Restorative proctocolectomy with ileal pouch-anal anastomosis remains the gold standard
treatment for patients with ulcerative colitis who desire restoration of intestinal
continuity. Despite a significant cancer risk reduction after surgical removal of
the colon and rectum, dysplasia and cancers of the ileal pouch or anal transition
zone still occur and are a risk even if an anal canal mucosectomy is performed. Surgical
care and maintenance after ileoanal anastomosis must include consideration of malignant
potential along with other commonly monitored variables such as bowel function and
quality of life. Cancers and dysplasia of the ileal pouch are rare but sometimes difficult-to-manage
sequelae of pouch surgery.
Keywords
ileoanal pouch - anal transition zone - dysplasia - ulcerative colitis - pouch cancer
- anal neoplasia