Familial adenomatous polyposis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Surgery

• Treatment for FAP depends on the genotype. Most individuals with the APC mutation will develop colon cancer by the age of 40.
• Therefore, prophylatic surgery is generally recommended before the age of 25.
• There are several surgical options that involve the removal of either the colon or both the colon and rectum.
• The decision to remove the rectum depends on the number of polyps in the rectum as well as the family history.
• If the rectum has few polyps, the colon is removed and the small bowel (ileum) is connected to the rectum (ileorectal anastomosis).
• If the rectum is involved then the colon and rectum are removed and a patient may require an ileostomy (permanent stoma where stool goes into a bag on the abdomen) or have an ileoanal pouch reconstruction.