Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice

Aim. To study long-term results of surgical treatment of patients with familial adenomatous polyposis (FAP) with the cell reconstruction of the rectal mucosa.Materials and methods. 57 FAP patients were subjected to treatment, which involved colproctectomy, the preservation of the lower rectal ampull...

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Main Authors: D. V. Vyshegorodtsev, A. M. Kuzminov, S. I. Achkasov, E. A. Kogan, V. Yu. Korolik, G. T. Sukhikh
Format: Article
Language:Russian
Published: Gastro LLC 2019-09-01
Series:Российский журнал гастроэнтерологии, гепатологии, колопроктологии
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Online Access:https://www.gastro-j.ru/jour/article/view/398
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author D. V. Vyshegorodtsev
A. M. Kuzminov
S. I. Achkasov
E. A. Kogan
V. Yu. Korolik
G. T. Sukhikh
author_facet D. V. Vyshegorodtsev
A. M. Kuzminov
S. I. Achkasov
E. A. Kogan
V. Yu. Korolik
G. T. Sukhikh
author_sort D. V. Vyshegorodtsev
collection DOAJ
description Aim. To study long-term results of surgical treatment of patients with familial adenomatous polyposis (FAP) with the cell reconstruction of the rectal mucosa.Materials and methods. 57 FAP patients were subjected to treatment, which involved colproctectomy, the preservation of the lower rectal ampulla, mucosectomy and the reconstruction of the mucosa by cell transplantation. Endoscopic monitoring was carried out, with the endoscopic observation covering the period of 19–120 months (median — 44.3 months). Morphological and immunohistochemical studies were conducted. The long-term functional results of treatment (anorectal manometry (profilometry)) were studied. The patients were surveyed using the SF-36 questionnaire to monitor the quality of their life.Results. Our results show that the use of cell transplantation leads to the reconstruction of the rectal mucosa over a fairly short time: in 44/57 (77.2 %) patients, the endoscopic picture corresponded to the unchanged rectal mucosa 4 weeks after the surgery. In 13/57 (22.8 %) patients, a complete mucosal reconstruction was achieved 8–12 weeks after the surgery. The absence of polyp growth in the preserved part of the rectum was observed. Late complications developed only in 5 (9.4 %) patients. Good functional results (acceptable frequency of defecation, lack of signs of anal incontinence and nocturnal defecation) were observed in 48/53 (90.6 %) patients. The quality of life was at a fairly high level in 90.6 % of patients.Conclusion. The proposed method of FAP treatment allowed the immediate and long-term treatment results to be improved significantly.
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spelling doaj.art-7c6442d57a6e4984949806631c25e9b52024-03-25T16:53:08ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732019-09-01294606510.22416/1382-4376-2019-29-4-60-65320Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical PracticeD. V. Vyshegorodtsev0A. M. Kuzminov1S. I. Achkasov2E. A. Kogan3V. Yu. Korolik4G. T. Sukhikh5State Scientific Center of Coloproctology named after A.N. RyzhykhState Scientific Center of Coloproctology named after A.N. RyzhykhState Scientific Center of Coloproctology named after A.N. RyzhykhI.M. Sechenov First Moscow State Medical University (Sechenov University)State Scientific Center of Coloproctology named after A.N. RyzhykhResearch Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian FederationAim. To study long-term results of surgical treatment of patients with familial adenomatous polyposis (FAP) with the cell reconstruction of the rectal mucosa.Materials and methods. 57 FAP patients were subjected to treatment, which involved colproctectomy, the preservation of the lower rectal ampulla, mucosectomy and the reconstruction of the mucosa by cell transplantation. Endoscopic monitoring was carried out, with the endoscopic observation covering the period of 19–120 months (median — 44.3 months). Morphological and immunohistochemical studies were conducted. The long-term functional results of treatment (anorectal manometry (profilometry)) were studied. The patients were surveyed using the SF-36 questionnaire to monitor the quality of their life.Results. Our results show that the use of cell transplantation leads to the reconstruction of the rectal mucosa over a fairly short time: in 44/57 (77.2 %) patients, the endoscopic picture corresponded to the unchanged rectal mucosa 4 weeks after the surgery. In 13/57 (22.8 %) patients, a complete mucosal reconstruction was achieved 8–12 weeks after the surgery. The absence of polyp growth in the preserved part of the rectum was observed. Late complications developed only in 5 (9.4 %) patients. Good functional results (acceptable frequency of defecation, lack of signs of anal incontinence and nocturnal defecation) were observed in 48/53 (90.6 %) patients. The quality of life was at a fairly high level in 90.6 % of patients.Conclusion. The proposed method of FAP treatment allowed the immediate and long-term treatment results to be improved significantly.https://www.gastro-j.ru/jour/article/view/398familial adenomatous polyposismesenchymecell transplantation
spellingShingle D. V. Vyshegorodtsev
A. M. Kuzminov
S. I. Achkasov
E. A. Kogan
V. Yu. Korolik
G. T. Sukhikh
Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
Российский журнал гастроэнтерологии, гепатологии, колопроктологии
familial adenomatous polyposis
mesenchyme
cell transplantation
title Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
title_full Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
title_fullStr Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
title_full_unstemmed Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
title_short Cellular Reconstruction of the Rectal Mucosa during surgical Treatment of Familial Adenomatosis of the Colon: 12 Years after the First Experience of Introduction into Clinical Practice
title_sort cellular reconstruction of the rectal mucosa during surgical treatment of familial adenomatosis of the colon 12 years after the first experience of introduction into clinical practice
topic familial adenomatous polyposis
mesenchyme
cell transplantation
url https://www.gastro-j.ru/jour/article/view/398
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