Lancet Gastroenterol Hepatol. 2022 Sep;7(9):871-893.doi: 10.1016/S2468-1253(22)00039-5. Epub 2022 Jul 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

Author information

¹Division of Colorectal Surgery, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

²Division of Gastroenterology, Hepatology, and Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.

³Department of Gastroenterology, Tel Aviv Sourasky Medical Center and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

⁴Indiana University School of Medicine, Indianapolis, IN, USA.

⁵Department of Clinical Research and Department of inflammatory Bowel Disease, Yokohama Municipal Citizens Hospital Yokohama, Japan.

⁶University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA.

⁷IBD Center and IBD Interventional Unit, Center for Interventional Endoscopy, Orlando Health, Orlando, FL, USA.

⁸Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA.

⁹Department of Pathology and Cell Biology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

¹⁰Department of Pathology and Immunology, Washington University, St Louis, MO, USA.

¹¹Department of Radiation Oncology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

¹²Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

¹³Institute of Immunology and Immunotherapy, NIHR Birmingham Biomedical Research Centre, University Hospitals NHS Foundation Trust, University of Birmingham, UK.

¹⁴Department of Surgery, Academic Medical Center, Amsterdam, Netherlands.

¹⁵Division of Colorectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.

¹⁶Division of Hematology and Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

¹⁷IBD Outpatients Clinic, Catholic University of Paraná, Curitiba, Brazil.

¹⁸Department of Abdominal Surgery, University Hospital Leuven, Belgium.

¹⁹Department of Surgery, St Mark's Hospital and Academic Institute, Harrow and Department of Surgery and Cancer, Imperial College London, London, UK.

²⁰Pancreatic and Biliary Disease Program, Digestive Diseases, Cedars Sinai Medical Center, Los Angeles, CA, USA.

²¹Department of Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA.

²²Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Division Colon and Rectal Surgery, Rozzano, Milan, Italy.

²³University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, MB, Canada.

²⁴Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

²⁵Inflammatory Bowel Disease Program, University of Maryland School of Medicine, MD, USA.

²⁶Department of Gastroenterology, Henry Ford Health System, Detroit, MI, USA.

²⁷Division of Colon and Rectal Surgery, Allegheny Health Network, Pittsburgh, PA, USA.

²⁸Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.

²⁹Inflammatory Bowel Disease Center, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.

³⁰Jill Roberts Center for IBD, Gastroenterology and Hepatology, Weill Cornell Medicine and NewYork Presbyterian Hospital, New York, NY, USA.

³¹Department of Gastroenterology, Vanderbilt University Medical Center, Nashville, TN, USA.

³²Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH, USA.

³³Department of Radiology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

³⁴IBD Clinical Center, University Hospital Center Dr Dragiša Mišovic, Belgrade, Serbia.

³⁵Department of Medicine, University of California San Diego, San Diego, CA, USA.

³⁶Mount Sinai Hospital Inflammatory Bowel Disease Centre, Toronto, ON, Canada.

³⁷Center for Interventional Inflammatory Bowel Disease, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA. Electronic address: bs3270@cumc.columbia.edu.

Abstract

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.