Familial adenomatous polyposis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Mohamad Alkateb, MBBCh [3]

Surgery is the mainstay of treatment for familial adenomatous polyposis (FAP). The preferred surgery technique is laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy. Another technique is total colectomy with ileorectal anastomosis.

Surgery is recommended in patients with FAP who present with:^[1][2]

• Diffuse polyposis
• High-grade dysplasia on colonoscopy
• Invasive adenocarcinoma on colonoscopy

Surgery is the mainstay of treatment for familial adenomatous polyposis.

• The preferred surgical technique for FAP is:
  • Laparoscopic total proctocolectomy with ileal pouch anal anastomosis (IPAA) and mucosectomy which has:^[1]
    • Good patient satisfaction
    • Excellent functional outcome
    • Few postoperative complications
    • No colorectal occurrence or recurrence

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• Other surgical techniques include:
  • Total colectomy with ileorectal anastomosis

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