Literature Review

Since 1991, seventeen studies comparing the results from primary IRA and primary IPAA for FAP [2,13, 14,20,25,29,31,35-37,41-48] have been published in the peer-reviewed literature (including all languages). One of these studies reported on a mixed patient group of both FAP and UC patients [47], making it difficult to draw conclusions from its results. In addition to this, in four papers, the authors reported on overlapping patient groups (these patients had already been reported on in another paper) [25, 36,45,46]. In this case the most informative and highest quality paper was selected to represent this patient group. The results from the remaining twelve studies (containing 1002 subjects) published between 1991 and 2003 comparing primary IPAA to primary IRA for FAP and were therefore included in this review [2,13,14,20,29,31, 35, 37,4144]. Table 1 shows the characteristics of these twelve studies with 535 (53.3%) patients undergoing IPAA

Table 1. Characteristics of studies included in the systematic review

Author

Institution

Year

Design

IPAA

IRA

Group

Male (%)

Follow-up (months)

Madden [35]

St. Marks

1991

R

24

62

IPAA

42

62

IRA

53

78

Ambrose [2]

Mayo Clinic,

1992

R

91

18

IPAA

55

48

Minnesota

IRA

56

72

Rodriguez [42]

Santander,

1992

R

11

8

IPAA

55

26

Spain

IRA

25

3

Penna [29]

St. Antoine, Paris

1993

R

120

23

IPAA

N/A

N/A

IRA

Ziv [13]

Cleveland Clinic,

1995

R

7

17

IPAA

57

36

Ohio

RA

53

46

Rotondano [43]

Napoli, Italy

1997

R

15

25

IPAA

N/A

46

IRA

54

Tonelli [14]

Florence, Italy

1997

Pr

24

14

IPAA

63

61

IRA

57

82

Soravia [20, 24]

Mount Sinai,

1999

R

38

60

IPAA

48

72

Toronto

IRA

42

92.4

Van

Leiden,

1999

R

118

161

IPAA

57

79

Duijvendijk [44]

Netherlands

IRA

49

144

Ko [41]

Lahey Clinic,

2000

R

30

14

IPAA

N/A

120

Massatussets

IRA

168

Bjork [31]

Multicentre,

2001

R

20

43

IPAA

40

84

Sweden

IRA

51

128

Gunther [37]

Erlangen,

2003

R

37

22

IPAA

59

118

Germany

IRA

50

180

R, retrospective patient identification, prospective data collection; Pr, prospective study

R, retrospective patient identification, prospective data collection; Pr, prospective study and 467 (46.7%) undergoing IRA as the primary treatment for FAP. Please note that the mean/median length of follow-up for both IPAA and IRA groups was at least 36 months in all but one study.

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