Risk factors for adenocarcinoma in the surgically transposed colon not exposed to the fecal stream. Etiological considerations extrapolated to sporadic colon carcinoma in the general population.

Abstract Background The aim of the study was to analyze the clinical characteristics and outcomes of patients with de novo secondary adenocarcinoma arising in the operatively transposed colon not exposed to the fecal stream. Methods Two investigators collected and reviewed papers from June 1938 to June 2019, reporting patients with adenocarcinoma arising in the transposed colon, not in contact with the fecal stream. Results Overall, we identified 98 patients with a transposed colonic autograft, positioned as conduit but not in contact with the fecal stream, in whom a secondary de novo adenocarcinoma was diagnosed. In 50% of the patients, the secondary adenocarcinoma was diagnosed at an advanced stage, with a subsequent poor clinical outcome. Earlier diagnosis allowed local resection with long term success. The occurrence of the adenocarcinoma appeared to be closely related to aging, and to clinical evidence of chronic inflammation. Conclusions Patients in whom the colon has been surgically transposed to different anatomic positions, away from the fecal stream, can develop a secondary colonic adenocarcinoma with. Aging and chronic inflammation seem to be risk factors for a secondary adenocarcinoma more than time from implant. Screening for polyps and adenocarcinomas in these patients should be considered.