Subtotal Colectomy for Familial Polyposis: A Clinical Series and Review of the Literature

Michael A. Skinner, Douglas Tyler, Gene D. Branum, Giovanni Cucchiaro, Mary Ann Branum, William C. Meyers

Research output: Contribution to journalArticle

Abstract

Familial polyposis is an inherited syndrome in which untreated persons have virtually a 100% incidence of developing colon cancer. Much controversy exists over whether subtotal colectomy with ileoproctostomy is the appropriate procedure in these patients owing to the risk of subsequent cancer in the retained portion of the rectum. At Duke University Medical Center, Durham, NC, a group of 25 patients chose to undergo the subtotal colectomy and ileoproctostomy instead of the definitive total proctocolectomy. Of the 25 patients in this series, invasive adenocarcinoma has developed in the rectal segment in only 1 patient. This patient, the oldest in our series, had carcinoma in situ in her initial operative specimen and has done well following an abdominal perineal resection and 13 years of follow-up. Six other patients have subsequently undergone definitive resections of the rectum because of intractable benign polyps. These results compare favorably with those reported in the literature. We conclude that subtotal colectomy with ileoproctostomy is still a useful and successful mode of treatment for select patients with familial polyposis if they are followed up frequently and aggressively and if the surgeon maintains a low threshold for recommending completion proctectomy.

Original languageEnglish (US)
Pages (from-to)621-624
Number of pages4
JournalArchives of Surgery
Volume125
Issue number5
DOIs
StatePublished - Jan 1 1990
Externally publishedYes

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Colectomy
Rectum
Carcinoma in Situ
Polyps
Colonic Neoplasms
Adenocarcinoma
Incidence
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Subtotal Colectomy for Familial Polyposis : A Clinical Series and Review of the Literature. / Skinner, Michael A.; Tyler, Douglas; Branum, Gene D.; Cucchiaro, Giovanni; Branum, Mary Ann; Meyers, William C.

In: Archives of Surgery, Vol. 125, No. 5, 01.01.1990, p. 621-624.

Research output: Contribution to journalArticle

Skinner, Michael A. ; Tyler, Douglas ; Branum, Gene D. ; Cucchiaro, Giovanni ; Branum, Mary Ann ; Meyers, William C. / Subtotal Colectomy for Familial Polyposis : A Clinical Series and Review of the Literature. In: Archives of Surgery. 1990 ; Vol. 125, No. 5. pp. 621-624.
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