Results of a thirty-year study of familial adenomatous polyposis coli.

Abstract

This study was designed to estimate the efficiency of the various methods used to treat familial adenomatous polyposis coli. Three hundred ninety patients (219 males) underwent surgery for familial adenomatous polyposis coli; postoperative follow-up was from 1 to 30 years. Coloproctectomy with preservation of the anal sphincter and coloproctectomy with ileoanal pull-through procedures resulted in development of anal canal cancer in 3 (4.1 percent) of 74 patients. Follow-up revealed development of cancer in the large bowel in 26 (10.7 percent) of 242 patients, in whom colectomy with preservation of various colonic segments was performed. The occurrence rate of cancer is not significantly related to patients' gender, age, length of preserved colonic segment, presence of cancer in the removed colonic segment, or postoperative follow-up period; however, presence of polyps in the colonic segments preserved during surgery significantly increased the risk of development of cancer at a later time.