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  Global Journal of Surgery. Volume 2, Issue 4 (2011) pp. 176-179
  Research Article
Can Sulindac treatment postpone proctocolectomy in children with familial adenomatous polyposis?
  João Moreira-Pintoa,c,*, José Ferreira de Sousaa, Carlos Enesa, Fernando Pereirab  
a Department of Pediatric Surgery, Centro Hospitalar do Porto, Portugal
b Department of Pediatric Gastroenterology, Centro Hospitalar do Porto, Portugal
c Surgical Sciences Research Domain, Life & Health Sciences Institute, University of Minho, Portugal

  Familial adenomatous polyposis is an autosomal dominant disease resulting from germinative or acquired mutations in the tumor suppressor gene adenomatous polyposis coli. It leads to development of hundreds or thousands of intestinal polyps that can progress to colorectal cancer. Although prophylactic proctocolectomy is the standard care, timing for surgery in children is still controversial. Sulindac is a cyclooxygenase-2 (COX-2) inhibitor and can be used in patients with familial adenomatous polyposis awaiting proctocolectomy. We present a case of an 8-year-old boy, who was treated with sulindac and close endoscopic follow-up in order to postpone proctocolectomy until the age of 14. Histological analysis of the specimen showed FAP with areas of moderate and high dysplasia without submucosal invasion.
  Familial adenomatous polyposis; Proctocolectomy; Sulindac; Prophylaxis  

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