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October 1956

Preservation of Rectum in Familial Polyposis of the Colon and Rectum

Author Affiliations

St. Louis
From the Department of Surgery, Washington University School of Medicine, Barnes and St. Louis Children's Hospital; Clinical Fellow, American Cancer Society (Dr. Coleman).

AMA Arch Surg. 1956;73(4):635-644. doi:10.1001/archsurg.1956.01280040091011

The operative procedure to be used for familial polyposis of the colon should be selected mainly on the bases of the extent of involvement of the mucous membrane at the time treatment is instituted, the apparent rate of progression of the disease, and the presence or absence of cancer. Familial polyposis is usually progressive. New polyps form, and in any one of them cancer may evolve. The ordinarily progressive nature of the disease has dictated the belief that total colectomy with proctectomy is the only means of freeing the patient from the risk of cancer. The surgical management of polyposis of the colon up to 1948 was thoroughly reviewed by Hoxworth and Slaughter1 and will not be repeated. Ravitch * showed that satisfactory bowel function followed anastomosis between the terminal ileum and the anus, thereby permitting total coloproctectomy to be accomplished without abdominal ileostomy. Best4 has used this operation