Bowel Disease, Yokohama Municipal Citizens Hospital Yokohama, Japan.
University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA.
IBD Center and IBD Interventional Unit, Center for Interventional Endoscopy, Orlando Health, Orlando, FL, USA.
Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.
Department of Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.
Department of Pathology and Immunology, Washington University, St Louis, MO, USA.
Department of Radiation Oncology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.
Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Institute of Immunology and Immunotherapy, NIHR Birmingham Biomedical Research Centre, University Hospitals NHS Foundation Trust, University of Birmingham, UK.
Department of Surgery, Academic Medical Center, Amsterdam, Netherlands.
Division of Colorectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Division of Hematology and Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
IBD Outpatients Clinic, Catholic University of Paraná, Curitiba, Brazil.
Department of Abdominal Surgery, University Hospital Leuven, Belgium.
Department of Surgery, St Mark's Hospital and Academic Institute, Harrow and Department of Surgery and Cancer, Imperial College London, London, UK.
Pancreatic and Biliary Disease Program, Digestive Diseases, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Department of Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.
Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Division Colon and Rectal Surgery, Rozzano, Milan, Italy.
University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, MB, Canada.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Inflammatory Bowel Disease Program, University of Maryland School of Medicine, MD, USA.
Department of Gastroenterology, Henry Ford Health System, Detroit, MI, USA.
Division of Colon and Rectal Surgery, Allegheny Health Network, Pittsburgh, PA, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.
Inflammatory Bowel Disease Center, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
Jill Roberts Center for IBD, Gastroenterology and Hepatology, Weill Cornell Medicine and NewYork Presbyterian Hospital, New York, NY, USA.
Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH, USA.
Department of Radiology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.
IBD Clinical Center, University Hospital Center Dr Dragiša Mišović, Belgrade, Serbia.
Department of Medicine, University of California San Diego, San Diego, CA, USA.
Mount Sinai Hospital Inflammatory Bowel Disease Centre, Toronto, ON, Canada.
Center for Interventional Inflammatory Bowel Disease, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

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.

中文翻译：

储袋瘤形成的管理：国际回肠储袋联盟的共识指南

建议对溃疡性结肠炎或家族性腺瘤性息肉病的恢复性直肠结肠切除术和回肠储袋-肛门吻合术的患者进行储袋镜检查，监测间隔取决于肿瘤形成的风险。回肠小袋患者的肿瘤主要来源于腺体，较少来源于鳞状细胞。不同级别的瘤形成可发生在回肠前袋、袋体、直肠袖带、肛门过渡区、肛门或肛周皮肤。主要治疗方式为内镜下息肉切除术、内镜下消融术、内镜下黏膜切除术、内镜下黏膜下剥离术、外科局部切除术、外科环周切除再吻合术和储袋切除术。治疗方式的选择取决于肿瘤病变的等级、位置、大小和特征，

更新日期：2022-07-05

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