Table 1 Indications and advantages of colectomy options in patients with FAP
From: In the Beginning There Was Colectomy: Current Surgical Options in Familial Adenomatous Polyposis
Total colectomy + ileorectal anastomosis | Restorative panproctocolectomy | |
|---|---|---|
Indications | • Rectal sparing | • Rectal cancer |
• Sparse polyposis | • Multiple rectal polyps | |
• Compliant with follow-up | • Widespread colorectal polyps | |
• Non-compliant with follow-up | ||
Advantages | • Less operative morbidity | • ⇓ Rectal cancer risk |
• Larger reservoir function | • Less frequent surveillance | |
Disadvantages | • ⇑ Rectal cancer risk | • Longer procedure |
• Rectal surveillance every 6 months | • Greater complication rate | |
• IPAA or ileostomy may be required at a later date | • Likely two-stage procedure | |
• Poorer functional outcome |