Off the Cuff Markers: Surveillance and Endoscopic Approaches for Dysplasia After Ileal Pouch-Anal Anastomosis

Excerpt

Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the most common surgical procedure for patients with medically refractory ulcerative colitis (UC) or those patients with UC-related dysplasia [1]. Although relatively rare compared with the general population of patients with UC, the risk of developing cancer after proctocolectomy with IPAA should be discussed with patients, particularly among those patients at the greatest risk for these complications. We present two cases of neoplasia in the rectal cuff arising after IPAA that were detected with surveillance pouchoscopy. These cases highlight the need for standardization of surveillance practices in high-risk patients undergoing IPAA as well as the potential for endoscopic management of early lesions detected via surveillance. …