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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